Coronavirus in Europe: Overworked hospitals become death traps
28 March 2020
The coronavirus pandemic has so far claimed over 23,000 lives worldwide as of this writing. According to data from Johns Hopkins University, the number of confirmed cases in Germany is now almost 44,000, exceeding the number of cases in South Korea (9,240) and Iran (29,400), and rapidly approaching the levels in Spain (over 56,000), the United States (almost 76,500) and Italy (almost 81,000), where the highly infectious virus has already killed more than 8,200 people and continues to rage despite a general curfew.
While the army in the north of Italy is still transporting coffins away because they can no longer be buried by the completely overburdened crematoria, in the last 24 hours over 700 people have again fallen victim to the virus.
The criminal inactivity of European governments in recent days has led to a murderous and vicious circle of overwork, infection and work absences in hospitals throughout the continent. The first threatening signs of this were announced by Italian research institutes on Tuesday. According to these reports, 5,760 of the cases of infection in Italy have been among health care workers.
A report in the New York Times gives an insight into the catastrophic conditions already prevailing in European hospitals. In the province of Brescia, the centre of the outbreak in Italy, 10 to 15 percent of doctors and nurses have been infected and incapacitated, according to a doctor from the region. But the problem is widespread throughout Europe. In Italy, France and Spain, more than 30 doctors and nurses have died of the coronavirus, and thousands of others have had to isolate themselves, according to the Times.
In France, 490 health workers have been isolated due to infection with the virus. In Spain, where the number of cases doubles every four days, the authorities say that as many as 5,400 doctors are infected, almost 14 percent of all those who are ill.
In the countryside, the Times says, some Spanish communities have had to send up to 30 percent of their nurses home for health reasons over the past week. In the capital, Madrid, the mass deaths have led to the temporary storage of corpses in the Olympic skating stadium before they can be buried.
In all three countries, the ranks of doctors and nurses are thinning, the newspaper concludes. At the same time, the percentage of infected people who are currently showing no symptoms remains unclear. As they are not sufficiently protected in their daily life-saving missions, and there is a lack of protective equipment at all corners and ends, “infected [health care] workers and their clinics are increasingly becoming active disease carriers.”
A spokesman for the Spanish nurses’ union SATSE told the Times that even when it was already known the virus was circulating in hospitals, they were told to limit the use of protective equipment to certain circumstances. The absence of their colleagues, in turn, has increased the pressure on the remaining hospital staff, who are already under extreme stress. Hospitals in Spain are already among the worst sources of infection in the country.
The assessments of leading epidemiologists and doctors leave no doubt that the catastrophe that has shaken Italy, Spain and France could become a bitter reality in Germany in the coming weeks if the appropriate measures are not introduced.
Last Friday, Lothar Wieler, head of the Robert Koch Institute, a public health institute in Germany, warned the press that the pandemic was of a “magnitude I could never have imagined myself.” Since then, the number of infections in Germany has almost doubled and the death toll has quadrupled to 239. Moreover, serious epidemiologists estimate that the number of unreported cases could be 10 times the official figures.
“Anyone who still thinks that the German health care system can easily cope with a situation like the one in Italy has not understood anything,” newsweekly Der Spiegel quotes Gerald Gass, President of the German Hospital Federation. Doctors and hospital directors warned the news magazine of an “impending catastrophe” and the “massive effects” of the pandemic.
Der Spiegel itself speaks of a “state of emergency” and an “imminent shortage of ventilators.” Countless hospitals and nursing staff are already at the absolute limit of their capacity. At least 17,000 nursing positions are presently unoccupied.
“Patients are simply pushed directly into the intensive care unit without anyone looking to see if they might be contagious,” one nurse told Spiegel. “By the time a diagnosis is made, we have all had contact with them—and without protective clothing.” The whole station then subsequently becomes contaminated.
“Consideration that a doctor or nurse has already been infected and could thus have become a risk for patients and colleagues is no longer taken into account in some places,” Der Spiegel ’s cover story continues. “A loss of staff cannot be compensated for, despite all efforts to recruit students and retired doctors for the crisis.”
The infection rate among medical staff is rising rapidly throughout Germany, like the situation in France, Spain and Italy. At the same time, protective clothing and disinfectants are becoming scarce in more and more German hospitals, so that some clinics have had to provisionally purchase alcohol from industrial painters and meat producers, reports Der Spiegel. The senior physician of a private clinic from Bavaria openly expressed the inhuman situation that nursing staff face under these conditions: “Everyone works until they have symptoms. Otherwise it can no longer be managed.”
Moreover, the pressure to maintain profits ensures that many clinics are dependent “on income from knee prostheses, hip operations or heart catheter examinations.” These lucrative procedures are still being performed, although experts “often consider them unnecessary.”
An open letter from nursing staff to the Federal Ministry of Health, signed by 300,000 people on the Internet within a few days, quotes from a communication of the Baden-Württemberg Hospital Association, which was apparently coordinated with the state ministries: “Efforts are being made to obtain protective material, but [...] one does not know when it will be available. If none can be organised, we should simply continue working without protection.”
In the meantime, reports are piling up in the media of sick people who find themselves in front of closed medical practices in search of COVID-19 tests and are then forced to wait in the cold for hours and fill out countless documents before being granted access to a container clinic.
Wherever infection rates are rising rapidly, Europe lacks the basic necessities to effectively counter the pandemic. For example, nurses in the Grand Est region of France are forced to wrap their shoes in plastic bags and tape because medically sealed boots are nowhere to be found.
Dr. Klaus Reinhardt, President of the German Medical Association, recently sent a confidential letter to Federal Health Minister Jens Spahn, listing some of the most important shortcomings. On Wednesday, he told former Handelsblatt publisher Gabor Steingart, “For weeks now, colleagues working in outpatient departments and their staff have been working without adequate protection. The nursing staff visit elderly people to be cared for mainly at home and thus move unprotected among the group of patients most at risk of death. General practitioners, who in their practice have daily contact with possibly infected patients without protective masks, must nevertheless guarantee the normal care of numerous nursing home patients. The case of a chain infection in a nursing home in Würzburg with nine deaths is a warning example.”
Jean-Paul Hamon, chairman of the largest French doctors’ association, also expressed “particular concern” to French television about the lack of protection for geriatric nurses and office-based doctors. The latter made up most of the physicians in France who have died of coronavirus.
In German hospitals, according to Reinhardt, the “normal” care of people with life-threatening illnesses is beginning to collapse because “strokes, heart attacks, cerebral haemorrhages and intestinal obstructions continue to occur unchanged.” Meanwhile, Reinhardt continues, general practitioners have “no protective material left” and it is “also not buyable, by anyone, because it has simply disappeared from the market.”
The 20 masks per day and per practice promised by the government would “not help” in this situation, and the masks actually available were “in no way sufficient.” As reported by Der Spiegel, in some cases clinics currently have to pay 25 times the normal price for respiratory masks.
The immediate cause of the acute shortage of respirators is that a shipment of 6 million respirators, which should have arrived in Germany on March 20, had surprisingly “disappeared without a trace.” The Federal Office for Armed Forces Equipment is responsible for the “central procurement” of coronavirus relief supplies. As reported by Der Spiegel, citing an internal report of the military department, the urgently needed masks “disappeared” under the eyes of the army authority in Kenya. The background to the incident is currently still unclear.
Meanwhile, Attilio Fontana, president of the Italian region of Lombardy, told the news magazine that they would “soon not be able to offer the sick any more treatment” because there were not enough respirators.
“There is a lack of protective equipment everywhere, improvisation is widespread,” doctor Antonio Antela told the Times from his sickbed at the university hospital in Santiago de Compostela, Spain. The doctor had been admitted to intensive care with pneumonia and a positive coronavirus test. Hamon, who is also infected, concludes, “The state is completely unprepared. It owes us an explanation.”
The real explanation is that behind the apparent “chaos” and the omnipresent scarcity, there is a class policy that has been consciously pursued in Germany, Italy, France, Spain and countless other countries by successive governments since the dissolution of the Soviet Union. In Germany alone, between 1990 and 2010, approximately 180,000 hospital beds (26 percent) were cut, 360 hospitals (15 percent) were closed, and the number of hospital beds for acute inpatient care was drastically reduced.
“This pandemic has been rolling towards us foreseeably for weeks,” notes the open letter from the nurses to the Ministry of Health. The letter, which also demands significant wage increases, explains: “We expect from you in concrete terms ... an immediate organisation of the procurement of effective protective materials, including all possibilities. In case of emergency, also by nationalising manufacturers and their suppliers to protect us nurses.”
The International Committee of the Fourth International (ICFI) advocates uniting workers across Europe and beyond in the struggle against the virus and the criminal indifference of governments. The effects of the global pandemic are, in the eyes of millions of people, proof of the unscrupulousness and moral, economic and political bankruptcy of the ruling class.
The working class must counter this policy with its own programme. A statement by the ICFI published on February 28 explains that the fight against the pandemic requires globally coordinated emergency measures and the immediate provision of trillions of dollars and euros. These demands are part of an international socialist perspective and must be implemented against the resistance of all bourgeois parties and trade unions. We call on all those who agree with these demands to contact us today.