there are many visitors. to. make up your mind. for minds. thousands of covert 1000 patients are fighting for their lives in german intensive care units it's vital that in germany half the patients who end up on respirators die and we have to remember these are human beings with families for some of these numbers are abstract maybe coronavirus 10 iris can't put themselves in someone else's shoes but each number stands for person in these that size mesh. we've

been filming the work of i.c.u. teams at fribourg university medical center since the start of the pandemic. but the cut you can't get any more air you can't speak you realize that you might die. how can we beat this virus what are the possible long term effects in germany 2nd wave many young and healthy people have caught the coronavirus unfortunately being young and healthy is no guarantee for getting a mild case. of the there was a young man 45 years old with the release of a tax this is a textbook case of how someone who is young and healthy and without significant preexisting conditions can almost end up dying off.

the air ambulance arrives with a corona patient on board he's enclosed in a special protective box to prevent others getting infected during the journey to the hospital a little later the patient in his late forty's arrives at the intensive care unit where dr vivian saltzman were. the patient is already in an artificial coma and has been into baited that means he's connected to a ventilator. manpads and the patient came from a smaller hospital he had coughing at a temperature for a few days and then his condition suddenly deteriorated placed he developed severe breathing difficulties he was in debated and there transferred here. 6 medical workers carefully turn the patient so that he's lying face down prone positioning is proving to be one of the most important treatments to help many people severely affected by the virus. patients have to be adequately cushion to

avoid pressure sores on the face for example because they spend so many hours bed bound. off their work site they're known that is adamant that if you die on your back secretions collect and inflammation worsens the lungs can't heal properly our patients lie in bed for a while said turning them face down allows the rear areas of the lungs to be ventilated and to heal the patients alternate between their back and the front so that all parts of the lungs can be equally ventilated and. every day the patients are turned on their stomachs and then back again it's very work intensive for the medical staff. of ventilator is not enough for many of the seriously ill covert 900 patients they would die if they were not also attached to an artificial long the catheter channels the blood out of the body and then back into it with its twin

2 and i think it's something that after making a small incision the doctor pushes the catheter toward the heart using a guide wire that's. the sort. of thing that occurs. to me. if. you go to. this is the e.c.m. or the heart lung machine. it's attached by a plastic tubing and in this instance takes over the work of the lungs. what it worth my blood flows into the machine the carbon dioxide is removed and the blood is in rich with oxygen then it's pumped back into the patient. that you know of course we also use it for far too long support we use it after a heart attack after resuscitation they have

a wide range of medical uses but the ones just on long support here are primarily coronavirus patients we don't have many options left for really sick patients that's the last card we have a carsley. they're going to do the 5 we have $23.00 e.c.m. o's in fribourg university medical center $23.00 that's it and currently we only have 2 that are not in use so i hope the way board be so severe and so disruptive because this is not just about intensive care beds as such are. tested in the 1st wave of the pandemic one in 3 patients here are needed to be hooked up to an e.c.m. 0 to have a chance of survival. to 10 up audition the therapeutic options are sobering of we supply oxygen we have the e.c.m. 0 site but it just buys time the body the lungs have to heal themselves there is no

medication to treat coronavirus. almost half of the patients who ended up in intensive care in fribourg during the 1st wave died at the beginning of march a few people suspected what the medics would soon be facing the 1st cases were only detected in germany in late january. this is barbara. she was one of germany's 1st covert 1000 patients she is a pediatric specialist at the university medical center her colleague consultant yohannes culp and has worked with her on many occasions. you. post a percentage of their visitors who are when the patient arrived in intensive care she had severe breathing difficulties otherwise she was very alert unlike some of the patients we encounter she was feverish but not at all disorientated we were really struggling to get her breathing difficulties under control we gave her a lot of medication to try to control and we had to give her an awful lot of oxygen

. then given the rapid progression of the onus we decided to anita times and into bait on this amount as to supply her with a very rich concentration of oxygen but we saw she was suffering from severe lung failure. that's our. barbara spent more than a week fighting for her life. she made it her ventilation tube is gone in all likelihood she is no longer infectious today's 1st test was negative she has beat the virus but it was a close call. the situation was frightening at that moment. you can't get any air anymore. you can't speak. you realize that you might be going to die or. then i began giving instructions with my last remaining strength about my last wishes if i don't make it. but.

it was on whatsapp. it was a nightmare. in germany's 1st wave of the covert 900 figures rose rapidly in the south of the country. versity medical center switched to treating only medical emergencies and patients with a new coronavirus. this is clements the source on his face are from a long periods of time that he has spent lying face down before contracting the virus clements was a fit man in his mid sixty's a passionate mountaineer with no preexisting conditions. vivian saltsman has been treating him for weeks his lungs were so badly affected that she's been keeping him alive with an artificial long that supplies his blood with oxygen clemens has been

attached to the machine for almost 3 weeks but the intensive care team is confident he will make it. now after 20 days they have decided that he no longer needs the e.c.m. oma she. is going to remove the tubes from here growing it's a big step forward we're all really pleased. that . the e.c.u. mo is no longer needed but he still needs ventilation via the tube inserted in his trachea. that afternoon clemons gets visitors his wife but tina and his daughter have come to see him they're still not allowed to touch because of the danger of infection.

out of. there. his eyes are half open but not focused he's only semi conscious. barbara has just received her 2nd negative test the treatment was successful the virus can no longer be detected in her body she's not infectious she has survived kovac 19. she's still weak but she's no longer getting oxygen what she doesn't realize is that the nightmare is still far from over a little later she's back on a normal hospital ward where she gets some sobering news from a lung specialist. he puts her back on oxygen she's not getting enough air just hit means i'm not independent it's ok when i'm in the room. but it's

a bit tiresome to find quite honest this. is from disability if i want to go outside i have to carry this heavy bottle. and i had really been hoping that i would get taken off it soon. but i think i'll just have to resign myself to my fate . you are clear and i am is a long specialist cope at 19 has also confronted doctors in his discipline with a completely new range of challenges. the food. for the inflammation triggered by the virus has also destroyed healthy tissue in the lawn and scars have formed. and the scars are a defect that hamper the normal functioning of the longer. they hinder the gaseous

exchange and we want to restrict bad as far as possible by suppressing the inflammation that leads to these scars. and talking. with antiinflammatories like cortisone no one knows yet what the long term consequences will be of a severe case of coronavirus as a doctor barbara is only too aware of that you know. you can't but help thinking how will i cope with every day life will i be able to live and work on the only after this. that's the $1000000.00 question. but if i'm left with lung damage it wouldn't be so great of course. but i can't do anything about it.

back in intensive care clemons condition has barely altered. his lungs are being ventilated via a tracheotomy he hasn't received any sedatives for some time now but he still isn't properly conscious the doctor suspect coburg 19 also attacks the brain as indicators suggest. the incest in many cases we see the brain being severely affected many patients are agitated disoriented and the lack of sleep medication if they become so disoriented during the course of the illness the brain has to be involved in the title. in the high security lab of the viral a-g. department they're studying the coronavirus there infecting cells with covert 19 so that they can examine it more closely all of the light colored dots are infections that are spreading. under the microscope you can see alongside the blue cell

nuclear lie that there are masses of red virus particles that are self replicating . such research is helping viral or just done yellow herzliya and helmet and go to know what they're up against the sars coronavirus too which is causing the current covert $1000.00 pandemic is a much more successful and unpredictable opponent than the 1st sars virus. we've are all or just thought we knew about coronaviruses the songs coronavirus tune is a science virus that's much more advanced than the sars virus that we were confronted with in 20022003 which had difficulties with effective transmission about the current virus manages it. exactly that it is efficiently transmitted via the arrow we breathe and of course that's really bad news for us from so far as this there is a fuse in my 25 year career as a viral

a just it's the nastiest virus i've come across because it's so unpredictable and it's becoming clear just how unpredictable when you get the flu you know you're going to get sick seriously ill if you're unlucky but there is a vaccine we can treat it sars c.o.v. to is quite different some people get it but don't get ill though they are infectious others die from it without it being clear why and of course it affects older people but also the odd young person it's an absolutely unfair opponent no phones. after being unconscious for around 6 weeks clements has come around. to the. area he took a long time to really become conscious and communicate it's bad now he is not at all disoriented and can join in he's mostly pretty cheerful and he's

a fighter have he's a cyclist he wants to do all these things again he has goals i think that's very important to know what you are fighting for to stick with it. clemens has beaten the coronavirus but he keeps getting other infections mike ammonia each one is a new threat to his life. this is hope it's a roller coaster when he got an infection again he was just lying there again i began to despair and wonder what would happen. next bad piece of news always seems to be around the corner so i'm afraid of being too optimistic you stop wanting to engage even with the positive stuff that. clemens has been. in intensive care for more than 2 months. his constant focus getting his own life back he has lost more than 15 kilos and most of his muscles have wasted away.

he's getting high energy nutrition by on a feeding tube he is fighting to recover. files about loans and he is in a kind of rehabilitation phase at the moment with us he's doing a lot of physiotherapy he's using the pedal exercise or he's also able to get out of his chair already and can do that pretty well the situation with the artificial ventilation is getting better. slowly that. his wife pitino records every bit of progress that he makes. it cut in this is him going into his room he couldn't get up and sit down alone at that point without them this was the 1st time more than 4 weeks ago that you even recognised as. a jury member that yes you can remember that i can remember. yes his

gaze looked human again through a series of feet of him and it is a huge difference of someone has light in their eyes or. it's really frightening when someone just looks completely blank at least i was really afraid. you wonder whether his spirit will return and he will be back to the way he was or not so it's terrifying. barbara has been at a rehabilitation center in the black forest for almost 6 weeks now she doesn't need oxygen anymore and she's fighting her way back to normality. amazing if you saw me on the walker. here she is 7 weeks ago on

a walker at the intensive care unit in freiburg when she arrived there she was at the point of suffocation. as you know that it was absolutely apparent to me that i would not have survived without artificial ventilation and so in principle they've given me a new lease of life and i experienced an amazing sense of gratitude the 1st 23 days i was really over the moon. it was the feeling of happiness that i think i have never experienced before it's. not me. and some are clemons 2 was on his way to a rehabilitation center in the black forest after more than 70 days in intensive care. before he got the coronavirus he could climb 4000 meter high mountains. now the slightest incline taxes him.

about his removal yes i can feel that i've been active. in most of it's not my legs that are the problem it's my lungs. tell. her 3. times i asked myself what made me so vulnerable. i was very nice i thought that i would definitely not be affected as badly as someone with respect for. her. so i don't have high blood pressure or diabetes i know other chronic illnesses. who's not. i haven't found any answer to that. it's easier if you bring up one leg next to the other. really get your thighs does

or. the physical rehabilitation program has modest goals this isn't about climbing 4000 meter peaks but ensuring that clements can cope with daily life. a few weeks after completing her rehab barbara has a check up at the university medical center she has been training hard as a doctor she knows that your lungs don't recover on their own. take a big breath out breathe out out out out out. then quickly deeper deeper and quickly breathe it all out out out out out stay with it really press out over the air until there's nothing left gone gone gone great. what have the hours of training achieved disappointment. only 67 really. this would that would mean that my lung capacity has only approved by 10

percent in 8 weeks 5 of them spent working like a dog to improve my lungs. i'm off tomorrow. the doctors want to take a look inside her longs b.g. i believe in and hold your breath. are there still size of inflammation. can mean anything. are there signs of pulmonary fibrosis scarring of the lungs to covert 19 leave lasting damage in severe cases. at least cloudy areas here these very fine lines here these don't exist in normal lungs 1st so no hard data because there haven't been any long cohort studies that would tell

us whether or not these changes i'm likely to diminish over time well how they might develop but. there are types of pulmonary fibrosis that continue to develop even when a virus has gone i can't tell from your m.r.i. at the moment. the woman. barbara performs well on the following running test but will she remain so fit. as a doctor she knows how dreadful pulmonary fibrosis can be. this is this goes for. the 2 there is what she used to call it a apathic lung fibrosis that people can get after a severe case of influenza and at some point you end up meeting a lung transplant. that's something that takes place after 10 years rather than one . but of course its progression can come to a halt with a bit of luck that it's much too much to just but you can also end up battling to

get air. it's a horrible way to die. from school. in autumn the number of cases begins rising again. clemens has come to the medical center to thank the staff put in order the i'm glad i'm a visitor this time and not a patient. to suffer that really shook me off it. i bet it did all your fears come flooding back don't they. clemens continues to convalesce meanwhile more and more. virus patients start arriving at the hospital in fribourg then freed karen's infectious diseases department is full again just like in spring and additional normal wards have already been transformed into covert 19 more. this is this i

think we are seeing that several other hospitals in the area are already full so we have to brace ourselves for even more cases in the next 7 to 14 days. really older age groups are now being affected and we know from our experience of the 1st wave that this will result in more hospital admissions. here at the normal coburg ward patients often require oxygen but they don't yet need artificial ventilation about all the staff can do is give oxygen inhalations and stop patients from getting additional infections. the winter weeks will be crucial ones for the hospitals the team led by. is responsible for forecasting for the hospital working out how many patients will likely need to be admitted if we don't stick to the restrictions. you have to see

things from the point of view of the virus. the virus has a semi parasitic relationship to us and exploits our needs as does the iris exploits the need of people to be sociable to get together to celebrate with the family with the neighbors successful viruses take advantage of this in a perfidious way. in the 1st wave relatively few people were affected in germany now the virus is almost on the present any family can be affected. including the funds which. the far reaching social penetration of the virus and also means that we are going to have to be more patient when it comes to fighting this virus now that it is much. more widespread. i assume that a short lock down like the one that worked so well in april will not work again in that way and that we will have to come to terms with a longer lockdown of. there are more difficult times

ahead for the people working in intensive care vaccination is no quick fix to be covert 19 we're going to need greater staying power. i hope that we'll have to corona virus pandemic under control in the 3 years and by then we will have successfully vaccinated the entire population and know that the immunity conferred by the vaccines well last several years then we consider the question of when a booster vaccine might be needed it 3 years in 3 yes many intensive care units are already at or over full capacity in fribourg they still fight to save every life in the intensive care ward so working at their limit we have to say that quite clearly we still have empty beds but every day the numbers are increasing and the patients remain in hospital for weeks for months the beds aren't freed up in just

a few days so i think. i don't know how but we have to manage even if the numbers rise we have the beds that we have adopters pozole who and we will do our best looking after every workers. we can't really do anymore is that we have to look after the severe cases we have to cut we can't say we can't cope with anymore here is the cutoff point this option does not exist a good solution. we have to carry on somehow that's quite clear. and with those words philip schmidt gets to work preparing a fresh intensive care bed in the next coronavirus patient is already on the way.

because. mom fox news is to. blame. to go beyond yes. as we take on. all of the stories that matter to you. never. cut. out.

play. this is news live from berlin impeachment 2.0 in the u.s. lawmakers take action again to impeach u.s. president donald trump democrats formally accused of inciting violence last week a mob that overran the capital they say took cues from the president also on the program former california governor arnold schwarzenegger compares the storming of the u.s. capitol to nazi podhoretz against the jews. against the jews carried out the night. that the nazi.