Some of the ICEs to Duesseldorf and beyond could run via Moenchengladbach though, presumably (although loads of trains from the latter to Duesseldorf these days)? I seem to recall that some took that route in the 80s?
Otherwise, it's much like the GB network: if all worked as per timetable, Koeln Hbf would be fine but there is only a little ability to handle out of course running. One day in June 22, the service seemed to completely meltdown with trains stuck in all directions.... that was a sight to behold! Took about 1.5 hours to unblock...
In realtime, Northbound ICEs can be routed via the West of the City and then from the Northwest end of the Hbf. en route to Duesseldorf. I would guess this takes about 10 mins longer, but avoids the delays associated with reversing moves when all tracks are busy....
Btw, the S-Bahn lines on the branch are non-exclusive and are used by some RB and I think RE trains as well.