Deaths from COVID-19 mount in German elderly care homes

By Markus Salzmann
10 April 2020

Recent days and weeks have witnessed a spike in COVID-19 deaths in Germany’s elderly care homes. Elderly residents of these facilities, who often suffer from pre-existing health conditions, are more likely to experience a serious illness as a result of a COVID-19 infection. The large number of deaths stems from the failure to implement timely countermeasures or follow them, a shortage of staff, overworked personnel and the absence of personal protective equipment (PPE).

The outbreaks of COVID-19 in care homes have risen dramatically. Virologist Christian Drosten referred to the development as “a new phase in the Coronavirus pandemic.” At just one care home in Wolfsburg, where the first cases were identified on March 18, 29 residents have died. After five residents died at a Karlsruhe care home, all 200 residents and 160 staff members were tested. One hundred and four tests came back positive, with the other results still pending.

In a care home in Wurzburg, 16 residents have died. Many more residents and care workers have tested positive for COVID-19. Sixteen residents and four staff members tested positive at a care home in Neuköln in Berlin, and 45 people at a home in Hamburg. The list goes on.

Due to the lack of testing in Germany, there is also undoubtedly a large number of unreported cases. Across the country, some 800,000 people live in elderly care homes. However, there is no official statistic for the number of COVID-19 cases in these facilities.

The irresponsible and criminal indifference of the government and big business is to blame for the horrific conditions in care homes and hospitals.

In an interview with Der Spiegel, patient ombudsman Eugen Brysch responded in the affirmative to the question as to whether care homes are being transformed into centres of death. Brysch acknowledged that the totally inadequate number of tests for the virus is having especially lethal consequences in the care sector, stating, “The strategy of not testing care home residents as a general rule was wrong.”

The lack of PPE is having an even more dramatic impact on care homes than on hospitals. Brysch justifiably referred to this as a “scandal.” Despite existing plans for a pandemic, there were “no stockpiles in retirement and care homes. Prices on the market have increased 100-fold, and no institution can afford them.”

A poll by the Süddeutsche Zeitung, NDR, and WDR revealed that thousands of doctors and health care workers are already infected with COVID-19, and that institutions have been forced to close due to staff shortages resulting from sickness, or a lack of PPE. The Robert Koch Institute (RKI), Germany’s federal agency for infectious diseases, estimates that across the country, “2,300 medical staff in hospitals are infected with SARS-CoV-2.” Unreported cases are also undoubtedly much higher, and this figure does not include workers in doctors’ practices, care homes, and care services.

According to figures from the Registered Doctors’ Association in Bavaria, 244 practices in this federal state alone are closed—141 due to quarantine, 82 due to a lack of PPE, and 21 due to a lack of clinic staff.

The situation is being exacerbated by the emergence of some clinics as “COVID-19 hot spots.” This process is exemplified by the Ernst von Bergmann clinic in Potsdam. The hospital stopped accepting patients on March 28 because too many had already been infected by the coronavirus. By Wednesday, April 1, nine people at the hospital had died due to COVID-19. After one in five patients and 63 staff members had been infected, the RKI sent a crisis team to the state capital of Brandenburg.

The reality is that for too long, nothing was done in the care sector to prepare for the pandemic. Even when the first infections in Germany were reported and it became clear that the capacity of the health care system was far too low, no measures were taken to protect the vulnerable people in the elderly care system or care workers.

Instead, politicians sought to pass the buck. Lower Saxony’s Social Affairs Minister, Carola Reimann (Social Democrats, SPD), blamed “irresponsible relatives” for bringing the virus into the Wolfsburg care home, according to the daily TAZ. Only two weeks after the first infections in Lower Saxony did the state government issue an order banning the acceptance of new residents in elderly care homes. In Bavaria and several other states, this straightforward but effective measure was only adopted after dozens of people had died.

In the case of Wolfsburg, the government did not utter a word about the irresponsibility of the care home operator. Workers who had tested positive at this facility and many others were forced to continue working, putting their own health and that of residents in grave danger. “On the infection ward, people who have tested positive but have shown no symptoms are still working. With the authorization of the local health authority, quarantine can be suspended in such cases,” the TAZ wrote with respect to the Wolfsburg case.

The state prosecutor is now investigating a charge of involuntary manslaughter in the case of the Hans Lilje care home in Wolfsburg. A spokesman for the state prosecutor said that the trigger was a complaint that made serious accusations about the standard of care. Employees of the Diakonie, the operator of the care home, reportedly spoke of “catastrophic hygienic conditions” that encouraged the spread of the virus. The lawyer who filed the suit noted that a ban on visits was imposed far too late.

A question to the Federal Ministry of health from the Paritätische Gesamtverband, which represents a number of care home operators, underscored how widespread the disastrous conditions are. On the one hand, the submission declared, they are obliged to equip staff with masks and personal protective equipment. But on the other, it is virtually impossible to obtain PPE on the market. This leads to the question of whether one can be permitted, or ought to continue caring for residents or patients, and whether the care home is liable if it compels staff to work without providing them adequate protection. An answer from the Health Ministry has yet to be received, according to a report in the Süddeutsche Zeitung.

Cuts and privatizations have created the disastrous conditions presently experienced in the care sector. The huge shortage of staff in the current crisis is linked to the miserable working conditions and low wages in the sector. As the Süddeutsche Zeitung reported, 17,000 employees in the care sector depend on state welfare benefits to get by, including 10 percent of this figure who work full time. More than 1,600 full-time workers in the health care and paramedic services do not earn enough to cover the costs of rent and basic necessities of life for their families.

At the same time, the number of privately-owned for-profit operators in the care sector has increased dramatically. The turnover of Alloheim SE, one of Germany’s largest care home operators, rose from €110 million in 2014 to €631 million in 2017.