National COVID-19 patient reallocation scheme

The cloverleaf-concept (cc) is used when intensive care units in certain hospitals in Germany are overloaded and the coordination of distribution of affected patients who are requiring intensive care to other cities or even other states becomes necessary. This should enable all patients to receive a comparably high, comprehensive level of treatment in accordance with current medical standards. Within this concept Germany is divided into five parts, like a five-leaved clover. These parts are: North, East, South, South-West and West. One leaf includes one to five states with strategic and operational maangement stakeholders. Within the leaf one state is nominated as single point of contact (SPoC). SPoCs function as regional coordinating authorities. The SPoC describes the patients to be transferred according to an agreed protocol, which is the basis for the requested SPoC to search for a clinic. The patients can be transferred regionally or nationally. If the states within one leaf still have capacity, the patients are transferred regionally. If the capacities in one leaf are exceeded the patients are transferred nationally. East cloverleaf activated the cc in 12/2020 to transfer the patients regionally. The South and East cloverleaves activated the cc in 11/2021 due to high regional congestion. Since then, strategic transfers over greater distances for capacity balancing took place throughout Germany. In the fourth wave, 34 patients were flown out from Saxony into other states