Across Germany, government agencies and hospitals are assessing whether the healthcare system could withstand a major armed conflict, a mass influx of wounded, and drone strikes. Bloomberg reported this on September 16.
According to Bundeswehr estimates, in a war on NATO’s eastern flank, 300 to 1,000 wounded service members could be evacuated to Germany every day, with about a third requiring intensive care. The country’s five military hospitals would quickly reach capacity. Civilian clinics are legally required to step in during wartime, meaning they would have to treat soldiers and civilians at the same time and carry out triage.
Authorities at the military hospital in Ulm are considering bringing a Cold War-era underground medical bunker back into service. Completed in 1979, it was designed to hold 2,000 people and operate independently for up to 90 days. Restoring it would require upgrades to ventilation and power systems. Other hospitals are examining drone protection — bullet-resistant glass and physical barriers — stocks of medicines and supplies, operations during power outages, and the use of underground parking garages as shelters.
The preparations have accelerated since Russia’s full-scale invasion of Ukraine and a rise in hybrid attacks inside Germany. Bloomberg cites an attempted strike with an explosive-laden drone on Leipzig Airport last month and cyberattacks on hospitals. Defense Minister Boris Pistorius has warned that Russia could be able to attack NATO territory by 2029. Given its location, Germany would become a key rear and transit hub: troops would move east, the wounded would come back west.
Staffing is a separate problem: only a few hundred German doctors have experience treating combat injuries. The Bundeswehr and the German Trauma Society are running courses for civilian surgeons on mass casualties and wartime wounds. Federal Health Minister Nina Warken said medical facilities are building up stocks of drugs and surgical materials and strengthening resilience to armed conflict.
Experts stress that beds alone are not enough. The system also needs reliable medicine supply chains, coordinated military-civilian operations, and a legal framework for a defense or alliance scenario. For now, the healthcare system is not ready for that.
