If you are a nurse or part of the medical staff of a hospital or a medical practice, you will find information here.
If there are no symptoms, a negative test result only has limited validity. Even if a person does not test positive for SARS-CoV-2, it does not preclude the person from getting sick and passing the virus on at a later stage. We therefore do not recommend testing people without symptoms. This approach allows the laboratories to test the samples from acute cases in a timely manner without becoming overburdened. The Robert-Koch Institute has developed a detailed illustration of how medical staff are to perform their duties, available here.
A high risk of infection exists if a person has direct contact with secretions or bodily fluids from a person with a COVID-19 infection. This can occur through coughing or sneezing, or in the course of medically necessary activities. The risk can be reduced through the use of applicably protective clothing and equipment. The Robert Koch Institute has published information on its website regarding the hygiene measures to be observed when treating and caring for patients with a SARS-CoV-2 infection.
Products with proven efficacy in hand disinfection are those that include the area of application “virucidal against enveloped viruses”. Ethanol-based products or alcohol-based products made using propanol also work. The Robert-Koch Institute has published a list of tested and recognised disinfectants and disinfection methods online.
For medical staff, a variety of masks can be used: A medical mouth and nose mask (surgical mask) serves to protect others from coming into contact with infectious droplets from an infected person. Filtered face pieces (FFP2 and FFP3) are used as protective equipment to ensure workplace health and safety, and are designed to protect the wearer from coming into contact with droplets from other people. A homemade, non-medical mouth and nose mask does not protect the wearer from becoming infected with coronavirus. This is why a mouth and nose mask should not be described as a “protective” mask. However, a non-medical mouth and nose mask can help to reduce the volume of droplets of saliva or respiratory secretions that reach other people when you breathe out, talk, sneeze or cough. At all times, even if you wear a mouth and nose mask: Keep at least 1.5 metres away from others, practice good hand hygiene and adhere to sneezing and coughing etiquette. As a general rule, Only FFP2 or FFP3 respirators (filtering face pieces) protect the wearer from infection with pathogens. Such respirators are intended solely for medical staff and not for private individuals. Please do not purchase such respirators for private use. In private circles, hand disinfectants are generally not necessary unless someone is infected with the novel coronavirus. Here, it is more important to wash your hands regularly with soap and to make sure that towels, toothbrushes, cutlery and the like are not shared with other family members or flatmates. Please adhere to the hygiene rules and practice the coughing and sneezing etiquette. Here you can find further information.
A lack in protective clothing means an increased risk of infection for medical staff, and also for patients. Across Germany, representatives from the areas of policy and medicine are currently working on securing the supply of protective clothing such as protective masks, goggles and gowns. The Federal Ministry of Health centrally procures medical protective clothing, which is distributed via the Bundesländer and regional associations of SHI-accredited physicians. Nursing homes, hospitals, doctors’ practices and the Bundesländer have been asked to provide additional protective equipment. This is arranged through the statutory health insurance.
The availability of transport services is currently secure. Depending on the region, there may be restrictions on public transport. Please inform yourself regarding local connections and check the timetables. The Länder have introduced rules on wearing non-medical mouth and nose masks, called everyday masks, when travelling on public transport and when shopping. Rules on wearing mouth and nose masks can differ from region to region, so please familiarise yourself with the rules that apply where you live. Heed the rules on contact and maintain a minimum distance of 1.5 metres from other travellers. Remember to carefully wash your hands once you get back home.
Bins used to collect disposable articles indoors should be placed in front of the door of the room in which they are used. Please ask your supervisor for instructions about this. There are rules on carrying and disposing protective clothing.
Information on COVID-19, for instance regarding the required hygiene measures, can be found on this website.
Quality assurance audits have been postponed until the end of September. Under the COVID-19 Hospital Relief Act (Krankenhausentlastungsgesetz), no quality assurance checks (regular audits) made be made by either the statutory health insurance medical review board (MDK) or the private health insurance medical review board (PKV-Prüfdienst) until 30 September 2020. This prevents additional risk of infection for people in need of long-term care, nursing home staff and auditors which could arise in the course of the quality assurance checks. Also, the checks tie up nursing staff who are currently needed to provide medical care given the pressing situation caused by the novel coronavirus SARS-CoV-2. Ad-hoc checks – for example where there is a reliable indication of quality deficiencies or other irregularities – should continue to be made. Whether this is possible in the form of an inspection of the nursing home or the nursing service premises and the home of the person in need of long-term care must be decided by the regional long-term care fund associations (Landesverbände der Pflegekassen) and the statutory health insurance medical review board (MDK) in conjunction with the local authorities, particularly the health authorities. Collection and transfer of indicator-based quality data has been postponed for six months: With the COVID-19 Hospital Relief Act, the introductory phase for a new quality management system in residential care has been extended by six months to 31 December 2020. To relieve the burden on residential nursing homes in the acute pandemic situation, the deadlines associated with the collection and transfer of indicator-based quality data have been extended by six months. This means that collection of indicator-based data will be interrupted for six months to ensure that in the current situation all available staffing capacities in nursing homes can be used to provide actual nursing care. Until 30 September 2020, the 25-working-day deadline for decisions on applications for care benefits submitted between 1 February 2020 and 30 September 2020 will be limited to cases in urgent need of a decision. Such a case exists where, even in the absence of a timely decision by the long-term insurance fund, the provision of medical care is at risk. As was previously the case, to secure care benefits the date of application and the existence of conditions which meet the respective criteria are decisive. On 27 March 2020, the National Association of Statutory Long-term Care Insurance Funds (GKV-Spitzenverband) set out criteria for cases where a decision is urgently needed under Section 147 (3) SGB XI. A particularly urgent need for a decision is seen in the case of an initial application for care benefits in kind for home-based care under Section 36 SGB XI or an initial application for combined benefits under Section 38 SGB XI if the provision of care can only be guaranteed via the share of care benefits in kind to which the person is entitled under Section 36 SGB XI, an initial application for full residential care under Section 43 SGB XI or an application for a higher care grade classification due to rapidly deteriorating state of health. The decision as to whether a particularly urgent need for a decision exists is made by the long-term care insurance fund. Where such a need exists, the long-term care insurance fund informs the statutory health insurance medical review board (MDK) at the time of placing the order. If the long-term care insurance fund fails to approve the application in writing within 25 working days following receipt of said application or if shortened assessment deadlines are not met, when the deadline has passed the long-term care insurance fund must, under Section 18 (3b) SGB XI, pay €70 to the applicant immediately for each commenced week of delay. To relieve at least part of the burden caused by the novel coronavirus SARS-CoV-2 on long-term care insurance funds and staff of the statutory health insurance medical review board (MDK), the obligation on the part of the long-term care insurance fund to approve a fixed-sum additional payment for applications submitted between 1 February 2020 and 30 September 2020 has been suspended until 30 September 2020.The statutory health insurance medical review board (MDK) can relieve the burden on nursing staff: They have declared their willingness to temporarily deploy available staffing capacities – especially involving nursing staff and employees with medical or professional care training – in nursing homes, hospitals and health authority offices free of charge without the need for reimbursement of costs or expenses. In collaboration with the Länder ministries and stakeholders at Länder level, the MDK will determine which deployment options are both meaningful and feasible in practice.
Under prevailing law, persons in need of long-term care are also entitled to short-term care in institutions which provide residential nursing or rehabilitation care if, while receiving medical treatment or rehabilitation care, the person in need of long-term care needs to be accommodated and cared for in the respective institution. To take account of special needs in response to the pandemic caused by the novel coronavirus SARS-CoV-2, nursing homes and rehabilitation centres are to be able to provide short-term care without having to fulfil this requirement. Until 30 September 2020, short-term care may thus be made use of without medical treatment or rehabilitation care being provided for a person in need of long-term care at the same time.
"To protect the person receiving care and also their family members while also maintaining the level of care to be provided, care allowance may be received from 1 January 2020 to 30 September 2020 without the need for an advisory consultation. The possibility of receiving advice remains intact. People in need of long-term care who solely receive care allowance must provide proof to the long-term care insurance fund or the private insurance company that they have had one advisory consultation every six months in their own homes if they have Care Grade 2 or 3, and once every quarter if they have Care Grade 4 or 5. The advisory consultation is usually conducted by an approved home nursing service. These consultations service serve the purpose of quality assurance in home nursing and of providing home carers with regular help and practical professional support. If people in need of long-term care do not make use of the advisory consultations, the long-term care insurance fund or the private insurance company must reduce the amount of care allowance accordingly and in repeated instances withdraw it altogether. Assessment of the need for long-term care has up to now involved a detailed personal assessment in the applicant’s home. File-based assessments should be the exception. To protect people in need of long-term care against additional risk of infection, assessments up to and including 30 September 2020 are made based on the available documentation. Both applicants and other persons able to provide information, such as family members, neighbours and doctors, will be contacted by the assessors and asked for information about the applicant in structured interviews conducted on the telephone or by digital means. Based on the information received, the assessors determine the degree of need for long-term care and recommend a care grade classification. This applies for applications submitted between 1 February 2020 and 30 September 2020. As was previously the case, applications for a higher care grade due to a worsening state of health may be submitted at any time. To significantly reduce the risk of infection for applicants and assessors, and to counter staffing shortages at the medical review board (MDK), repeat assessments have been postponed until 30 September 2020."
The obligation for nursing services to make mandatory visits to recipients of care allowance to monitor the provision of home nursing care has been withdrawn. Consultations for recipients of care allowance are still possible, where desired. Ideally, these will be conducted by telephone, online or via video.
The country-wide restriction of visits to residential homes for people with disabilities was announced as a special protective measure. Regular visits to a facility for disabled persons by a specified person will be permitted in future as long as there are no active COVID-19 cases within the facility. Please check the rules in place at the individual facility.
In many cases, dementia patients belong in the risk group on account of their advanced age. Utmost care must be taken. Increased care must be taken to observe hygiene rules. Care should be organised in close consultation with relatives. Country-wide requirements have been announced for visits to nursing homes as a special protective measure.
Until September, the rule is that people in need of long-term care will be assessed and subsequently classified based on a review of their files and a telephone or video consultation. This avoids direct contact with patients.
A risk of infection exists for everyone in direct contact with others. In care provision, personal protective measures should be taken, such as carrying a respirator mask, gloves, gown. Additionally, eye protection may be useful. Please pay attention to the general rules: Sneeze or cough into the crook of your arm, regularly wash your hands and avoid shaking hands (10 most important hygiene tips. Please heed the regulations on wearing protective clothing.
People with pre-existing conditions run a higher risk of infection with the novel coronavirus becoming more severe. It is particularly important for these people to adhere to the rules regarding contact and hygiene. In addition, they should discuss with their employer as to what further measures may be required.
If someone becomes ill in the nursing home where you work, you should adhere to the following instructions: Does that person have a respiratory infection or fever? Do they need to be isolated in their own room? Inform the doctor or the out-of-hours patient care services. If they have life-threatening symptoms, call the rescue services and report a potential Covid-19 infection. Follow the instructions issued by the health authority. If hospitalisation is not necessary, the sick person must be isolated in the nursing home until such time as the results of their diagnosis come through (usually one day). When caring for sick persons with fever or respiratory symptoms, the recommendations concerning protective clothing and equipment must be followed. Ask your supervisor and inform the management, the supervisory authorities as well as family members/carers.
You may not reduce the number of patients you care for on a daily basis at your own discretion. Please approach your supervisor with questions of this kind.
It is particularly important that relatives of older people in need of long-term care and of people with disabilities maintain physical distance. Country-wide requirements have been announced for visits to nursing homes and residential homes for people with disabilities as a special protective measure. Medical staff or professional carers still need to remain available for family members to reach them by telephone. More information on how to handle relatives can be found in our article "Geschützt, aber nicht einsam. Wie Pflegeheime Besuche sicher gestalten" (Protected, but not lonely. How nursing homes enable safe visits).
If a member of staff in a nursing home has become infected, it must be reported immediately to the long-term care insurance fund (Pflegekasse). The home and the insurance fund will then decide how to fill the gap with staff from other areas.
Disinfectant (alcohol-based liquid/gel – containing a minimum of 60% alcohol), gloves, masks and a thermometer must be available in the home of a person in need of long-term care.
The ad-hoc “COVID-19” working group of the Committee for Biological Agents (Ausschuss für Biologische Arbeitsstoffe/ABAS) has developed a briefing paper on behalf of the Federal Ministry of Labour and Social Affairs regarding this question. This is available here .
Furthermore, in case you have further questions or issues, it is recommended you contact your local occupational safety and health authority or accident insurer. A list with the occupational safety and health authorities’ contact details is available under the following link.
You can also obtain information from the Robert Koch-Institute. The contact details of the employers' liability insurance associations and accident insurance funds is available at the following address.
The Gesetz zum Ausgleich finanzieller Belastungen in Gesundheitseinrichtungen infolge von Covid-19 (law on corona-related financial assistance for medical practices) provides for compensatory payments for doctors with private practices and psychotherapists experiencing loss of earnings caused by the Covid-19 pandemic.