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      Fighting against COVID-19

      With joined forces

      B. Braun has been fighting against COVID-19, and for patients and medical professionals around the world since the start of the pandemic.

      January 24, 2020

      +++ The first European cases of the disease appear in France. Two individuals are infected during a trip through China. A few days later, the first cluster of infections occurs in Germany at a Bavarian automotive supplier. +++

      Something big is coming. Something that, in the coming months, will change the life of every person on the planet—however, only a few suspect it at this point. While the “novel coronavirus” has been appearing more and more in the news since the start of 2020, Wuhan—the location of the initial outbreak—is a long way from London, New York, or Rio de Janeiro. In Europe, everyone still feels safe. At B. Braun, however, the situation is already being taken quite seriously, since it is clear that if the virus spreads, the medical supplies that are already critical to the system will become even more important. On January 24, the company issues its first official statement about the coronavirus, sharing a tutorial on proper hand hygiene on LinkedIn: Spread the word—not the germs. The B. Braun subsidiary Aesculap Academy, which offers medical training around the world, switches to online courses in China, starting in February. Other countries follow suit. In the coming months, over 60,000 individuals around the globe will continue their education digitally. 

      At the start of the pandemic, the entire inventory of sanitizer sold out in just a few days.

      Beginning of February 2020

      +++ On February 11, the disease is given its official name: COVID-19, short for coronavirus disease 2019. In Germany, the hoarding starts. Above all, disinfectant becomes scarce, demand is 8.5 times higher than the year before. +++

      B. Braun produces over 50 different germicidal products. Production at the Center of Excellence (CoE) for Infection Control in Sempach, Switzerland already runs at full capacity during normal times, which is why a new production facility is being built, which will be completed by 2022. “Virtually overnight, we were bombarded with inquiries—from all over Europe but primarily from Asian countries,” says Rolf Widmer, Head of Supply Chain Management in Switzerland. “We could’ve done three to five times our normal sales volume.” Production, however, can only be increased by about 30 percent, because preliminary products such as ethanol were almost unavailable.

      “In this situation, we had to decide to make distribution as fair as possible. Even though we received unbelievable offers, we didn’t want to control sales using price,” explains Widmer. Instead, current customers were given first priority, they were promised at least as much disinfectant for 2020 as they had purchased in 2019. “We then focused on new customers from the German-speaking countries,” says Widmer.

      Beginning of March 2020

      +++ On March 11, the WHO officially declares a pandemic. Infection and death rates in Europe rise quickly. Testing centers are set up in major German cities. On March 8, the federal government recommends canceling large events and encourages businesses to allow employees to work from home. Life as we know it changes. +++

      At B. Braun, as many employees as possible are also working from home to prevent infections at the company. Within just two weeks, every location around the world switches to video meetings. This is a new situation for many employees—and something of an acid test, with colleagues facing a flood of customer inquiries while working at home. This is what happened at the Brazil location: In March, B. Braun received over 13,000 e-mails just at this location—an increase of nearly 50 percent. You do everything you can, though, to stay in touch with customers and partners during the pandemic, because communication is everything in a pandemic. The Communications department responds to this situation with the hashtag “#wearebusy—because our customers are”. In a large-scale campaign, employees report on their new daily routines working from home.

      The number of available ICU beds has become an indicator of whether the crisis can be managed.

      March 16, 2020

      +++ All ICU beds in Germany are required to be reported using the German ICU Registry web portal. Elective surgeries that are not urgent are postponed to keep ICU beds available. +++

      After seeing the photos from Italy and given the deteriorating situation in large parts of southern Europe, operations at German hospitals are completely overhauled, explains Dr. Michael Vogt, CEO of the German doctors’ association, Hartmannbund. “It then turned into massively slowing the increase in infection rates while also admitting as many ICU patients as possible.” Various means were used to achieve this. “Hospitals, of course, exercise the utmost care with regard to hygiene,” says Vogt. “Still, new standards had to be set. For example, some procedures were performed as though the patient had tested positive for corona.” Tending to patients in the isolation wards who are actually infected is particularly stressful for both doctors and nurses. “At the start of the pandemic, the lack of adequate protective equipment was a huge problem,” says Vogt.

      B. Braun has many products in their portfolio that are designed to make working in a hospital better. Sometimes, all it takes is just a humble idea: self-adhering foam pads customized to prevent pressure on the skin under the weight of safety glasses and face masks.

      The preparations for the wave of COVID-19 patients are demanding and require many hours of overtime from hospital staff. “But the German system has thoroughly proven itself so far,” says Vogt. At no time are ICU beds filled near capacity—even some patients from Italy and France can be treated.

      Life in lockdown: At the end of March, social life in Europe is almost at a standstill.

      March 22, 2020

      +++ Italy and Spain are under lockdown. Even in Germany, the federal government and the states agree on comprehensive contact restrictions to stop the spread of the virus. +++

      The lockdown hits everyone hard. The measures are particularly drastic for people who depend on dialysis. These patients must leave the house and visit a renal care center as often as three times a week in cases with total renal activity replacement. And because the average age of these patients is just over 60 and some have multiple severe comorbidities, they belong to a risk group. In Germany, 0.3 percent of those who get COVID-19 die from it; for infected dialysis patients, this figure is 20 percent.

      After the start of the pandemic, it immediately becomes clear to the B. Braun team in Melsungen who coordinate the work of renal care centers in 30 countries that everything needs to be done to protect patients and employees. “We immediately activated our global pandemic plan, in which the specific preventive measures for every center are described in detail and implemented accordingly,” says Martin Meier, manager of Global Provider Operations. By and large, it involves the overall recording of all measures necessary during the pandemic, including hygiene, training, communication, behavior patterns, and emergency protective equipment supply. Everyone who enters the renal care centers has their temperature taken and they are asked about any health conditions.

      The pandemic also effects the routine processes inside the center, says Meier. “During weighing before and after dialysis, for example, sometimes lines form, that now needs to be prevented. The employees constantly need to be on alert to monitor the patients.” One serious challenge for the centers is staff shortages. “As soon as an employee starts showing symptoms of the disease, they’re tested,” says Meier. “Until the result comes back, however, they need to be in quarantine. This is why the schedule needs to be rewritten so often. We’re proud of our employees who kept things going at these centers and gave everything they could under difficult circumstances.”

      Patients at B. Braun renal care centers around the world, 2015–2019

      March 28, 2020

      +++ More than 750,000 people have been infected with the novel coronavirus worldwide. At its peak, Germany reports more than 6,000 new infections in a single day. German doctors’ association the Marburgerbund expresses concern over a dangerous lack of medical-grade face masks in Germany. +++

      Even a wealthy and technologically advanced country like Germany has serious trouble providing an adequate supply of personal protective equipment during the pandemic. Together with logistics services provider DB Schenker and Lufthansa Cargo, B. Braun transports 2.8 million medical-grade face masks from China to Germany. An Airbus A330 was chartered to do this—a passenger airliner. The seats and even the overhead storage compartments were packed to stow about 6,000 boxes. After landing, the masks are distributed to hospitals throughout Germany—around 450,000 are used at B. Braun facilities. 

      Hospital staff in hard-hit Bergamo, Italy. The doctors there wanted to thank B. Braun with this photo.

      May 11, 2020

      +++ Coronavirus emergency clinic opens in Berlin. +++

      Within just six weeks, an emergency clinic is set up in a hall at the Berlin Messe trade show center to relieve pressure from other hospitals as needed. The facility can hold up to 500 ICU patients. B. Braun helps with the medical facilities—primarily by supplying critical infusion pumps. Since its opening, the clinic has been in standby mode. It has yet to treat any patients but can take them in at any time.

      Completed in record time: Thanks to B. Braun's support, the emergency clinic set up in the Berlin Messe trade show center is ready to accept patients.

      July 2020

      +++ New infections in Europe decrease steadily, hospitals switch back to normal operations. The backlog of surgeries is worked out. +++

      The pandemic has countless impacts on the healthcare system. Some, such as the increased need for ICU beds, are foreseeable. Others are surprising, such as the new demand for a device called an insufflator, which can reduce the spread of deadly viruses in the operating room. This device is used during laparoscopy, a surgical procedure that utilizes small incisions made in the abdomen to insert a camera and surgical instruments. In order for surgeons to even be able to work, however, they need room to operate. This is where the insufflator comes in: a device that pumps CO2 into the abdominal cavity using a tube. These types of minimally invasive procedures have been increasing for years and have become standard for gall bladder and intestinal surgery. The surgeons usually work with high-frequency electrical surgical instruments that use current to cut tissue and cauterize blood vessels. This produces something called surgical smoke, which the insufflator can evacuate through a second tube.

      How the insufflator makes operations in corona times safer

      Marco Metzger, a junior product manager at B. Braun, is responsible for the insufflator. As he explains, “The insufflator's pumping function is essential. Without it, you can’t perform the surgery. Whereas extracting the surgical smoke is optional, though sometimes it's necessary to improve visibility in the abdomen. The surgical smoke has an unpleasant odor and is potentially cancerous. For example, in Scandinavian countries, surgical smoke evacuation is mandatory. In other countries, though, it's sometimes considered practical but unnecessary.” Then came the pandemic—and with it, surgeries also needed to be made even safer.

      The question arose, can corona viruses be emitted from the patient’s body in the surgical smoke, making it a potential route for virus transmission? By using a filter, surgical smoke evacuation can prevent a very high percentage of the probability of transmission via surgical smoke. “Since the start of the pandemic, we've observed that the demand for products involving evacuation in particular has grown sharply—sales of disposable tubes rose by around 69 percent,” reports Metzger. “This is good for us, but ultimately the surgeons and OR staff benefit from procedures being easier and safer as a result.”  

      Doctors and nurses from all over the world sent photos and letters to B. Braun. Here is one from Newport, Wales.

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