Sjogren`s Patient living with the German Coronavirus Lockdown

Scenes from our daily walks.   River Rhein Duesseldorf  just 50 mtrs from our front door

 Montys House !  The former Dusseldorf home of  Field Marshall Bernard Law Montgomery, 1st Viscount Montgomery of Alemein KG GCB DSO PC DL and Gen. Sir Brian Robertson  during their time as head of the British Occupiying Forces in Germany. Robertson later became  Chairman of the British Transport Commission  1953 to 1961.

Later the house was used by British Consulate Generals until being returned back to Germany.  Currently subject to a major restoration and upgrade.

 

Coronavirus / Surviving the Lockdown in Germany

 

A different approach to highlight in this Article how German Hospiyal disciplines expienced by a Sjogrens and Lupus patient are being aaplied using the same standards of of organisation and discipline to mamage Coronavirus/

 

Having spent most of the six months prior to the Coronavirus lockdown in German hospitals suffering from a rare and very nasty form of Vascilitis which returned in the form of further attacks in different parts of the thighs and lower legs. Water on the lungs, heart problems.  I spent the final month of treatment under the Rhumatology Department at Uniklinikum Dusseldorf for a full assesment of my condition, treatment and medication under the direct care of the department head Professor Schneider and follow up outpatient (ambulanz) care under Associate Professor Dr. Severin, head of Outpatients Department  Rhumatology and head of clinical testing at the UKD.

 

I feel very fortunate that all this work was completed just before the Coronavirus situation appeared.   My time in hospital was able to underscore the difference in culture between the German healthcare  system which is based on extensive testing routines and detailed lab results and comprehensive recording of data.  This being a standard procedure and essential part of medical culture at a majpr specialist teaching hospital where higher qualifications such as professorships are required to head up departments.  Many of my recent Hospiral Dicharge notes from the wards and clinics were up to seventeen pages of minute detail.  I am very relieved to have got through the German coronavirus lockdown phase without the need to seek urgent medical appointments.  This was never experienced in the 20 plus years since Secondary Sjogrens Syndrome was diagnosed at Addenbrookes Hospital.  The UKD team have started from scratch after thoroughly checking all my medical notes from the UK and Germany,  with my new, fully up to date,  medication regime only retaining Hydroxychloiquine, Amiloride and Citalopram from my earlier medication regime.  The initial signs point towards a tolerance and if I can avoid Coronavirus , hopefully a better life

 

It was therefore no surprise that Germany would apply their same high thoroughness of standards of testing and analysis when the Coronavirus arrived in the country.

 

A unique survivor from 1937 is the Golzheim Estate just North of Montys House.  The estate was constructed as a Show Estate for Germanys largest Exhibition from the 1930 s era.  It represents one of the largest examlesof Nazi era domestic archiechture to be found in Germany.  The white painted houses had to be painted over in brown paint after the war on orders from the British Command. It was during the mid 1950 s that use of white paint was re permitted.  The wide piece of grass in the only evidence of the trackbed of the miniature railway that ran through the 1937 exhibition grounds and show estate. The three locomotives and caariges are all preserved today in the UK  

The Artists Colony  / Golzheim Estate.  To provide subsidised acommodation for artists

River Rhein lookin North from opposite Montys House, looking towards Golzheim Estate, Nord Park and Messe Dusseldorf (Trade Fair Grounds)

Montgomery s garden / the new white house built on the site overlooked this WW1 war memorial

 

Living In Lockdown

 

My wife and myself were automatically placed in the higher risk age group,  over here it is 60 years plus and not 70 as applied in Britain.  The German democratic system places politicians as the servants of its people and a high value is placed on all life.  The healthcare system is awash with money and governments cannot divert healthcare money. For example by cutting healthcare costs to divert money to tax cuts for the mega wealthy.  The level of political honesty applied in Germany appears of a much higher order.  

 

The lockdown was subject to a more sensitive form of policing than some of the examples we have seen coming out of the UK during recent weeks.  For example in areas such as people sunbathing in large public parks the activity is accepted as long as distancing of 2m and groups of less than three are observed.  The health benefits of vitamin D is perhaps better understood here than in Westminster.

 

Our daily walk is from our front door 50 meters to the Rhine Promenade in Rotterdamer Str.  As this riverside walk and cycleway can be very busy we often opt to walk on the side of the road opposite to the riverbank.  On very busy periods the police send a motorcyclist to monitor the scene, conspicuous by their presence rather than confronting people, in a manner which has come to note in the UK.   This article is illustrated with scenes from our nearby daily excesize routes.

 

During lockdown the numbers allowed to enter Supermarkets are controlled strictly and each store must display a sign at the entrance which  confirms the exact number of customers allowed to enter.  Cashiers are shielded by perspex screens and use of cash is discouraged.

 

The German have a term for hoarders (Hamster Shoppers) who bought up all stocks of pasta, toilet rolls, liquid soap, hand wash and kitchen rolls during the first week, but within a week normal service resumed with plentiful availability. 

 

Thankfully we are spared the daily onslaught of the UK televised government briefings , which appear to have significant levels of propaganda and lies which have been subsequently exposed at regular intervals.

 

Angela Merkel has restricted her addresses to the nation to two factual talks, presented alone and two with the Federal Health Minister and the Director of The Robert Koch Institute. 

 

The Robert Koch institute in Berlin an independent government medical science body is responsible for collating and publishing all data, including numbers of infections, number of deaths and number of patients cured.  It made an interesting comparison with the UK that was showing far less cases(due to  inadequate levels of testing, a high number of deaths (Even allowing for the absence of figures for deaths in care homes and in private homes, which have only just come to light in the UK) the third category related to persons cured.

 

German Sratistics dated to 3rd May 2020

 

Coronavirus Cases     165,554

Coronavirus Ceaths:         6,866

Patients Recovered:       132,700

 

 

The UK Results on the same date

Coronavirus Cases:      186,599

UK Govt Declared Deaths:      28.466

UK Govt Declared Recovered Patients:    N/A

 

 

The UK stopped publishing their very low paruent recovered figures just prior to the discharge of the Prime Minister from St Thomas`s Hospital and have failed to publish any recovered patients information since.

 

The last figures from the UK showed extremely low patient recovery figures compared to all other European Countries

 

 

Lockdown - empty roads and empty U Bahn (underground) train

Local councils arranged and erected information signs.   Translates to  ~ Remain at Home &  REMAIN HEALTHY

Simple Instructions in an international Pictogram Format.  Blue - Good Advice.   Red -  Avoid this

 

The Big Difference on how Germany tackled the Coronavirus Pandemic.

 

  1. Respect for the citizen.  One of the major differences is that in Germany

     the political structures exist to serve all the citizens. This is exemplified in       

     both national parliaments (Bundestag and Bundesrat) and sixteen regional   

     Federal Governments who have considerable devolved responsibilities, 

     each having its own regional Parliament (The Lander).  The next level of   

     responsibility is the Governmental Districts including Municipalities / large 

     cities that in some cases can also be Federal Capitals of a Lander (i.e.  

     Dusseldorf, Frankfurt, Munich, Dresden etc)  These bodies are headed by        an Oberbergameister(in) who is responsible for  further tiers of     

     responsibility.  Rural Districts and Urban districts take the same areas of  

     responsibility on a scale in keeping with the size of the district.

 

     Therefore in the current situation  The Bundes Chancellor Frau Dr. Angela        Merkel does not dictate policy from above as per UK Prime Minister  

     Alexander (Sacha) Boris Johnson but she works closely with the Sixteen   

     Lander Presidents and if necessary bangs their heads together to get a   

     consensus.  In turn the Oberburgermeistes and Burgermeisters form a   

     part of the operational chain to ensure the system can work smoothly, on

     work best suited to local level management and implimentation,

 

     Therefore our ending of Lockdown does vary from lander to lander with 

     face masks being required in some lander but not all, at present.

 

The Minister of Health Jens Spahn has been criticized on a personal level here for a slow recognition of the Corona Virus implications but the existence of a cash surplus in the health system, Hospitals that were not overstitched and The existence of the renowned Robert Koch Institute (RKI) who were designated to provide all data concerning the outbreak.   

 

 

The Robert Koch Institute

 

The Robert Koch Institute as international hub for health protection networks

When there are health emergencies across the world, such as disease outbreaks, the Robert Koch Institute’s expertise is in ever greater demand. RKI staff are involved in various international research projects and programmes. They help, amongst other things, with the surveillance of pathogens, to fight disease outbreaks, provide diagnostics capacities in partner countries and to collect comparable health data in EU member states. Thus, the RKI helps to tackle urgent public health problems and improve people’s health worldwide. People in Germany also profit from this international commitment, e.g. if disease outbreaks are stopped in time.

The Robert Koch Institute cooperates with many international partners like theECDC and the WHO. RKI is the WHO Collaborating Centre for Emerging Infections and Biological Threats and for Global Outbreak Alert and Response .

 The institute also contributes to the Global Health Protection Programme (GHPP) launched by the Federal Ministry of Health.

Since July 2017, RKI's central role in international health protection has also been fixed by law ("Gesetz zur Modernisierung der epidemiologischen Überwachung übertragbarer Krankheiten"). In January 2019, a new international department is set up at RKI – the Centre for International Health Protection (ZIG).

 

 

Infectious Diseases

The Robert Koch Institute is the German government's central institution for the identification, surveillance and prevention of infectious diseases in the Portfolio of the German Ministry of Health. Its experts monitor emerging infectious diseases and risk factors in the general population. They also provide scientific research. This allows appropriate measures to protect the health of the general public to be taken rapidly and effectively.

The Robert Koch Institute analyses pathogens and disease outbreaks, suggests measures for prevention and intervention, fills knowledge gaps and ensures the quality of health screening and care. Apart from that, its experts help prepare guidelines, recommendations and expert opinions for the federal government, the parliament as well as for the scientific and health sectors. An extensive knowledge base is a prerequisite for these tasks; the RKI ensures that it is up-to-date and continuously extended.

Here, we give an overview of the Robert Koch Institute’s aims, tasks and projects in the field of infectious diseases.

 

 

 

Charité Hospital  Berlin  in the Kaisers era

 

Robert Koch, Emil Behring, Paul Ehrlich and Rudolf Virchow, all researched at that time at the Charité, the largest hospital in Berlin. Their discoveries revolutionized science of the human body. They examined cells, sera and bacteria, and their findings opened up completely new possibilities in the treatment of diseases. The doctors developed important remedies, for example against diphtheria and syphilis, they were celebrated and received numerous awards, three of them even with the Nobel Prize.

Four men who did great things - and who were mainly connected by envy and resentment. They blasphemed, they mocked, they watched, drove and chase each other. Everyone wanted to outshine the other.

The television series "Charité", Series 1 is available on Netflix in the UK and tells of this tense relationship. Sönke Wortmann directed the six-episode series, that, describes the complicated network of relationships between the doctors in calm, unagitated images.

 

Heinrich Hermann Robert Koch

born 11 December 1843 in Clausthal Zellerfeld (Harz Mountains)  † 27 May 1910 Baden Baden.

 

Koch was a German Professor, Doctor, Microbiologist and Hygienist.  In 1876, Koch was able to cultivate the anthrax pathogen outside the organism and describe its life cycle. For the first time, this completely described the role of a pathogen in the development of a disease. 

In 1882 he discovered the causative agent of tuberculosis and later developed the supposed cure tuberculin

 

The "Royal Prussian Institute for Infectious Diseases" begins its work on 1 July 1891in Berlin-Mitte after its inception by Kaiser Wilhelm II.    Robert Koch headed the institute until 1904 

 

In 1905 he received the Nobel Prize in Physiology and Medicine. Robert Koch - along with his colleague Louis Pasteur  in Paris - has thus become the founder of modern bacteriology and microbiology.

 

Koch made fundamental contributions to the theory of  infection and to the development of tropical medicine.

 

Germany  is Coming out of Lockdown

 

The arrival of May 2020 is the month the strict lockdown begins to ease back with more business openings and a return to a new way of life.  At the end of April the Federal Chancellor Frau Dr. Angela Merkel met with the sixteen Federal Lander Presidents  and after the meeting concluded the Chancellor announced on National TV  the first part of the easing of lockdown, we have lived with since March.  Much of the information was already known but formal notification presented in a professional, knowledgable, straight talking honest and detailed manner, without any slogans. Six of the states had lived in a society where propaganda slogans were an everyday feature of life from 1945 to 1989.  To many who lived in the East Germany state slogans personified state control, interference and untruths.

 

The slogans were ever present however by the early 1990s,  I recall the best company worker award poster displayed at the Saalfeld locomotive depot of the former Deutsche Reichsbahn, was awarded by the staff to a certain Passenger Steam Locomotive allocated to the depot.    The use of repeated slogans used during corona virus by the British Government reminds me of too many shades of the Communist past in East Germany.

 

Public Transport

Changes included the following regulations when travelling on public transport  a) Full face and mouth covering masks must be worn at all times,  b) Seat use advice is applied to maintain social distancing 2 meters,  c) ticket issuing machines only accept credit or bank card payments.

 

Shops

Only shops below 800 sq. mtrs are allowed to open from 4th May

  1. Full face and mouth covering masks must be worn at all times,  b) stores generally only accept credit or bank card payments, cash payments are seen as a risk factor.
  2. Hairdressers open on 4 May,  appointments to be made by telephone in advance and strict new regulations apply to hygiene and cleaning all areas staff and customers come into contact between each appointment. d) Customers must wear masks at all time, hairdressers appear to have stocked up with medical visors in readiness for re opening.    e) All stores and premises have a regulatory maximum number of customers allowed in at any time.  As per supermarkets during the lockdown.  f) Perspex screens separate staff from customers.  

 

Restaurants

During  May certain restaurants are allowed to open for lunch service but must maintain social distancing.  It is hoped by June evening service can be resumed in restaurants.

 

Hotels 

Again it is hoped that a limited reopening of Hotels can recommence in June.

 

 

Places of Worship

All to reopen by early May for services, social distancing, face and mouth covering masks requied and no hymn singing to avoid spread of particles.

 

Hospitals

Outpatient clinics (Ambulanz) and Rehabilitation clinics are currently taking place online, via zoom or by telephone.  Hospitals are able to refer inpatients to Ambulanz clinics but no open access is allowed.   Hospitals hope to be in a position to reopen outpatients clinics at the end of the month.

 

 

Factual Public Information

Professional information vis the media has been very well disciplined with Dr. Merkel delivering the major national announcements.  Thus it is identified that when Angela Merkel speaks to the nation it is important.  The Lander Presidents announce the regional policies and changes.

Burgermeisters in the towns, cities and rural districts deal with posters and health advice in the local area and public information.

 

Scientific, Medical information and very accurate statistics related to a) numbers of daily infections  b) All deaths  c) Numbers of patients cured. 

 

All are the responsibility of the Robert Koch Institute which was originally formed as a Royal Institute for medical and chronic disease research by Kaiser Wilhelm in 1891  Professor Robert Koch was appointed to direct the institute. 

 

Today the RKI operates in the following areas

 

Research profile:

  • Providing a scientific basis for health-related political decision making
  • Identification, surveillance and prevention of diseases, especially infectious diseases
  • Epidemiological and medical analyses and evaluation of highly pathogenic, highly contagious diseases which are of great significance for the public

 

The RKI has a long history working with Berlin universities at the Charitie Hospital in Berlin.  Today Prof. Dr. Lothar H. Wieler, Präsident des RKI fronts all televised communication to the German nation related to corona virus.  

 

Views of an English resident in Germany

The German system with a State Chancellor, Regional Lander Presidents and one Specialist concerning medical and science issues presents a strong continuity, the public have responded well to this totally honest, disciplined, straight talking professional approach.

 

This is very embarrassing when friends and professional contacts relate to the chaotic situation in the UK .  Seriously mismanaged, chaotic organization, lack of honesty, slowness to react and undisciplined behavior presented by the UK government and many  of its key advisors.  They appear to have been extremely effective on passing Covd19 to each other!!! 

 

This is I believe an international civil disaster of unprecedented proportions, it is not WW2 and the UK has been extremely badly led in trying to go it alone and their continual war references.  I believe that the UK needs much better leadership than the bullshit, bluster, untruths, a recreation by government of wartime blitz sprit and numerous extremely poor attempts by the prime minister to pretend he is giving Churchillian speeches to a nation at War.

 

 

English language data coronavirus site by the German Health Ministry

 

https://www.bundesgesundheitsministerium.de/en/press/2020/coronavirus.html

 

 

Daily PDF File in published in English by the Robert Koch Institute

 

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-04-01-en.pdf?__blob=publicationFile

 

 

Federal Chancellor(in) Frau Dr. Angela Merkel (Right),  Federal Health Minister Jens Spahn (centre) and 

Professor Dr. Lothar Wieler, President of the Robert Koch Institute (Left)  all convey the seriousness of dealing with the Coronavirus Disease and show signs of the strain of the last few months.  The camera angle shows their proximity to be closer than was actually the case