By Grossekemper -

Doctors and nurses at the intensive care ward in Leipzig University Hospital are fighting desperately to save the lives of corona truthers. It can be a thankless task.

At 6 a.m. on a Monday morning, the start of the early shift, there are 19 extremely ill patients in the COVID-19 intensive care ward of the Leipzig University Hospital. And one dead body.

The man died a few hours ago in room B1115 and the corpse is lying on a bed, shrouded in a black plastic body bag. It will stay there for another two hours, in a room with two other patients. They are still alive, but have been put into artificial comas, sedated with benzodiazepines and opiates. Artificial lungs are supplying their blood with oxygen while dialysis machines have taken over the function of their kidneys.

At around 8 a.m., the morticians arrive and take away the body. There is no room set aside for mourning, no candles, no last moments of togetherness. That’s what it’s like to die in the coronavirus intensive care unit, where deaths are mounting as the fourth wave breaks over the country.

A total of 55 nurses work at Station IOI-C, and 12 of them are on duty on this Monday morning, along with an assistant who brings material into the room, picks up blood samples and returns with the results. With 18 patients already in the ward, it has actually reached full capacity, but new ones keep coming.

At mid-week, the seven-day incidence in the city of Leipzig was at 438.5 per 100,000 residents, and as high as 1,064.3 in the surrounding area. And finally, it is becoming clear to everyone that Germany is facing a catastrophic corona winter.

"We are certain that the fourth wave is going to be a nightmare," says Sylvia Köppen, head nurse at the Interdisciplinary Surgical Intensive Care Unit (IOI).

"We are certain that the fourth wave is going to be a nightmare,” says Sylvia Köppen, head nurse at the Interdisciplinary Surgical Intensive Care Unit (IOI).

"It’s going to be a catastrophe," says Andreas Knauth, a nurse specialized in intensive care and anesthesiology.

"It just going to be terrible," says Anke Schrötter, also a specialist, who has been working in health care for 18 years.

DER SPIEGEL spent three days with her and her colleagues in a station that has already reached its limits. It is a place where the fear of what lies ahead in the coming months is at least as great as their incomprehension for a society that is simply carrying on as if the coronavirus were history.

Monday morning, 6:15 a.m., 19 patients in the station

"One thing we have learned is that COVID is an asshole," says Knauth, just beginning his third early shift in a row. He has two more ahead of him. The rings under his eyes tell you all you need to know about his work schedule: four late shifts, then a day off, five early shifts, two late, two early. And any time he doesn’t have off is full of stress. "You can have the perfect patient for seven hours, with all the values stable and everything going well. And then COVID will just rip him away."

Like all the nurses here, Knauth is in high demand. When he moved to Leipzig in 2018 with his family, he was able to choose which hospital he wanted to work in – and decided on the university hospital. When his patients are stable, he says: "It’s all good." In his next three early shifts, he will have sole responsibility for two patients in room B1113, both of whom are in artificial comas.

In the bed up front is a 47-year-old woman who weighs 100 kilograms (220 pounds), suffers from diabetes and chose not to get vaccinated. "It hits the obese first," says Knauth. In the next bed lies a 37-year-old who is just half her weight and fully vaccinated, but he had a lung transplant. To prevent the body from rejecting transplanted lungs, the immune system must be suppressed by way of medication, which led to the man’s severe case of COVID.

A black crust stretches across the man’s breast, a condition called necrosis – essentially dead tissue stemming from decubitus. Decubitus, commonly called bedsores, is a sign that the patient has been incorrectly positioned and is often an indication of poor care. But here, in the war against the virus, decubitus is but the collateral damage of survival. The patient has to lie on his stomach so that his lungs can be sufficiently ventilated. But if he lies on his stomach, his breast suffers.

"COVID takes the satisfaction out of nursing," says Knauth, saying that caregiving at a COVID intensive care ward has very little to do with the training he received. The primary goal here, he says, is not that of reestablishing health, rather it is a desperate battle aimed at somehow keeping the patient alive. In other words, it’s better to survive with an ugly scar on the thorax than it is to die beautiful. Knauth has a term for it: "survival pragmatism.”

The people that Knauth is helping to survive are all hooked up to ventilators. A thick tube with air leads into the mouth, joined by two smaller ones. One of them is used to pump air into a balloon so that the thick tube doesn’t slip out. The other is for the extraction of secretions. A tube going in through the nose leads to the stomach and provides the patient with nourishment. The dialysis catheter is attached to the neck, while the central venous catheter is in the groin. Then there is the urinary catheter and additional entry points in the arms. The patient is sedated with midazolam, a benzodiazepine and with sufentanil, the strongest opioid approved for use in Germany.

Caring for two patients in such a condition requires eight hours of hard work and extremely high levels of concentration. Mistakes can be deadly. Knauth must keep a close eye on a dizzying number of different drugs along with four machines. He has to keep track of blood levels, air pressure and saturation levels. He must correctly interpret the endless columns of numbers on the various screens and react appropriately. "It is exhausting over time," he says. "You can never relax." There is a constant chorus of peeps and rings. If there is just a quiet chirping, then "it’s all good." But when the sounds become shrill and loud, then things get hectic. Everything is monitored, but nothing is really under control.