‘We’re Not Prepared at All’

He says the fight against the new pathogen is akin to a naval battle: “The big hospitals are our aircraft carriers in this new fight. They have the greatest strategic importance and need to be protected and shielded by health authorities and the practicing physicians.”

The same thing could theoretically also happen in Germany if the number of infected people increases. The first points of contact for most patients wouldn’t be hospitals, which are only supposed to handle serious cases, but — after a brief phone consultation — general practitioners. The doctors, wearing breathing masks and protective clothing, would then take samples for a virus test and, depending on the severity of the symptoms, either send the patients to the hospital or into quarantine at home. This is what DEGAM, for instance, recommends.

Yet many general practitioners feel left in the lurch by health authorities and politicians. “And Health Minister Jens Spahn seriously believes that Germany is well prepared for a pandemic,” says one cardiologist in Berlin. Apart from the online information, public health authorities haven’t sent any memos or letters to registered doctors. “We are completely in the dark.”

Medical health professionals are particularly concerned about the lack of FFP-3 fine-particle masks and protective suits. “In my opinion, the preparations are anything but optimal,” says Frank Unger, a general practitioner in Berlin’s Marzahn district. “I think that every practice should get a care package with 20 to 100 protective masks and protective suits,” he says. “But that hasn’t happened. Not even close. If we hadn’t been proactive ourselves, we wouldn’t have anything.”

Seizures and Export Bans

In fact, masks and protective suits, which are largely made in China, are all but impossible to get in Germany at the moment.

Ming Gutsche, who was born in China, sells protective clothing and respirator masks via her company in Rastatt, in southern Germany, and says her 21 employees can barely cope with all the orders. At the end of January, she even had a few shady men pull up into her company parking lot in small vans, asking if they could buy her entire inventory. Gutsche threatened to call the police, saying she didn’t want any “crisis buyers.”

She’s now distributing everything she has to her regular customers, which include hospitals, fire departments and pharmaceutical companies, via a quota system. But her stockpiles are shrinking.

The German Health Ministry is aware of the supply bottleneck. The few factories in Europe that manufacture protective masks and suits, the ministry noted in the minutes of a video conference with industry representatives, “couldn’t possibly compensate” for the disruption in supply from China.

One long-standing supplier of Gutsche’s is in Wuhan and churns out wares from 7 a.m. until 10 p.m. “But since the New Year’s celebrations there, the factories are no longer allowed to send us anything,” she says. “All of the product has been confiscated.”

Even countries like Taiwan and South Korea have imposed export bans on protective clothing, according to the minutes from the Health Ministry. And products that are still available are only getting more expensive. A spokesperson for the German Hospital Federation says packs of 50 simple protective masks, which once went for a mere 3.95 euros ($4.36) are now being sold on Amazon for 150 euros.

Michael Koch still has a couple of breathing masks lying around in his basement at home. He works as a product manager at Medika Medizintechnik, a wholesaler for medical products. But his inventory, too, he says, will soon dry up. “Ninety percent of all articles such as masks, protective clothing, swabs or bandages come from China. Many of them even come directly from Hubei Province,” the epicenter of the outbreak.

Such a shortage of supplies could pose a dangerous problem. Without adequate protective clothing, doctors and nursing staff will become infected with the coronavirus. Who would then take care of the patients, in hospitals that are already suffering from personnel shortages?

The issue is a top priority within the German government’s crisis management team. “We are currently doing everything we can to take another look at what we have in stock in Germany,” Spahn says. “And above all to legally ensure that nothing leaves the country, either by seizing it or banning its export.”

Stretched Thin

If new coronavirus infections are limited to certain regions, hospitals could move staff between states. But: “If we have to treat several hundred thousand additional patients nationwide, there isn’t a health care system in the world that wouldn’t have a problem with that,” says Susanne Johna, the head of the Marburger Bund, a doctor’s union, and the German Medical Association’s pandemic commissioner. “We managed to stem the large flu epidemic two years ago with the same number of staff we have now,” says Johna, who works as an internist at St. Joseph’s Hospital Rheingau near Frankfurt. She argues, however, that the health care system has reached its limits.

Many people could also become infected in waiting rooms as they sit near oblivious carriers of the Sars-CoV-2 virus. That’s why Andreas von Thüna, an internal medicine practitioner from the western German town of Brühl, prefers to make house calls in case of suspected infections. Many experts believe this is the right way forward. But this has yet to be systematically organized in Germany.

Great Britain, on the other hand, has been conducting a pilot project since the end of January in which people suspected of being infected are tested at home. Doctors in one London hospital came up with the idea after noticing ambulances had to be decontaminated for hours after transporting people suspected of having the virus.

Now those who test for the virus go to people’s homes. Their protective clothing is discarded after each visit. In Wales, almost 95 percent of all people suspected of having the virus have now been offered home testing.

In the Global Health Security Index, the United Kingdom ranks first in Europe and second worldwide. The British Department of Health has long since reacted to the coronavirus outbreak and has put detailed instructions for general practitioners, laboratories and medical staff online.

In Germany, meanwhile, public health authorities are suffering from a lack of personnel. “In Cologne, we’re well equipped,” says Niessen, the head of the Cologne health authority. “But in many places, an experienced doctor earns on average 1,500 euros less a month than in a hospital.”

Even in times of non-crisis, state health services are already hitting their limits, says Ute Teichert, chairwoman of the Federal Association of Physicians of Public Health Departments.

It’s little consolation that even the U.S., which ranks first in the Global Health Security Index, is having trouble dealing with the crisis. The country is having trouble with its virus test.

Jennifer Nuzzo, an epidemiologist at the Center for Health Security at Johns Hopkins University in Baltimore and one of the authors of the Global Health Security Index, is a hard woman to reach these days. When she finally found time to talk to DER SPIEGEL on Wednesday, she wanted to first get one thing straight: “In our view, no country on earth is fully prepared for this epidemic.”

By Jörg Blech, Kristina Gnirke, Hubert Gude, Veronika Hackenbroch, Nils Klawitter, Martin U. Müller, Christian Parth, Cornelia Schmergal, Christoph Schult, Samiha Shafy, Julia Smirnova, Frank Thadeusz and Bernhard Zand

Icon: Der Spiegel

Article source: https://www.spiegel.de/international/germany/we-re-not-prepared-at-all-a-d91de996-0705-437d-8706-5682e8c0cbee#ref=rss