ABSTRACT
Since March 2020, the corona pandemic has consistently exposed the weaknesses of the inpatient care system at the expense of those in need of case. No population group in Germany died more frequently as a result of corona-related infections (outbreaks) than residents of inpatient care facilities. By the end of March 2022. nearly 60% of Munich nursing home residents had become nosocomially infected with COVID-19, of which 18% died COVID-19 associated. Inadequate hygiene measures in the facilities could not and still cannot prevent large outbreaks. Because nursing facilities were not previously required to have hygienic staff, the Munich Health Department conducted standardized inspections and consultations during outbreaks. In almost no facility was a professionally correct outbreak management implemented. In addition, numerous hygiene deficiencies were identified that favored the transmission of SARS-CoV-2 infections to third parties. Furthermore, it became apparent that despite years of professional advice to the nursing facilities, no lasting positive effect on their hygiene management could be achieved. There are several reasons for this: a very high staff turnover, a low ratio of skilled workers, and a lack of commitment on the part of the facilities to a structured hygiene management system. Due to the continuing risk to the vulnerable population group in full inpatient care facilities, there is a fundamental need for regulation of binding hygiene management in these facilities - also with regard to risks from outbreaks with other pathogens. This was met by the legislature in September 2022 with an amendment to the Infection Protection Act. However, the theory-practice transfer required for functioning hygiene management can only succeed if sufficient numbers of professionally qualified staff with knowledge of German are available in the facilities to care for those in need of care.
ABSTRACT
Objectives: On January 27, 2020 the first COVID-19 case in Germany was confirmed. By June 22, 2020, the Robert Koch-Institute (RKI) published 190,359 confirmed cases (fatal: 8,885;recovered: 175,300). Objective was to analyse if the large regional differences in the cases per 100,000 inhabitants (casesp100k, range 33.9–1,566.8) are correlated with the number of physicians per 100,000 inhabitants (physiciansp100k) and / or the gross domestic product per capita (GDPpc). Methods: The number of cases and fatalities per county were extracted from the official source at the RKI website. These data were supplemented by the 2019 population, the 2017 GDPpc and the 2019 physiciansp100k for each county. We used a linear regression model with physiciansp100k, GDPpc and squared GDPpc (GDPpcsq) as explanatory variables for casesp100k. For fatalities per 100,000 (fatalitiesp100k), casesp100k were the explanatory variable. Calculations were performed with statistical software R. Results: Casesp100k per county were found to be significantly decreasing with physiciansp100k (coefficient = −0.4784;p-value = 0.0172) and a significant positive, non-linear relationship with GDPpC, (coefficient = −0.0109, p-value < 0.001;GDPpcsq, coefficient < 0.0000, p-value < 0.001). This means, that 10 additional physicians translate into 4.78 additional cases and an increase of 1,000 € at the average GDP per capita of 37,158 € to 6.34 additional cases (reducing to 1.85 at 2-times the average GDP). Fatalities per 100,000, were fully explained by casesp100k as the only explanatory variable (coefficient = 1.0000;p-value < 0.001). Conclusions: This research analysis the potential influence of socio-economic differences in German regions on COVID-19 cases/fatalities. Due to limited data availability on the county level it was not possible to analyse potential influence factors. In interpreting of these results, it needs to be kept in mind that our analysis captures correlation between variables and does not claim a causative relationship between the variables.