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Coronavirus infection numbers hit an all-time record Friday, with nearly 24,000 new daily cases recorded — and so did the number of patients in the country’s intensive care units. Official data from the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) show that the number of Covid-19 patients in German intensive care units (ICU) has climbed from 267 on September 21 to 3,615 as of November 20 — a more than 13-fold increase in the space of just two months.
Europe’s largest economy has gotten through the pandemic fairly well for now compared to its neighboring countries. This in in part due to its high intensive care capacity with 33.9 beds per 100,000 inhabitants; in contrast, Italy has just 8.6. But with Covid cases across the region skyrocketing, even Germany’s healthcare system is under strain and hospitals in some areas are increasingly coming close to their limits.

Germany’s leadership on Friday warned the system could collapse in weeks if the current trajectory continues. “The number of severe cases in intensive patients is still rising. The number of deaths is something that is not really being talked about and it remains very high,” said Steffen Seibert, spokesman for Chancellor Angela Merkel.

“We have not yet managed to bring the numbers back to a low level. We have basically only managed to get past the first step so far, that is, to stop the strong, steep, exponential increase of infections and we are now stable, but our numbers are still very, very high.”

‘Patients deteriorate very quickly’

Michael Oppert, head of intensive care at the Ernst von Bergmann hospital in Potsdam, just outside Berlin, is equally concerned about the dramatic rise in recent weeks — and expects things to get worse.

“We are not at the tip of the wave now, at least as far as I see,” he told a visiting CNN team this week. “And we do have a capacity for a few more patients, but if this carries on at the speed that we are experiencing right now I would imagine that even our hospital, with over 1,000 beds, will come to a point where we have to send patients home or to other hospitals to get treated.”

Bettina Schade, chief nurse on the Covid ward in the same hospital, described how the ward has changed over the last few weeks. “The numbers of patients have been increasing. We are getting a lot more patients with varying degrees of illness. Both for the normal Covid ward, but many also come to the emergency unit and very quickly have to be put into ICU,” she said. “We are currently experiencing having to put a lot of patients from the normal Covid ward into ICU very quickly because patients deteriorate very quickly.”

This applies even to many younger patients with severe symptoms, said Tillman Schumacher, a senior infectious disease physician. “We have patients of 30 or 40 years here who are on a ventilator and I am not sure if they’ll survive.”

Only two of the 16 ICU beds were vacant and the hospital staff was already canceling non-urgent operations to free up capacity — as well as making plans to convert more of its general intensive care facilities into Covid units.

Dr. Uwe Janssens, head of the DIVI, explained what measures would be taken if the current spike continues. “The regular program of hospitals has to be shut down, a partial closing down of the regular operations and admissions of patients which you can delay for several weeks without any strain, they can be delayed. There are people who don’t need an emergency surgery or an emergency catheter or something like that. They can be delayed. And doing this you get the capacity and get the nurses and the physicians to help the ICU physicians and ICU nurses on their wards.”

After taking into account non-Covid patients, 22,066 intensive care beds in the country were occupied as of November 20, while 6,107 remained vacant. Germany has a reserve of about 12,000 ICU beds, including field hospital beds at Berlin’s convention center.

Despite the large capacity, health minister Jens Spahn earlier this month warned that ICUs could be overwhelmed if daily infection rates continued to rise at the current level. “We are now increasingly seeing a rising burden and the threat of being overwhelmed in intensive care, in hospitals and at GPs,” he said in an interview with Germany’s state broadcaster ARD.

Germany offers help to other European countries

And that could be bad news for all of Europe. Until now, Germany has been taking in Covid patients from neighboring countries whose health care systems are overwhelmed.

Europe averted a Covid-19 collapse -- here's what the US could learn

The German Foreign Office confirmed to CNN that during the first wave of the pandemic, between March 21 and April 12, 232 patients were transferred to Germany for treatment — 44 of them from Italy, 58 from the Netherlands and 130 from France. In the fall too, the federal states of North-Rhine Westphalia and Saarland offered spaces to 36 patients — three of them from the Netherlands, 25 from Belgium and eight from France, a Foreign Office spokesperson said.

”These patients have a need for intensive medical care,” said Anja Wengenroth, a spokeswoman at University Hospital Muenster in Muenster, North Rhine-Westphalia. Her hospital established a system in the spring whereby Benelux countries — Belgium, the Netherlands and Luxembourg — could put in a request for ICU beds, a scheme which is ongoing. The North Rhine-Westphalia Ministry of Labor, Health and Social Affairs confirmed to CNN that currently ”46 hospitals have currently agreed to accept foreign Covid-19 patients. There are currently 76 beds on offer.”

Anne Funk, head of the division of cross-border cooperation in Germany’s smallest federal state of Saarland, which borders France, told CNN that during the first wave of the pandemic, its hospitals took in 32 French patients. At the end of October, Saarland offered France eight beds; three patients have been transferred to date.

“We would like to help wherever we can,” Funk said. “We do not want to differentiate between nationalities. At the moment we still have capacities. We are coordinating with medical and local authorities in France on an individual needs basis. We are here to help.”

For now they can continue to do that, but with Germany’s ICUs filling up quickly, it’s not clear for how much longer.

Nurses tend to patients in the coronavirus intensive care unit of the University Hospital Dresden, November 13, 2020.

Anti-pandemic protests

Germany has recently seen a string of demonstrations against the country’s anti-pandemic measures, with many protesters denying the severity of the virus.

The country is in a nationwide partial lockdown which requires restaurant and bars to remain closed, people to avoid travel, keep their contacts to an absolute minimum and limit public meetings to members of two different households. Schools and shops have remained open. German federal and state leaders will meet next week to decide on introducing further measures.

Demonstrators put up their hands in front of police officers during a protest against the government's coronavirus restrictions in Berlin, November 18, 2020.

On Wednesday, thousands of people gathered near the parliament in Berlin while lawmakers inside debated plans for greater legal powers to enforce restrictions. Police used water cannon and tear gas to disperse protesters, many of whom were not wearing face masks.

This is considered a slap in the face by frontline medical staff working hard to keep people alive, like Schade. “I also hear some people I know say things like: it’s like a flu or can be compared to a regular flu,” the chief nurse said. “We just cannot understand people saying that! Of course we all have the fear that maybe at some point we won’t make it anymore and could have a situation like they had in Italy where patients are outside in cars and get treated with oxygen because there’s no more capacity.”

Germany is still far away from such scenarios but, while there are still thousands of ICU beds available in the country, Oppert had a message of warning about the second wave of the pandemic and its dynamic.

“It is different, it is harder,” he said. “We do tend to see more patients now. Not only here in the Berlin/Potsdam region, in which we have a heavy burden of intensive care patients, but nationwide the numbers are climbing and they’re still climbing, they are not coming down at the moment.”

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Pelosi to move forward with impeachment if Pence doesn’t act to remove Trump

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“In protecting our Constitution and our Democracy, we will act with urgency, because this President represents an imminent threat to both,” Pelosi said in the letter to Democrats on Sunday night laying out next steps.

The House will try to pass a measure on Monday imploring Pence to invoke the 25th Amendment, through which he and the Cabinet declare Trump “incapable of executing the duties of his office, after which the Vice President would immediately exercise powers as acting president.” If Republicans object, as is virtually certain, Democrats will pass the bill via a roll call vote on Tuesday.

“We are calling on the Vice President to respond within 24 hours,” Pelosi wrote. “Next, we will proceed with bringing impeachment legislation to the Floor.”

But it’s not clear when exactly the Senate will take up the House’s measure. The Senate isn’t scheduled to return until Jan. 19, but will hold pro forma sessions on Tuesday and Friday. In theory, a senator could try to pass the House resolution by unanimous consent, but as of now it appears unlikely that it would pass.

On Monday, multiple House Democrats plan to introduce impeachment resolutions that would become the basis of any impeachment article considered by the House later this week.

Rep. David Cicilline (D-R.I.), who will introduce an article of impeachment against Trump on Monday, said on Sunday that roughly 200 Democrats have co-sponsored the measure.

Currently, 211 voting members (plus three nonvoting members) support Cicilline’s legislation, and they are hoping to reach 217 voting members by Monday morning, enough for the House to impeach Trump, one Democratic source familiar with the matter told POLITICO.

A small number of Democrats have opted not to co-sign the bill, but privately say they will vote to support the resolution on the floor, the source added.

The impeachment effort in the House is likely to be bipartisan, with Democrats expecting at least one GOP lawmaker — Rep. Adam Kinzinger of Illinois — to sign on. A handful of other House Republicans are seriously weighing it, according to several sources, though those lawmakers are waiting to see how Democrats proceed, and some are concerned about dividing the country even further.

Among the GOP members whom Democrats are keeping an eye on are Reps. John Katko of New York, Brian Fitzpatrick of Pennsylvania, Fred Upton of Michigan, Liz Cheney of Wyoming and Jaime Herrera Beutler of Washington.

Across the Capitol, at least two Republicans — Sens. Pat Toomey of Pennsylvania and Lisa Murkowski of Alaska — have called on Trump to resign. On Saturday, Toomey told Fox News, “I do think the president committed impeachable offenses,” but told CNN the next day that he does not believe there is enough time to impeach.

Sen. Ben Sasse (R-Neb.) has also said he would consider articles of impeachment.

Another option has emerged among some Republican and moderate Democratic circles — censuring Trump — though it remains highly unlikely to advance.

A censure resolution would gain far more support in the GOP than impeachment. Some Republicans have privately been pushing for that route and are trying to get Biden on board, according to GOP sources. That group of Republicans is also warning that impeachment could destroy Biden’s reputation with Republicans.

But censure is considered a nonstarter in an incensed House Democratic Caucus, where members see it as a slap on the wrist that gives Republicans an easy out.

The Democrats’ enormous step toward impeachment on Sunday comes after Pelosi and other top Democrats held a private call on Saturday night in which they discussed the potential ramifications that a lengthy impeachment trial could have on Biden’s presidency.

Democratic leaders discussed several options to limit the political effects on Biden’s first 100 days, with one option — floated by House Majority Whip Jim Clyburn (D-S.C.) — for the House to delay the start of an impeachment trial in the Senate by holding on to the article of impeachment.

Senate Majority Leader Mitch McConnell (R-Ky.) has sent out a memo to senators explaining that the Senate could not take up impeachment until Jan. 19 at the earliest, absent unanimous consent.

A final decision has not been made, and House Democrats will discuss the matter on a 2 p.m. caucus call on Monday.

Lawmakers are already privately expressing concerns about returning to the Capitol for multiple days this week, worried about both a potential coronavirus outbreak and whether the building is secure, given how easily an armed pro-Trump mob invaded on Wednesday.

The Capitol physician urged House lawmakers and staff to get tested in a memo Sunday, saying they might have been exposed to someone who had the virus while huddling for safety in a large committee room for hours on Wednesday. During the hourslong lockdown, several Republican members refused to wear masks despite being offered them by Democrats worried about the spread of the deadly virus.

Melanie Zanona, Olivia Beavers and Marianne LeVine contributed to this report.

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Matt Hancock Scraps “Unnecessary Training Modules” Blamed For Slowing Vaccine Rollout

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Matt Hancock has agreed to remove some of the training modules required for volunteers to sign up to deliver the Covid-19 vaccine (PA)


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Matt Hancock said people will no longer need to undertake training including an anti-terrorism course to give the coronavirus jab after MPs said “bureaucratic rubbish” was delaying mass vaccination.

It comes as MPs called for the government to produce targets for the number of people given immunity before lockdown can be lifted.

The health secretary said a series of “unnecessary training modules” are being scrapped to speed up the process of getting people qualified to deliver the jab.

Speaking in the Commons, Sir Edward Leigh said he was shown by his fellow the Tory MP, a qualified GP, the “ridiculous form” he had filled out to start delivering the vaccine.

“When he’s inoculating an old lady, he’s not going to ask her if she’s come into contact with Jihadis or whatever, so the Secretary has got to cut through all this bureaucratic rubbish,” he said.

In response Mr Hancock said: “I am a man after Sir Edward’s heart and I can tell the House that we have removed a series of the unnecessary training modules that had been put in place, including fire safety, terrorism and others.

“I’ll write to him with the full panoply of the training that is not required and we have been able to remove, and we made this change as of this morning and I am glad to say it is enforced.

“I am a fan of busting bureaucracy and in this case I agree with him that it is not necessary to undertake anti-terrorism training in order to inject vaccines.”

Dr Fox had earlier challenged Boris Johnson to drop the “bureaucracy” and “political correctness” of the forms vaccine volunteers must fill out.

He told MPs: “As a qualified but non-practising doctor, I volunteered to help with the scheme and would urge others to do the same. 

“But, can I ask the Prime Minister why I’ve been required to complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation in order to give a simple Covid jab?”

Mr Johnson said he had been “assured by the Health Secretary that all such obstacles, all such pointless pettifoggery has been removed”.

The government has been attempting to recruit thousands of volunteers to help with a mass vaccination programme, and with the recent approval of the more easily deliverable Oxford/AstraZeneca version has today revealed the location of seven mass vaccination centres set to open next week.

The Prime Minister’s official spokesman told journalists at a briefing they would be at Robertson House in Stevenage, the ExCel Centre in London, the Centre for Life in Newcastle, the Etihad Tennis Centre in Manchester, Epsom Downs Racecourse in Surrey, Ashton Gate Stadium in Bristol and Millennium Point in Birmingham, and it is expected they will be run with a combination of NHS staff and volunteers.

But so far the government has not said how many people need to be inoculated before it has an impact on the coronavirus restrictions.

Mr Hancock was asked by a number of MPs if the measures could be eased once the top few tiers in the vaccine priority list had been clear.

Former Conservative chief whip Mark Harper said once the top four groups, which includes care home residents and staff, frontline NHS workers, the clinically extremely vulnerable and everyone over 70 “we’ve taken care therefore of 80% of the risk of death”.

Adding: “What possible reason is there at that point for not rapidly relaxing the restrictions that are in place on the rest of our country?”

The health secretary replied: “We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope that we will see at that point, and so that is why we will take this – an evidence-led move down through the tiers, when we’ve broken the link, I hope, between cases and hospitalisations and deaths.”

The ex-Tory minister and another doctor, Andrew Murrison, said: “The logic of anticipating what is going to happen in two or three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse.

“That is to say, when we have a sufficient number of people vaccinated up we can anticipate in two or three or four weeks’ time how many deaths have been avoided. 

“That means, since it cuts both ways he will be able to make a decision on when we should end these restrictions.”

Mr Hancock replied: “The logic of the case that Dr Murrison makes is the right logic and we want to see that happen in empirical evidence on the ground.

“This hope for the weeks ahead doesn’t take away, though, from the serious and immediate threat posed now.”

The Cabinet minister said the challenge for the government is to increase the amount of doses available, claiming “the current rate-limiting factor on the vaccine rollout is the supply of approved, tested, safe vaccine”.

He added: ”We are working with both AstraZeneca and Pfizer to increase that supply as fast as possible and they’re doing a brilliant job.”

But Labour’s shadow health secretary Jonathan Ashworth called for the government to ramp up its vaccination programme to six million doses a week.

He told the Commons: “The Prime Minister has promised almost 14 million will be offered the vaccine by mid-Feb. That depends on around two million doses a week on average.

“Both [Mr Hancock] and the Prime Minister have reassured us in recent days that it’s doable based on orders.

“But in the past ministers have told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million of Pfizer doses by the end of 2020.

“So, I think people just want to understand the figures and want clarity. Can ministers tell us how many of the ordered doses have been manufactured?”

Mr Ashworth added: “Two million a week would be fantastic but it should be the limit of our ambitions, we should be aiming to scale up to three, then five, then six million jabs a week over the coming months.”

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How South African police are tackling pangolin smugglers

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Quiet, solitary and nocturnal, the pangolin has few natural enemies, but researchers believe it is the most trafficked mammal in the world. The tough scales covering its body are sought after for use in Chinese medicine, in the erroneous belief that they have healing properties.

The animal has also been of interest to researchers during the coronavirus pandemic. Related viruses have been found in trafficked pangolins, though there is continued uncertainty around early theories that pangolins were involved in the transmission of the virus from animals to humans.

After South African police seized a pangolin from suspected smugglers, BBC Africa correspondent Andrew Harding witnessed how vets tried to save the animal’s life.

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