Hospitals reach limits in E.coli crisis (AP)

HAMBURG, Germany – Blood specialist Dr. Cay-Uwe von Seydewitz has been making his rounds 16 to 18 hours a day, seven days a week, since the outbreak of a deadly bacterial epidemic.

The wing he's in charge of was a construction site a month ago — hastily converted back into useable space to keep up with the spike in patients needing massive blood plasma exchanges to try and purge their systems of the toxins from the aggressive, previously unknown form of E. coli.

Like other doctors, nurses and hospital staff around Germany, for von Seydewitz taking a day off has not been an option.

"If you have a new illness, it's important to have the same doctor from the start to the end to see how it changes over time," said von Seydewitz, wearing blue hospital scrubs and sporting a 5 o'clock shadow at midday, standing near stacks of supplies in brown boxes still on their pallets.

Investigators on Friday breathed a sigh of relief, saying that their epidemiological probe of the pattern of the outbreak produced enough evidence to conclude vegetable sprouts from a farm in Lower Saxony were the cause of the outbreak — even while noting that work for medical professionals was far from over. As of Saturday, the outbreak had killed 33 people and sickened nearly 3,100.

"There will be new cases," warned Reinhard Burger, head of the Robert Koch Institute — Germany's national disease control center.

In Kiel and Luebeck, which have also been hit hard in the outbreak, doctors have been taking only short naps on stretchers in hospital hallways and staying in the building for days in a row, said Oliver Grieve, the spokesman for the university hospitals in the northern cities.

Others canceled their vacations or called in from hospitals around the country to offer their help for overwhelmed clinics in northern Germany.

"There has been a very high level of commitment," Grieve said. "It is amazing to see how everyone has done the utmost to help out in this crisis."

More than 700 of the patients in Germany are suffering not only from diarrhea and cramps but have also developed a life-threatening complication that can cause kidney failure, and require round-the-clock medical care.

Dr. Friedrich Hagenmueller, the medical director of Asklepios Hospital Altona, the hospital where von Seydewitz works which has seen about 200 patients total, noted that with such an illness it's not just the doctors and nurses working overtime but the cleaning staff.

"We brought people back from the holidays — they must constantly clean and disinfect the toilets," he told The Associated Press during a break in making his rounds. "The turnover of the patients is relatively quick, and when a patient is released they have to quickly clean and disinfect the toilets and I haven't heard a word of complaint."

While the numbers of newly infected patients are slowly declining, hospitals are still working to the limit with hundreds of people still in intensive care. Earlier this week, health authorities said there were still some 670 patients suffering from severe complications including kidney failure, paralysis and epileptic seizures.

"We still have some extra 12 dialysis nurses from southern Germany working with us" at the university hospitals in Kiel and Luebeck, Grieve said.

At Asklepios Hospital in Hamburg this week, von Seydewitz was overseeing 22 patients undergoing blood plasma exchange to try and remove the toxins from their system. In the procedure, doctors remove which four liters (quarts) of blood plasma and replace it with fresh plasma for three days in a row — or longer if needed.

At the start of the outbreak von Seydewitz said he only had two machines to perform the relatively rare procedure, but since then has leased more machines, and borrow others from the hospital's dialysis treatment area and now has a total of eight functioning.

"Now we also have patients from other hospitals for the procedure as well," he said.

With the high demand for blood plasma, Germany's Red Cross has begun special blood drives.

In normal times, hospitals need between 500 and 700 250 milliliters (8.5 fluid ounce) portions of blood plasma in 14 days, they used 12,000 portions in the last two weeks, said Jense Lichte from the Red Cross.

People responded, with donations up 14.5 percent since the outbreak began, he said.

"Luckily, Germans have been coming to our blood drives," Lichte said, saying that despite the high demand the country never ran close to a real shortage.

In addition to physical exhaustion, some doctors say the epidemic has also taken a high emotional toll.

"It has been very stressful for all of us because we are dealing predominantly with younger patients without significant previous diseases ... many of us were deeply moved when a lot of these cases developed in such a dramatic way," said Marc Voss, a senior internist at Regio Clinic Elmshorn northwest of Hamburg. "The identification with the patients is very high, because one thinks 'it could have been me.'"

Some 77 percent of patients in Germany are women and the majority of them are between 20 and 50 years old, most fit and with healthy lifestyles.

"Our staffers are used to seeing very severe cases," said Grieve. "But to see those young, healthy girls break down from one day to the next, getting cramps and slipping into coma — that's been the most stressful thing ever."

Grieve added that even the psychologists at the hospitals were working day and night to comfort the traumatized family members of the sick who have been waiting for weeks in some cases for signs of recovery.

Karolin Seinsche, 29, has been in the hospital for the last two weeks slowly recovering from seriously complications from the sickness.

In that time she said she has received 11 blood exchanges on von Seydewitz's floor, and needed near constant care when she was first admitted to the intensive care ward with bloody diarrhea and cramping.

"There were a lot of ups and downs," she said, lying in her bed near the window, propping her head up with a pillow. "Just when I'd think it was getting better it would then get worse again — but now it's stable."

A vegetarian, Seinsche said she did not see herself doing an about-face on her eating habits, but that the sickness was so frightening and recovery so long that she was going to double wash everything before she ate it in future — even bananas.

"I've never done that before — who does — but now I will," she said.

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Grieshaber reported from Berlin, Dorothee Thiesing contributed from Elmshorn, Germany.

Merkel: debt crisis mustn't endanger economy (AP)

BERLIN – German Chancellor Angela Merkel said Saturday that it's important to avoid doing anything that could endanger the global economic upswing as Europe battles the debt crisis in Greece and beyond.

Merkel's government is willing to grant Athens further aid but wants Greece's private creditors to share the burden — something the European Central Bank opposes. Still, the head of a group that represents German private-sector banks signaled readiness to discuss the proposal.

A strong recovery in Germany, Europe's biggest economy, has yet to be dented by debt woes elsewhere in the 17-nation eurozone.

Asked in her weekly video podcast whether the crisis could endanger Germany's upswing, Merkel replied "if we don't act right, that could happen, but that's exactly what we want to avoid."

"That's why we say that we cannot simply allow an uncontrolled bankruptcy by a country," Merkel said, adding that Europe needs to see how it can help struggling countries improve their competitiveness and also allow them to reduce their debts. She didn't mention Greece by name.

"We must do nothing that endangers the global upswing as a whole and would then put Germany in danger again," she added.

Merkel recalled that the German economy contracted by nearly 5 percent in 2009 following the global financial crisis — "there hadn't been anything like it in decades, and anything like that absolutely has to be prevented from recurring."

Merkel's finance minister, Wolfgang Schaeuble, is pushing for Greece to get more rescue loans only if investors agree to get repaid seven years late on their Greek bonds. That would give the country more time to get a handle on its euro340 billion ($491 billion) in debt.

That demand is meant to rally support among the public and, particularly, lawmakers in Merkel's center-right coalition — some of them restless at the idea of giving Greece more money.

However, the ECB says Greece must not change the terms of its debt in ways that put it in official default.

Ratings agencies have said that a bond repayment that materially disadvantages bondholders would be considered a default. Germany has remained vague about key details, such as interest rates and any collateral provisions.

The general manager of the Association of German Banks gave Schaeuble's proposal a cautious welcome, signaling that banks might be prepared to go along with it — though he also stressed it is important "to see that we don't endanger financial market stability."

"The concept must be made more concrete," Michael Kemmer said on Deutschlandfunk radio. At the moment, "several important details, are missing, so that we can't say at the moment that this is suitable and we can participate."

"In principle, it is something we can talk about," he said — though he stressed that any solution must be voluntary. Greece owes German banks some euro10 billion.

Goldman Sachs subpoenaed for financial crisis role (Reuters)

NEW YORK (Reuters) – New York prosecutors have asked Goldman Sachs to explain its behavior in the run-up to the financial crisis, the latest investigation that has cast a pall over the reputation of the largest U.S. investment bank.

Goldman Sachs Group Inc now faces probes by several government authorities into derivatives trades it executed in late 2006 and 2007. On Thursday, sources close to the matter said Goldman received a subpoena from the Manhattan district attorney, who joins the Justice Department and the Securities and Exchange Commission in examining Goldman's actions.

Separately, New York Attorney General Eric Schneiderman is investigating Goldman as part of a broader probe into the mortgage operations and securitization practices of seven banks. A source familiar with the situation said Schneiderman's office met Goldman executives and attorneys in the past two weeks.

The probes follow a scathing report by U.S. lawmakers that cast Goldman as a central villain of the financial crisis and accused it of misleading clients about mortgage-linked securities.

The report by a Senate subcommittee, headed by Democrat Carl Levin, said Goldman offloaded much of its subprime mortgage exposure to unsuspecting clients as the market for such securities was starting to tank. In some cases, the bank dragged its heels when clients wanted to get out of their losing positions, according to the report.

The investigations do not imply the bank or its top executives will face criminal or civil charges, but they display a growing interest by prosecutors to build a case against Goldman, legal experts said.

"They have subpoena power to get certain records, correspondence, emails and they're trying to find out every last detail that could prove fraud," said Peter Berlin, an attorney who represents defendants in white-collar cases.

The U.S. Department of Justice is also likely to subpoena the bank, The Wall Street Journal reported recently.

The Manhattan district attorney, Cyrus Vance, is not seeking new documents, according to one source, but wants to ask further questions about the information contained in the Levin report.

Vance, the son of former U.S. secretary of state Cyrus R. Vance, said earlier this year he wanted to use a far-reaching 1921 law called the Martin Act to toughen penalties for securities fraud.

The state attorney general's probe is largely being conducted under that statute, according to the source familiar with that case. The state can seek civil or criminal charges, while the Manhattan D.A. can only pursue criminal charges, potentially making its burden of proof more difficult.

Still, the Manhattan D.A.'s office has used the Martin Law to crack down on white-collar crime in the past. High-profile cases the office prosecuted using the Martin Act include brokerage firm A.R. Baron & Co and ex-Tyco chief Dennis Kozlowski.

In a statement, Goldman said: "We don't comment on specific regulatory or legal issues, but subpoenas are a normal part of the information request process and, of course, when we receive them we cooperate fully."

Both Levin's and Vance's offices declined comment on Thursday.

SCATHING REPORT

The probes into the behavior of Goldman and some of its peers signal increasing determination by U.S. government agencies to investigate the actions of banks in the years leading up to the financial crisis and to determine whether misdeeds by executives made the meltdown worse.

One of the first big cases was the Securities and Exchange Commission's civil fraud suit against Goldman last year over the bank's failure to disclose information linked to a complex mortgage security. Goldman settled those charges in July without admitting or denying guilt, but it did express regret for failing to disclose information.

Goldman's shares fell as much as 3.4 percent as news of the subpoena emerged on Thursday, but then took back much of their losses and closed 1.3 percent down at $134.38. The stock has been declining since January, but its sell-off has accelerated since the release of the Levin report and it is now approaching its 52-week low of $129.50.

Even if there is a low likelihood of successful civil or criminal action against Goldman Sachs, continued pressure from politicians and the public could still hurt the firm, Sanford Bernstein analyst Brad Hintz wrote in a note on Wednesday.

"We believe that Goldman's clients will begin to rethink their relationship with the firm and the franchise will ultimately suffer," Hintz wrote, adding the bank would be wise to make amends with the public soon.

But other veteran analysts said recently that concerns about the Goldman investigations are overblown and little will likely come from them.

JPMorgan analyst Kian Abouhossein raised his rating on the bank to "overweight" from "neutral" earlier this week and said possible negative news is already reflected in the bank's share price.

However, some investors take a more negative view.

"When the government has you in its cross-hairs, it takes forever to get out of it," said Matt McCormick, portfolio manager at Cincinnati-based Bahl & Gaynor Investment Counsel.

"Shareholders need to understand, this is going to be an ongoing risk for years."

(Reporting by Lauren Tara LaCapra; additional reporting by David Gaffen, Maria Aspan; editing by Dan Wilchins, John Wallace, Matthew Lewis and Andre Grenon)