The COVID-19 pandemic has caused strains on health systems worldwide disrupting routine hospital services for all non-COVID patients. Within this retrospective study, we analyzed inpatient hospital admissions across 18 German university hospitals during the 2020 lockdown period compared to 2018. Patients admitted to hospital between January 1 and May 31, 2020 and the corresponding periods in 2018 and 2019 were included in this study. Data derived from electronic health records were collected and analyzed using the data integration center infrastructure implemented in the university hospitals that are part of the four consortia funded by the German Medical Informatics Initiative. Admissions were grouped and counted by ICD 10 chapters and specific reasons for treatment at each site. Pooled aggregated data were centrally analyzed with descriptive statistics to compare absolute and relative differences between time periods of different years. The results illustrate how care process adoptions depended on the COVID-19 epidemiological situation and the criticality of the disease. Overall inpatient hospital admissions decreased by 35% in weeks 1 to 4 and by 30.3% in weeks 5 to 8 after the lockdown announcement compared to 2018. Even hospital admissions for critical care conditions such as malignant cancer treatments were reduced. We also noted a high reduction of emergency admissions such as myocardial infarction (38.7%), whereas the reduction in stroke admissions was smaller (19.6%). In contrast, we observed a considerable reduction in admissions for non-critical clinical situations, such as hysterectomies for benign tumors (78.8%) and hip replacements due to arthrosis (82.4%). In summary, our study shows that the university hospital admission rates in Germany were substantially reduced following the national COVID-19 lockdown. These included critical care or emergency conditions in which deferral is expected to impair clinical outcomes. Future studies are needed to delineate how appropriate medical care of critically ill patients can be maintained during a pandemic.

[1] Using the updated Singapore wind from 1953 to 2007 for the lower stratosphere 70-10 hPa, courtesy of Barbara Naujokat of Free University of Berlin, we examine the variation of the period of the Quasi-Biennial Oscillation (QBO) as a function of height and its modulation in time by the 11-year solar cycle. The analysis is supplemented by the ERA-40 reanalysis up to 1 hPa. Previously, it was reported that the descent of the easterly shear zone tends to stall near 30 hPa during solar minimum, leading to a lengthened QBO westerly duration near 44-50 hPa and the reported anticorrelation of the westerly duration and the solar cycle. Using an objective method, continuous wavelet transform (CWT), for the determination of local QBO period, we find that the whole QBO period is almost invariant with respect to height, so that the stalling mechanism affects only the partition of the whole period between easterly and westerly durations. Using this longest data set available for equatorial stratospheric wind, which spans five and half solar cycles (six solar minima), we find that in three solar minima, the QBO period is lengthened, while in the remaining almost three solar cycles, the QBO period is lengthened instead at solar maxima. We suggest that the decadal variation of the QBO period originates in the upper stratosphere, where the solar-ozone radiative influence is strong. The solar modulation of the QBO period is found to be nonstationary; the averaged effect cannot be determined unless the data record is much longer. In shorter records, the correlation can change sign, as we have found in segments of the longest record available, with or without lag.

In this paper we present numerical simulations of two-dimensional turbulent convection on a hemisphere. Recent experiments on a half soap bubble located on a heated plate have shown that such a configuration is ideal for studying thermal convection on a curved surface. Thermal convection and fluid flows on curved surfaces are relevant to a variety of situations, notably for simulating atmospheric and geophysical flows. As in experiments, our simulations show that the gradient of temperature between the base and the top of the hemisphere generates thermal plumes at the base that move up from near the equator to the pole. The movement of these plumes gives rise to a two-dimensional turbulent thermal convective flow. Our simulations turn out to be in qualitative and quantitative agreement with experiments and show strong similarities with Rayleigh-Bénard convection in classical cells where a fluid is heated from below and cooled from above. To compare to results obtained in classical Rayleigh-Bénard convection in standard three-dimensional cells (rectangular or cylindrical), a Nusselt number adapted to our geometry and a Reynolds number are calculated as a function of the Rayleigh number. We find that the Nusselt and Reynolds numbers verify scaling laws consistent with turbulent Rayleigh-Bénard convection: Nu ∝ Ra 0.31 and Re ∝ Ra 1/2 . Further, a Bolgiano regime is found with the Bolgiano scale scaling as Ra −1/4 . All these elements show that despite the significant differences in geometry between our simulations and classical 3D cells, the scaling laws of thermal convection are robust.