Rapid vaccination may be of benefit in long-term care facilities (LTCF) that are affected by an ongoing COVID-19 outbreak. However, there are concerns regarding the safety and effectiveness of such an approach, particularly regarding the vaccination of pre-symptomatic patients. Here, we report the effectiveness of vaccination in a German LTCF hit by an outbreak that was detected 5 days after the first vaccine doses were administered. In detail, 66.7% of the unvaccinated patients experienced an unfavorable course; this proportion was much lower (33.3%) among the vaccinated patients. Even though this study is limited by a small number of patients, the observation and the comparison with related published data shows that vaccination (i) is safe and (ii) may still be of benefit when given shortly before an infection or even in pre-symptomatic LTCF-patients.

Zusammenfassung: Hintergrund: In der deutschen Krankenhauslandschaft sowie Notfallversorgung stellte die COVID-19-Pandemie eine Belastungsprobe dar. Die notfallmedizinische Gesundheitsversorgung wird in Deutschland durch die Versorgungskette zwischen prähospitaler Notfallrettung und klinischer Notfallversorgung in den Notaufnahmen sichergestellt. In Krankenhäusern und in der Notfallversorgung wird ein schneller, einfacher, genauer und kostengünstiger Test benötigt, um SARS-CoV‑2 zu identifizieren. In der zentralen Notaufnahme (ZNA) ist es wichtig, Patienten/Patientinnen mit COVID-19-Verdacht strikt von nichtinfizierten Notfallpersonen zu trennen. Methode: Es wurde die Leistungsfähigkeit von Antigentests in dem Rettungsdienst der Stadt Jena und in einer zentralen Notaufnahme des Universitätsklinikums Jena untersucht und mit dem RT-PCR-Goldstandard überprüft. Hierzu wurden multiple Testungen sowohl im Rettungswagen als auch in der Notaufnahme mittels Antigentests und RT-PCR-Tests durchgeführt. Insgesamt wurden 980 Patienten/Patientinnen in einem Zeitraum von 2 Monaten (Oktober und November 2022) in die Untersuchung eingeschlossen. Ergebnisse: Das Durchschnittsalter aller Patienten/Patientinnen lag bei 65 Jahren. Über die Hälfte der behandelten Patienten/Patientinnen kamen aus der Stadt Jena. Die Sensitivität und Spezifität der Antigentests lagen im klinischen Setting (in der Notaufnahme) bei 66,7 % resp. 99,2 % und im prähospitalen Setting (im Rettungsdienst) bei 68,8 % resp. 96,7 % im Vergleich zur RT-PCR. Im prähospitalen Setting lag die Sensitivität der Antigentests mit 2 % etwas höher als die klinische Antigentestung. Bei der Paralleltestung hatten 6 % der Antigentests ein falsch-negatives SARS-CoV-2-Antigentestergebnis im Rettungsdienst und 4,6 % der Antigentests ein falsch-negatives SARS-CoV-2-Antigentestergebnis in der ZNA. Die falsch-negativen Antigentests und somit die potenziell nicht erkannten Personen wurden durch die Betrachtung des Ct-Werts weiter abgeschätzt. Schlussfolgerung: Durch die Verwendung von Antigentests im Rettungsdienst und in der Notaufnahme kann eine zügigere Disposition in den COVID und Non-COVID-Bereich einer Notaufnahme erfolgen. Die Messgenauigkeit der Antigentests im Rettungsdienst und in der ZNA entspricht nicht der der RT-PCR. Dennoch ist der Antigentest ein nützliches Erstscreeninginstrument für die Früherkennung von SARS-CoV‑2 im prähospitalen und im klinischen Bereich. Eine zweifache Antigentestung kann für eine akkuratere Diagnostik des SARS-CoV-2-Erregers sinnvoll sein.

Healthcare professionals are particularly vulnerable to mental health issues during epidemics, as evidenced by the COVID-19 crisis. German public health authorities, crucial for disease prevention, faced significant strain from chronic understaffing and resource limitations exacerbated by the pandemic. The study was designed as a cross-sectional, observational online survey. This study conducted an online needs assessment survey among heads of municipal public health authorities in Thuringia, Saxony, North Rhine-Westphalia, Bavaria, and Berlin between June and November 2023. Of the 191 contacted authorities, 74 responses (38.7%) were analyzed, focusing on professional demands, recognition, stress resilience, general life satisfaction, operational organization, and communication during the pandemic. Validated scales such as ERI, RS-13, L-1, and the COVID-19 add-on module of the COPSOQ were utilized. Statistical tests included descriptive statistics, correlation coefficients, Chi-Square tests, linear regression, T-tests, and ANOVA with a significance level set at p < 0.05. Respondents were mainly from North Rhine-Westphalia (43.3%) and Bavaria (24.3%), predominantly female (54.1%), and had a mean age of 52.7 years. The majority were medical specialists (71.9%). The RS-13 mean score was 72.66 (SD = 12.42), with 58.9% demonstrating high stress resilience. Public health degree holders showed the highest resilience. The ER-ratio indicated high effort versus reward for 96.7% of heads. Larger districts showed lower ER-ratios, suggesting resilient organizational structures. The study highlights high psychosocial workload and resilience among German public health authority heads during COVID-19, suggesting the need for optimized crisis management and scalable staffing for future pandemics and crises.

Background: Effective hygiene and infection prevention are essential for patient and staff safety in EMS. This study assessed hygiene and infection prevention knowledge among EMS personnel and emergency physicians in Thuringia, Germany. Specifically, it examined knowledge of WHO recommendations on hand hygiene, standard infection prevention measures, appropriate use of personal protective equipment (PPE), and the management of patients with confirmed multidrug-resistant organisms (MDROs). In addition, associations with digital health literacy, job satisfaction, teamwork, and patient safety were explored to inform future training needs in EMS. Methods: A quantitative cross-sectional study was conducted using an online questionnaire between June and September 2025. A total of 72 EMS personnel and emergency physicians participated. The survey included the Digital Health Literacy Instrument (DHLI), the WHO questionnaire on hand hygiene knowledge, a knowledge test on standard infection prevention measures, PPE use, and MDRO management, the short questionnaire on general and facet-specific job satisfaction (KAFA), and the German version of the questionnaire on teamwork and patient safety (FTPS/SAQ). Group comparisons were performed using Fisher’s exact test or t-tests, as appropriate, and associations were examined using correlation analyses. Results: WHO-based hand hygiene knowledge was predominantly moderate (59.5%). Emergency physicians demonstrated higher levels of knowledge than EMS personnel (57.1% vs. 28.6%) and were more likely to answer basic questions on transmission routes correctly. In the extended hygiene knowledge test on basic hygiene measures, PPE use, and MDRO management, most participants showed low (43.1%) or moderate knowledge (45.1%), while only 11.8% achieved a good level. Digital health literacy was generally high, particularly for basic application skills. Respondents reported a high level of job satisfaction. Teamwork and patient safety were also perceived positively overall; however, communication was rated less positively by emergency physicians than by EMS personnel (p = 0.005; d = 0.81). Conclusions: Relevant gaps in hygiene and infection prevention knowledge were identified in the EMS setting, particularly regarding standard infection prevention measures, PPE use, and MDRO management. Future EMS training should therefore address both knowledge gaps and implementation-relevant factors such as communication, teamwork, and digital competencies. This study should be regarded as an exploratory pilot study.

Der Besuch von Kindern auf Intensivstationen, Intermediate-Care-Stationen und in Notaufnahmen hat aus psychosozialer Sicht in der Regel mehr Vorteile als Risiken. Aus hygienischer Sicht ist ein Kinderbesuch auf der Intensiv- und IMC-Station grundsätzlich möglich. Einheitliche Empfehlungen helfen Klinikmitarbeiter*innen, den Besuch von Kindern auf Intensivstationen als Bestandteil einer familienzentrierten Versorgung im Alltag umzusetzen. Article published online: 09 November 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany