ZTo assess the situation in the pandemic, experts bring the number of new intensive care units admissions within seven days into play as a guide. The incidence, i.e. the number of infections per 100,000 inhabitants within a week, already does not correlate well with the situation, confirmed the epidemiologist Gérard Krause on Tuesday in a video link of the Science Media Center (SMC). The value can both overestimate and underestimate risks.
According to the expert from the Helmholtz Center for Infection Research in Braunschweig, several indicators are needed to properly map the situation and take targeted measures. According to Krause, the Robert Koch Institute (RKI) provides a large amount of data that is unfortunately not taken into account in the decision-making process. “If you are forced to limit yourself to just one measured value – and that seems to be the case – then the number of new admissions to intensive care units would be what best suits the situation.”
Focus on the seriously ill
Focusing on the seriously ill will be even more important in the future, as the seven-day incidence is increasingly decoupling from the actual health situation, said Krause. The reason for this are two effects that are desirable in themselves: increasing tests, for example in schools. And the vaccinations of the risk groups, which hopefully reduced the health burden. However, the number of infections will not decrease to the same extent. This means that the seven-day incidence is “no longer a good point of reference”.
Because a few days pass between infection and the intensive care unit, the incidence is an indicator that shows at an early stage how the situation is developing. From the point of view of Christian Karagiannidis from the scientific management of the Divi Intensive Care Register, the loss of time would be bearable: The advantage of the intensive care bed numbers is the greater robustness. One is not dependent on daily fluctuations and delays in the reporting system or on test frequencies. “We really see what’s going on.” He spoke out in favor of a joint consideration of this number in connection with prognosis models for the occupancy of the intensive care beds. One should never look at just one value.
In the Divi Intensive Care Register, data on bed occupancy with Covid 19 patients in intensive care units are published. A federal value is shown for new additions including relocations. Regional data are not yet available, so an estimation model with limit values has been developed depending on the federal state, said Helmut Küchenhoff, head of the statistical consulting laboratory at LMU Munich. According to a report by authors around Küchenhoff and Krause, a “possible time delay” could be compensated for with low limit values.
Age and virus mutation determine the length of stay
However, new admissions are also associated with restrictions, as the scientists themselves write: For example, the length of time a patient is in the intensive care unit is not constant over a long period of time, as it also depends on the age and changed virus properties. When counting, a distinction must also be made between patients who are admitted due to Covid-19 and those with other diseases but positive Sars-CoV-2 evidence. The researchers also find information about the place of origin of the patient – instead of the location of the treating intensive care unit – important.
The Bundestag votes on the so-called federal emergency brake on Wednesday, and the Bundesrat on Thursday. According to the current state of information, it is planned to couple the tightening and tightening of the measures depending on the development of the seven-day incidence.
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