
Map of usage of intensive care beds in Germany - epaga
https://interaktiv.morgenpost.de/corona-deutschland-intensiv-betten-monitor-krankenhaus-auslastung/
======
pacificmint
Translation of the German captions:

The number of hospitals that report that their ICU capacities as:

Blue: Has Free Capacities (639 currently)

Yellow: Some Contention (326 currently)

Red: Fully Utilized (41 currently)

Covid 19 patients in ICUs: 2453 (76% of which are on ventilators)

ICU beds reported by hospitals: 19,663 (58% in use currently)

~~~
DoreenMichele
Thank you.

The translation I saw described yellow as something like "emerging
bottlenecks." There seem to be a lot of them in Bavaria, where I have
relatives.

~~~
Cass
My Bavarian hospital is on there as yellow. I'm currently sitting in the empty
urgent care clinic and just had a chat with the nurse from the almost empty
emergency room about the fact that both the COVID-19 ward and the ICU are far
from capacity. Not really sure why we're yellow, to be honest.

~~~
neuronic
Whatever is reported to government agencies ends up in these graphs
(Gesundheitsbehörde).

------
evaneykelen
Germany has also accepted patients from Italy, France, and The Netherlands.
For the latter the university hospital in Münster is coordinating the
distribution of Dutch patients who require ICU care across Germany. Great to
see neighboring/close by countries cooperate in this way.

~~~
bsaul
Do you have more infos on that ?? I live in france and the general message we
keep hearing is that every nation is dealing with the crisis alone and that
the european union project may die because of that.

~~~
quonn
Alone? Like with the 500 billion euro EU emergency fund that was agreed
yesterday?

~~~
sakisv
These 500bn are loans from the ESM. The part of that will go to support public
healthcare will be without conditions, but the rest that will go to support
the other parts of the economies will be given on conditions of austerity.

This agreement comes on the heels of the rejection of what 9 Eurozone
countries including France had asked initially: A Eurobond, or coronabond as
it made some headlines. That would have allowed the EU as an entity to borrow
money instead of individual counties, but the governments of Germany and
Netherlands seems that were against it.

~~~
notechback
Actually coronabonds would not allow the EU to borrow. It would allow
individual countries to borrow with the guarantee given by all countries
jointly. Those against it were mainly Netherlands, Austria and Finland, but
Germany was not exactly a fan either.

See it this way: everyone knows Italian debt at 140% of GDP is unsustainable.
Successive governments have promised again and again to do something about it,
but then each finds a reason not to follow this promise. The Italian state is
leaking money in all corners with many politically friendly businesses making
huge gains at the cost of taxpayers. The default is mostly inevitable if there
is not finally a serious attempt to address this issue.

Successive Italian governments have asked for mutualised debt - while
increasing the national deficit and debt further each year. It would be crazy
for any other government to give Italy a blank check and say "okay take
whatever loans you need, wecll guarantee it". It means you are consciously
taking up the risk of default for yourself while having no way to stop
overspending or fix the underlying systemic issues. This means Italian
governments have even less incentive to change the horribly corrupt and broken
system.

That other countries say no is not a decision against the Italian citizens. It
would be irresponsible towards their own citizens to take this up without some
kind of real guarantee that Italy will finally fix the systemic issues,
because the past 20 years of promises have been broken.

~~~
yayr
I consent this argument. Unfortunately there are parts of human nature that
imo require checks and balances also with help in these circumstances. Any
help money that goes to an actually unneedy person or business or is spent in
unresponsible ways takes unnecessarily from others, either now or in the
future. It‘s a fine line that shifts depending on the trust the acting parties
have in each other. However, these bad actors are everywhere, even in Germany
are apparently cases like public servants sent home with full pay claiming
help money or people making up fake lost businesses. So also there checks are
increasing

------
jamessb
There is a more detailed interactive map of critical care bed capacity created
by researchers at Konstantz University.

Visualization:
[https://coronavis.dbvis.de/en/](https://coronavis.dbvis.de/en/)

Press release (English): [https://www.campus.uni-
konstanz.de/en/science/university-of-...](https://www.campus.uni-
konstanz.de/en/science/university-of-konstanz-develops-visualization-tool-for-
illustration-of-critical-care-bed-capacities-all-over-germany)

------
est31
Germany is pretty well equipped with ICU beds and they've increased the
capacity even further in preparation for Corona. I'm not worried about Germany
really. I'm more worried about other parts of Europe like eastern europe. A
Czech friend told me they have barely any respirators in the country.

~~~
DoreenMichele
If it's any comfort, the death rate is so high with ventilators (80%+, which
is bad even for ventilators) that some doctors are trying to avoid using them,
if possible, because they are concerned the ventilators are actually killing
people.

[https://news.ycombinator.com/item?id=22819580](https://news.ycombinator.com/item?id=22819580)

I previously suggested that ventilators were problematic and I wasn't happy
with the rush to create more of them instead of promoting less invasive
treatments. I'm glad some doctors are looking for alternatives, but we really
need to be a lot more aggressive about that angle.

~~~
est31
Interesting points, thank you. I previously mostly had the death rate for
"ordinary" ICU admissions in mind, which were 50%. Didn't know that once you
are you are connected a ventilator, you have a 80% death rate.

To compare the effect of ventilators vs none, one needs good studies with
randomized groups where one gets ventilators and the other doesn't. But I
guess those aren't available and doing them is probably not possible due to
moral issues.

I wonder if there are statistics that are the next best thing, death rate of
people who doctors would have wanted to connect to ventilators but there were
none available. You shouldn't compare it to the death rate of people with
ventilators in places where there is ventilator shortage because then
obviously there is some element of choice in who gets the ventilator and who
doesn't, e.g. they choose the patients with the worst symptoms, or the
patients with the largest chances of survival. Most places probably have/had
shortages, so the data we have are all pretty bad to judge whether ventilators
help, and if yes how much.

~~~
DoreenMichele
I have a really serious lung condition. I used to use mechanical intervention
to treat my condition. I have found other methods and no longer do that, in
part because such interventions are hard to keep adequately sterile and are
known to increase risk of antibiotic resistant infections because of that
element.

It's really not good to think of this problem space in terms of finding some
group without ventilators at all. I get your point about the data, but the
problem is that lungs are a critical system. If you have lung issues, you are
a priority admit at an ER because that whole not breathing thing can kill
within minutes. Inability to breathe is one of the quicker ways to die.

What I was previously suggesting was non invasive airway clearance methods and
management techniques like being mindful of better positions to sleep in
(which is apparently at least part of what some doctors are now doing
according to the article I linked above). I got hounded and attacked as
"practicing medicine without a license" for talking about my first-hand
experience with managing my very deadly condition using such techniques.

You really can't just not treat patients experiencing lung distress and hope
they live. That's a good way to kill people.

But I have looked at a little info on ARDS (the process that actually kills
people with Coronavirus) and how ventilators work and I'm quite horrified that
the world rushed to create more ventilators rather than rushing to say "We
must do everything possible to intervene effectively without ventilators.
Ventilators must be an absolute last ditch effort after every other possible
intervention has been exhausted."

They aren't doing that. They are too quick to put people on ventilators and
the fact that doctors are now coming up with non invasive alternatives tells
you they haven't been sufficiently aggressive in exhausting all other
treatment modalities first.

I have substantial first-hand experience with staying alive in the face of
having routine lung distress that could kill me. I knew from the outset that
they were putting people on ventilators too quickly, that ventilators are
quite dangerous in their own right and that there are, in fact, other options
available.

I'm quite frustrated by the whole thing. This absolutely never needed to be
this ugly. I'm certainly not the only person on the planet who knew ahead of
time that ventilators are problematic and that there are myriad other options
available that can be tried first, especially before it gets that severe in
hopes of not letting it get to that point.

~~~
hutzlibu
How is you experience with oxygen? I can imagine it helps without stress to
the lungs, which lung ventilators might introduce?

~~~
DoreenMichele
I've never been put on oxygen.

A downside of oxygen is that it's very flammable. Also, to whatever degree it
involves a cannula, masks, etc, it has some of the same issues in terms of
sterility challenges.

I've generally relied on things like airway clearance and dietary intervention
in recent years.

~~~
m0zg
> it's very flammable

Nit: oxygen is not flammable. Other things are flammable in its presence. A
lump of coal, for example, burns white hot when oxygen is blown on it from a
welding torch.

~~~
DoreenMichele
Touche.

Still, it's a fire hazard.

------
a_bonobo
This may make more sense if it's normalised by the size of each hospital?
Small hospitals are immediately at limit and make a red dot for obvious
reasons.

For example, there's a red circle next to Bremen, Alle-Weser-Klinik Verden,
they have 131 beds [1]. Verden has about 27k inhabitants. There's a large blue
circle in Baden-Wuerttenberg, Klinikum am Gesundbrunnen, they have 970 beds
[2]. It's in Heilbronn which has 120k inhabitants.

So in a way, this is a population density map
[https://xkcd.com/1138/](https://xkcd.com/1138/)

[1] [https://de.wikipedia.org/wiki/Aller-Weser-
Klinik](https://de.wikipedia.org/wiki/Aller-Weser-Klinik)

[2] [https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-
slk-k...](https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-kliniken-
in-zahlen/)

------
tullatulla
Looks like the peak ICU occupation in Germany has clearly passed:

11/04: 2088, 76% on ventilators 10/04(?): 2453, 76% -"-

04/04: 2680, 83% -"\- 03/04: 2421, 83% -"\- 02/04: 2139, 83% -"\- 01/04: 1876,
82% -"-

Can't find data for in between 04/04 and 10/04, since DIVI stopped publishing
daily reports apparently, but must have peaked in between.

[https://www.intensivregister.de/#/intensivregister](https://www.intensivregister.de/#/intensivregister)
[https://www.divi.de/images/Dokumente/DIVI-
IntensivRegister_T...](https://www.divi.de/images/Dokumente/DIVI-
IntensivRegister_Tagesreport_2020_04_04.pdf)

------
k__
People from other countries are always hating "just wait, we laughed too, but
then things got worse!"

But I have the feeling, in Germany we are doing pretty good for ourselves.

I don't think this will be over soon, but when I look at our numbers, I just
can't see it getting much worse, let alone as bad as our neighbors or the US
has it...

~~~
zwaps
Death rates will rise and things will get worse, but if we are lucky not
dramatically so.

In contrast to literally every other large European country, we did a lot of
testing (compare for example CDR for France against Germany, we did ten times
more tests especially early on). If you run the numbers on tests vs.
infections, assuming that death rates are more accurate, you have to conclude
that Italy, Spain and France likely have a magnitude more cases than tests
would suggest.

Initial infections were mostly young people at the carnival events. This helps
with the death rate.

Furthermore, Germany is more decentralized than any other country in the EU,
and has "decent" capabilities spread.

We had a good start. Call it luck. However, it'll get worse, especially since
people are itching for it to be over.

Here in Germany, we have the "weekend reporting" lull, where cases go down.
Each time, people in big cities somehow take this as "peak reached" and go
out. All actions have a two-week lag, so we don't really know anything about
what works and what doesn't. Yet.

We NEED to be vigilant now, and you need to urge everyone you know to keep
distancing and quarantining. Do your part. Yes, it's 27C and sunny outside,
but we are not over the bump yet.

IF we keep going like this, we may be able to get over this crisis without
ever having a health care catastrophe like France, Spain and Italy. But if we
let our guard down too early, then we can get in trouble.

Yes, we were lucky with initial cases and our testing capability. But if we
get to infection rates like other countries (10x more than current numbers
suggest, at least), then our hospital system will also collapse.

It's best to ignore daily infection numbers, especially here where few cases
are sent to RKI over week-ends and holidays. Let's celebrate when the death
rate goes toward zero.

~~~
k__
Sure, the rate changes didn't drop constanly every day, but overall there is a
downwards trend.

~~~
zwaps
If you look at the case rates on the RKI tracker / GIS app, you can see that
there is a weekly cycle.
[https://experience.arcgis.com/experience/478220a4c454480e823...](https://experience.arcgis.com/experience/478220a4c454480e823b17327b2bf1d4/page/page_0/)

The peak of the last weekly cycle was April 2nd, and was the highest peak yet.

The current cycle is still in progress. Cases get added to previous days of
the week retroactively. For example, there were days when it looked like case
would go down, and then the next day several thousand cases were added to
prior days and we went back to the weekly cycle.

We need to wait until next week to make any judgement about what is going on
right now.

Up until now, there seems to be a linear increase if we ignore the cyclic
component. At least for two weeks, people have been fantasizing about a
decline that did not occur.

I agree that it looks like as if we'll have less cases this week. However,
since it's holiday, this may be deceptive. We will not know for certain until
next week, perhaps week after next week.

It's too early to celebrate. Obviously I share the hope.

------
perlgeek
This is very cool, though not quite complete.

[https://www.klinikum-fuerth.de/](https://www.klinikum-fuerth.de/) is missing
from the map, which is the biggest hospital in Fürth, Bavaria.

Also interesting: some hospital report some contention, but no COVID-19 cases.

------
polycaster
According to the district office there are 778 cases in the district of
Ortenau right now [1]. Curiously the map colors indicate shortages in several
places but checking the individual clinics yield 0 cases.

[1] [https://www.ortenaukreis.de/Politik-
Verwaltung/Verwaltung/Si...](https://www.ortenaukreis.de/Politik-
Verwaltung/Verwaltung/Sicherheit-Ordnung-
Gesundheit/Gesundheitsamt/Corona/778-best%C3%A4tigte-Covid-19-F%C3%A4lle-im-
Ortenaukreis.php)

~~~
polycaster
... I am aware cases != clinic beds. But 0 clinical cases at 778 total cases
is unlikely (right?).

~~~
yorwba
There's a single patient with COVID-19 in MediClin Herzzentrum Lahr/Baden.
Some of the other 777 will probably end up hospitalized over the next week.

------
riedel
Probably from the same data source(DIVI Intensivregister/RKI):
[https://diviexchange.z6.web.core.windows.net/report.html](https://diviexchange.z6.web.core.windows.net/report.html)

~~~
riedel
It includes Fürth, so I guess it is a scraping problem. Maybe all cities with
umlauts are missing :)

------
themark
Why can’t we see data like this here?

~~~
techolic
New Jersey has started to publish this yesterday, see 'Hospital Census'

[https://covid19.nj.gov/#live-updates](https://covid19.nj.gov/#live-updates)

------
chvid
Germany (like a few other countries) is in the situation "too much lockdown,
too few sick".

So it has to remove those lockdowns. This creates a fun political dynamic
where the authorities who just spend a month scaring the population in doors
now has to explain and justify why it is ok to go out and get a little sick.

~~~
_ph_
I strongly disagree with the statement, that we have "too few sick" here in
Germany. With the lockdown, we managed to just keep the health system from
being completely overloaded in the most infected regions. But that already at
the price of postponing non-urgent medical procedures. So yes, there are a few
free beds in hospitals still, but we might still need them.

What is not accounted for is, that supplies (masks...) are still scarce and
more importandly, most medical personal is working at an unsustainable
intensity. There is plenty of reason of desiring even less sick people.

The reasons for reducing the lockdown are practical, social and economic. The
lockdown is hard on many people, depending on their social and living
situation. Especially in dense cities, most people don't have housing which
was designed to be confined to it for many weeks. And apart from that, people
want to go out, want to meet other people again. Need to do shopping for
clothing, get a haircut. Also, we should try to keep the economy from
collapsing.

The trick will be to reduce the lockdown while keeping the minimum safety in
place and without too many people acting reckless and endangering the
population again.

~~~
chvid
It is the same "problem" here in Denmark; massive lockdown and overcapacity
for COVID19 treatment.

The current level of lockdown is unmaintainable as this virus is probably
going to be here for a year or two. However it is very hard for our
politicians to say: It is too expensive to save these lives - other lives are
cheaper to save.

In a way the media coverage has been so effective that people actually do not
want the restrictions lifted.

~~~
Dahoon
You clearly live in a different Denmark than I do. Maybe you read too much
Ekstra Bladet.

We are following the curve just as planned - not over and not under. There are
no "overcapacity" and the lockdown isn't "massive" at all. Only a tiny
percentage of shops are closed down and the rest isn't close to what a lot of
other countries are doing.

Stop spreading FUD and try to appreciate we have a system that is working
great in this crisis.

~~~
chvid
Thanks for the insults.

You can follow the writings of our ex pm Lars Lokke who says something similar
to what I wrote.

------
m0zg
Would be cool to have this for NY as well. I have this nagging suspicion that
the press is only showing the small number of hospitals that are overflowing,
and not showing the ones that are under capacity, to stoke panic and drive
clicks. Similar to the "mass graves" bullshit they wheeled out the other day.

To see why it's bullshit, one has to do some basic arithmetic. Consider that
if life expectancy in NY metro area is 75 years and 21 million people live
there, 1/75th of the population, or 280K people die per year in NY metro area
alone. That's 7671 person per day on average. At the time of this writing 7844
people have died of corona in the entire state, total. I'd bet good money a
good chunk (if not most) of these people would die of something else if it
wasn't corona, so that's not a "net" increase. If you want to tell me these
deaths require mass graves, I have some fine swamp land in Florida that you
might want to check out.

~~~
usr1106
Yes, you really need to follow death rates.

According to some claims up to 70% of corona infections could not result in
observable symptoms.

However, if you take just dying people, it would not come as a surprise that
they are so weak that the additional infection can produce visible symptoms
and their death is attributed to COVID.

In some places in Lombardy (Italy) the death rate is clearly higher. You
didn't need the army to transport coffins before. No statistical anlysis
required here.

The analysis is further complicated that death rates vary a lot over the year
even under normal circumstances. I don't doubt that in some countries a corona
peak will be seen, but it will still take months to be sure how big it is.

[https://www.euromomo.eu/](https://www.euromomo.eu/) shows long term death
rates in selected European countries.

~~~
Lewton
> According to some claims up to 70% of corona infections could not result in
> observable symptoms.

This is a ridiculous claim

Any place that has done random sampling is reporting a very low asymptomatic
rate

~~~
mrighele
Not ridiculous. After the first town in north east Italy was put in quarantine
(Vo Euganeo) the local governor decided to test the whole town for Coronavirus
(a few thousand people). More than half of the infected people where without
symptoms.

~~~
Lewton
[https://www.icelandreview.com/sci-tech/is-icelands-
coronavir...](https://www.icelandreview.com/sci-tech/is-icelands-coronavirus-
testing-showing-that-50-of-cases-have-no-symptoms/)

It should be obvious, when you have a virus with an infection rate doubling X
number of days and it takes X or more days to start showing symptoms, if you
do a random sample, 50% will be asymptomatic. That does NOT mean that they
will continue to be asymptomatic

~~~
Erikun
70% would certainly seem to be too high. Data from the Diamond Princess showed
17.9% of infected persons never developed symptoms.
[https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm](https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm)

~~~
m0zg
And _all_ the people who died there were in their 70s and beyond and had
comorbidities. Just one of those things fearmongers never mention.

