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The dying of the elderly

Many old people with Covid-19 do not die in the hospital. Does a hidden triage take place in Germany? The opposition and patient advocates see this as a danger.

Almost every day the Robert Koch Institute reports the deaths of 1,000 people who have died with or from Corona. The numbers show a discrepancy: the vast majority of these people did not die in the hospital or in an intensive care unit. That feeds a suspicion.

Corinna Rüffer, disability policy spokeswoman for B'90 / Die Grünen, suspects that a hidden triage has long been underway:

We have to fear that sick elderly people in nursing homes in particular will not receive the medical care they actually need.

Corinna Rüffer, B'90 / The Greens

So are old people with a corona infection left to their fate in the nursing home and not admitted to clinics?

In connection with Corona, almost half of all deaths in Germany died in the vicinity of old people's homes - including mainly residents, but also carers and carers.

Association of Statutory Health Insurance Physicians in Saxony addresses medical professionals

ZDF has received a letter from the Association of Statutory Health Insurance Physicians (KV) Saxony from the beginning of December 2020. It is addressed to all general practitioners and internists in Saxony under the heading "Prescription option 02 concentrator during the pandemic". Dr. Klaus Heckemann, CEO of KV Sachsen, asks whether "in the case of patients in nursing homes" who are suspected of Covid-19 or who have a confirmed diagnosis, "inpatient admission without an alternative" is really the best course of action "?

He recommends an "oxygen supply via nasogastric tube" when people in need of care stay in the nursing home. Heckemann closes the letter with friendly greetings and thanks the doctors for "their" pragmatic actions.

When asked by ZDF, Heckemann explains that it is only a matter of a message and in no way can one speak of a triage. "It is always a matter of weighing up appropriate and maximum therapy." The will of those in need of care is decisive.

"It's something inhuman for those who have to decide," says Hélène Eichrodt-Kessel about the triage. Your father was almost affected.

Challenge: Additional effort for nursing staff

The letter recommends the "alternative" of "oxygen supply". If this measure of "oxygenation" is not sufficient, writes Heckemann, "hospital treatment should of course be considered". However, this also means that if the condition deteriorates, posting is not mandatory, it should be considered.

The use of a so-called "oxygen concentrator" is problematic for several reasons: The handling is, as Heckemann assures, "no problem for the nursing staff", "every home has experience with it". Of course, it means an additional expenditure of time, especially if several people in need of care are sick with Covid-19.

Corona rapid tests in homes - nursing staff: "We can't do it!"

Rapid antigen tests are intended to protect residents of care facilities from corona infections. There are enough tests - but the already overloaded staff is reaching their limits.

When asked about the medical check-up, Heckemann admits that there are certainly homes that are poorly set up in this regard. He could not quantify how many people in need of care had been admitted to hospitals.

Corona in nursing homes: patient protectors have been alerted

Eugen Brysch, director of the German Foundation for Patient Protection, is concerned and alarmed. He speaks for those in need of care and the dying in this society. Brysch asks why - based on the overall German situation and according to his calculations - 15,000 infected nursing home residents did not even make it to a hospital ward?

In Germany, medical, home and nursing staff, as well as people over the age of 80, are currently vaccinated against Corona. But in many places there are problems with assigning vaccination appointments.

If the corona patient or the authorized representative has made a free decision, staying in a retirement home is not a problem, but if: "(...) family doctors, relatives or nursing home managers determine here, then that would be extremely threatening for those affected".

Brysch accuses the oxygen supply of Covid-19 patients in care facilities without adequate diagnostics and medical supervision is equivalent to triage.

Dramatic appeal - Ethics Council calls for more help for nursing homes

No isolation, more visits, more rapid tests: the Ethics Council is making an urgent appeal to improve the situation for people in old people's and nursing homes.

Karl Lauterbach, health expert of the SPD, denies this. "In contrast to the first wave, older people in need of care more often no longer come to the clinic or intensive care unit if they are seriously ill with Covid." There are medical reasons for this, explains Lauterbach. "I don't think that's an indication of silent triage." However, Eugen Brysch asks: "Does the person in need of care really have a choice in the case of Covid disease?"

Human rights activist sees lawmakers as an obligation

Human rights activist Raul Krauthausen says that many older people are left to their fate if they are not taken to clinics:

In my opinion, as long as capacities are still available in the hospital and the patients concerned do not expressly express their wish not to want to go to the hospital, this practice fulfills the facts of failure to provide assistance, if not even of killing by failure.

Raul Krauthausen

A constitutional complaint has been pending last summer. According to Krauthausen, it aims to ensure that the legislature "fulfills its duty to protect citizens" and "regulates constitutionally verifiable principles according to which decisions are to be made in the event of triage". Such a legal regulation on the question of triage does not yet exist in Germany.