"Germany has fewer deaths due to earlier treatment"

[lljkk]

I saw this claim on the Germany threads... sorry, didn't want me asking to get lost in long threads. The claim was that people in Germany with c19 get admited to hospital earlier and then... something special happens. They get some great treatment that means a lower death rate.

What is the special treatment that MNers know about, that is available in Germany but always administered too late or not offered in UK?

[CaptainMerica]

Oxygen, I think. Not sure there is evidence to back up whether that is true, but I think that is the (entirely plausible) claim.

[TartanTexan]

Isn’t that as per the ‘precautionary measures’ re: Boris? ‘Early’ oxygen (?)

[SimpleKindofLife]

Oxygen, fluids, antibiotics for secondary infections... basic care really!

[crazydiamond222]

See this article for an explanation. Basically early treatment with oxygen is key and helps avoid the use of ventilation
www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html

[enragedpenfold]

Not treating people until their lips turn blue isn’t being terribly pro-active in the grand scheme of treatments.

[Lovely1a2b3c]

Yes- Oxygen and supportive care (e.g. fluids, CPAP, bronchodilators to aid breathing, steroids).

Boris was apparently admitted to hospital earlier than most patients would be and moved to intensive care earlier (higher sats and requiring fewer units of Oxygen than is usual for intensive care admission).

[NoMorePoliticsPlease]

@Lovely 1a2b
According to the new zealand nurse who looked after Boris, he was not given oxygen earlier than others, was not moved into ICU earlier than others and definitely needed to be there

[NoMorePoliticsPlease]

I dont think MN experts are really the ones to make a call on this, it will take some time for all the analysis

[GrumpyHoonMain]

In the UK you won’t get A&E treatment until you stop breathing (unless you are an MP or rich / famous in which case you will be treated with oxygen if you look rough).

[wonderstuff]

I also think the fact that Germany went into this with a better funded healthcare system with far more hospital beds means that a) their population is likely healthier and b) due to this and a good testing and tracing system they were far less worried about overwhelmed hospitals and so more relaxed about admitting patients meaning people got/get treatment earlier.

[SpongeCake23]

My understanding is if oxygen is administered first, there’s less need for a ventilator which can decrease your chances of survival anyway.

[TartanTexan]

@NoMorePoliticsPlease Boris was flanked by two nurses who watched 24/7. Would others be?

[KrakowDawn]

As far as I understand it, in the UK if you have pneumonia at present, you won't be admitted until you can no longer utter a sentence. Seems a bit late to be treating pneumonia to me, as surely it would clear up quicker with earlier intervention?
Germany are presumably treating people far earlier in their symptoms than the UK hence people having more chance of recovery.

[lljkk]

My understanding is that my local hospitals have about 150 cv19 people in them who are not in ICU. If those folk in regular beds aren't getting Oxygen, fluids, or antibiotics for secondary infections, then I wonder what they are getting (other than a bed). There are maybe 35 additional patients in ICU. I don't know what they are getting in ICU that the people in regular beds don't get.

[lljkk]

ps: I was shocked about that nurse saying BJ "needed to be there". I thought they could get struck off for saying anything about an individual patient's needs.

[Derbygerbil]

I was shocked about that nurse saying BJ "needed to be there". I thought they could get struck off for saying anything about an individual patient's needs.

Almost certainly had BJs permission, to downplay suspicions that he wasn’t actually that ill. It won’t stop the conspiracy crew though.

[stuckindoors77]

In the UK you won’t get A&E treatment until you stop breathing (unless you are an MP or rich / famous in which case you will be treated with oxygen if you look rough).

Just to clarify @GrumpyHoonMain you won't get any treatment until you stop breathing all together?

But if you've stopped breathing then aren't you dead, essentially?

So in the UK they only treat people when they're already dead?

Which makes the recovery rates pretty incredible then doesn't it?

[fallfallfall]

Germany also has more hospital beds per capita than the UK. Germany, 8 hospital beds per 1000, UK, 2.54 per 1000 as per wiki.
The difference seems to be in the timing, earlier treatment in Germany.
My understanding is it’s rather brutal and can take several weeks to recover.
A Canadian woman who was in ICU and ventilated for a few days said following ventilation she had a difficult recovery needed refeeding (stomach shrunk) physio due to muscle loss.
I gather it takes a few weeks hence longer hospital stays.
Needed to be there is a very safe innocuous comment. Especially since it’s a dr who decides who is admitted or discharged.

[BunsyGirl]

What interests me is the difference between the Swiss death rate (187 per million) and the German death rate (70 per million). Medical care is Switzerland is usually outstanding (I have family members who regularly use it) so why is Germany performing much better now?

[jcyclops]

Warrington Hospital is getting good results through EARLY treatment with sleep apnoea "black boxes".
news.sky.com/story/coronavirus-hospital-cuts-covid-19-death-rates-with-black-boxes-for-sleep-disorder-11977789
Maybe it is something like this that the Germans are using. It does seem strange to me that the general NHS treatment success rates do not seem to be improving much after weeks of experience.

[RogueV]

The MN medical experts are out in full force today

[stuckindoors77]

@jcyclops I've read about that in a few places. I assume what they're doing will be widely shared and trialled in other areas. I wish Germany would share their expertise with other countries, there's obviously something they're doing.

[GrapefruitsAreNotTheOnlyFruit]

It looks like we are now trying to treat people a bit earlier //www.dailymail.co.uk/news/article-8258913/Paramedics-ordered-coronavirus-sufferers-hospital-scorecard-threshold-lowered.html

[BigChocFrenzy]

I live in Germany

Success is basically down to treating the patients as early and as much as they need
Germany has plenty of doctors and hospital beds, so doesn't need to ration care

(In fact rationing has never been part of the German health system and still wouldn't be acceptable now)

There are 500,000 tests per week, so a lot of cases get picked up v early

Anyone infected gets monitored daily by phone, to check if symptoms are worsening

If they start having more than minor symptoms, they are visited regularly at home by medical teams in full PPE "spacesuits"
They test blood O2, BP, heart etc and take blood samples to test for any additional infections, that often happen once the immune system has been weakened

They give meds and O2 as needed

If there are breathing difficulties, or low O2 levels, they are admitted to hospital

• doctors keep saying on TV and in newspapers here how important it is to treat such symptoms early,

because it can often stop things getting more serious

[GrapefruitsAreNotTheOnlyFruit]

I think everything is still a bit confused though. Lots of GPs have answering messages saying please don't bother us if you think you have covid.

When they should really say, if you are having breathing difficulties or your symptoms have lasted longer than a week please get in touch. Then they could do proper triage / monitoring in the community by phone or video link.

111 is pointless. You either need nothing (if mild) a GP or hospital treatment