Pulmonary doctor Çelik in an interview: "We had to expand our ward again"

Doctor Çelik, you are senior physician in the isolation ward for Covid-19 patients at the Darmstadt Clinic;

we talk regularly about the state of affairs.

How is the situation right now?

Julia Anton

Editor in the “Society & Style” department.

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I would like to start with the good news: we continue to have a low occupancy rate in the ICU with Covid cases.

We also have to transfer fewer patients to the intensive care unit, despite an increasing number of symptomatic and oxygen-dependent patients in our Covid normal ward area.

Case mortality is also far from the first waves.

This has mainly to do with the increasing immunization in the population and especially the high vaccination rate among the over 60-year-olds.

Does that mean there is also bad news?

For about five weeks, i.e. with the emergence of the BA.5 variant and the subsequent increase in the number of cases, more patients with a severely symptomatic, complicated course have been coming to us again.

We therefore had to expand the normal Covid ward, which we had reduced to one ward in our last conversation two months ago - even though we now only have patients who have respiratory symptoms or need oxygen.

The patients with Covid as an additional finding are now isolated in the appropriate wards of the treating departments.

Otherwise we could even fully occupy a third station.

What kind of patients are you with?

On average, the patients are 75 years old, they often have previous immunosuppressive diseases, so they clearly belong to a risk group.

They often get the severe course as a result of a complication directly related to the Covid disease: such as a pulmonary embolism or a bacterial superinfection immediately after the viral infection.

These older patients are usually vaccinated two or three times.

It is not surprising that these high-risk patients end up with us despite being vaccinated.

The classic Covid pneumonia, which we observed frequently in the first three waves, we only rarely see in our vaccinated patients, even in old age.

Antibiotics are now being used more frequently to treat superinfections.

In addition, we take in a disproportionately large number of unvaccinated patients compared to the general population.

This shows in everyday clinical practice that severe courses are more likely in them, even if the unvaccinated patients are in the minority on the ward.

an always has to look at this in relation to the proportion of the population, with the elderly there are only just under nine percent unvaccinated.

In our ward, about 25 to 30 percent had not been vaccinated in the last few weeks and the patients were on average 20 years younger.

among the elderly it is only just under nine percent unvaccinated.

In our ward, about 25 to 30 percent had not been vaccinated in the last few weeks and the patients were on average 20 years younger.

among the elderly it is only just under nine percent unvaccinated.

In our ward, about 25 to 30 percent had not been vaccinated in the last few weeks and the patients were on average 20 years younger.

Why is it that the number of severely symptomatic patients is increasing again?

That's not entirely clear yet.

There are indications that the BA.5 variant makes you sicker than BA.2, i.e. it is more virulent.

But the RKI does not yet see sufficient evidence of this in its surveys, but rather the problem in the high number of infected people.

In addition, the BA.5 variant escapes the immune system better.

Older people in particular, who react to the vaccinations with a less strong immune response, are more frequently infected by the BA.5 variant.

This leads to more hospital stays.

Anecdotally, however, I can report from our ward that although we had to treat more patients of a similar age a few weeks ago, even during the high incidences of the BA.2 variant, these patients were significantly less dependent on oxygen.

That would be an indication for me that BA.

5 is clinically more severe.

It would of course also be conceivable that the number of unreported cases is currently much higher than for BA.2, in which case this impression would be deceptive.