Covid-19: what went wrong in ‘exemplary’ Germany, which sees a new wave of deaths and cancels Christmas

So far, 21,975 people have died in the country of 83 million people.

Merkel’s direct and very concerned call last week was followed by the announcement of a more severe blockade in the country. The announcement was made this Sunday (12/13). The confinement will begin on Wednesday (12/16) and will last until January 10.

Now, under the national lockdown announced by Merkel, non-essential stores will close, as will schools. Remote work is encouraged. New Years events are prohibited.

These are tough measures to contain an uncontrolled increase in cases.

So what went wrong in Germany?

Summer holidays and confinement ‘light‘

Tight lockdowns in European countries during March and April provided temporary relief. With the physical distance imposed by the confinements, the chains of contagion were broken and the number of cases decreased. With that, the countries reopened their economies and many Europeans went to enjoy the summer holidays.

Those holidays contributed directly to the rise in infections, says Hajo Zeeb, a professor of epidemiology at the University of Bremen in Germany. “You could clearly see the relationship between the return of Germans from certain countries and the increase in infections in the regions of Germany to which they had returned,” he says. Furthermore, the virus continued to circulate in Germany, with an even greater spread due to the opening of services. The combination led to an increase in cases and the second wave.

And then, in response, Germany decided to adopt a “mild” lockdown in November, not as severe as the one in March and April. Meanwhile, European neighbors like France and Belgium, also in a critical situation, adopted stricter lockdowns.

Restaurants, bars and entertainment centers have closed in Germany and some regions of the country have imposed their own confinement. Schools, shops and churches remained open and restaurants could sell takeout.

In the country, the debate about the opening or closing of services has also revolved around the economy, with restaurant owners saying they would have to close their business if there was a second closure, for example, although Germany has invested in financial aid for the population.

When Merkel announced this “light” lockdown at the end of October, she was already saying that the situation was serious and that the contact tracing system could not discover the source of infections in 75% of cases.

“It’s always easier to say in hindsight. The ‘light’ blocking wasn’t enough, of course. But at the time no one could identify where the infections were spreading,” says Zeeb. Restaurants, which can be a source of infection, have been closed, for example.

For the professor, the big mistake was not to change the strategy at the end of the four weeks of this “light” confinement, that is, at the beginning of December. Even with the increase in cases, Germany only extended the partial blockade. “We should have gone into more rigid confinement when we realized that the more light had not been enough,” he says.

Just this week, already in mid-December, a stricter lockdown was announced.

Germany’s biggest asset during the first wave of infections was an acclaimed contact-tracking program.

This means having a system that identifies people who came into contact with those who tested positive for the coronavirus. In this way, they must also be isolated, so as not to contaminate other people and thus break chains of contagion.

Germany took advantage of the existing infrastructure in its 375 local public health offices to build a robust monitoring system. Public officials were relocated to work on this, and the country also recruited medical students and firefighters to work by email and phone. The country had a goal of having at least 5 followers for every 20 thousand inhabitants. A mobile contact tracker app was launched in June.

The investment in this initiative, together with the massive tests, has placed Germany in a good position to face the crisis and prevent new groups of infection.

But in the second wave things got out of control.

This time, health officials were unable to locate possibly infected people, simply because of the large number of cases in the country. According to the Robert Koch Institute, the last weekly average of cases was 176 per 100,000 inhabitants. The number makes it impossible to trace contacts, as the system only works when there are, on average, 50 cases per 100,000 residents over a seven-day period, according to the German government.

“The government can no longer comply due to the large number of infections,” says Zeeb. According to him, in addition, the spread has become so uncontrolled that infections are occurring in a generalized way in the population and not in identifiable bubbles. He says that it is now possible to identify the source of only 20% of the infections, while the origin of 80% of them remains unknown.

“People don’t know if it was on that visit to the city center, or when they met a person, or in a subway station. Now it is much more difficult to identify the origin of the infections,” says Zeeb. There are no more, he says, records of unique pollution events, such as parties, etc. “It is very widespread.”

“The only pollution bubbles we have this time, sadly, are in nursing homes.”

Age group also played an important role in the perception of what Germany was like at the beginning of the pandemic. At that time, Zeeb says, the country’s effective response to the pandemic was also helped by the profile of those infected.

“At first, it was the younger population that was contaminated. Many came back from holidays in ski resorts in Italy and Austria, and then went to meetings and Carnival parties,” he says. Italy was the country in Europe that initially suffered the most from the pandemic. “This caused a relatively low number of deaths compared to the rest of the world” and allowed the country more time to prepare its health system.

This time after summer break, the teacher says, the age distribution started in a similar way, but that has already changed. “It is reaching the older population and with that, more deaths are coming.”

And the supply of ICU beds for this large portion of the virus-infected people in the country may also be on the tightrope, according to Deutsche Welle in a report this week.

At the beginning of the pandemic in Europe, the number of beds in Germany gave the country some breathing space compared to other countries where hospitals were reaching their maximum capacity.

“We did a lot of preparatory work, we invested resources in the construction of ICUs. Some hospitals are really stressed to the limit, but in general, the system is maintained,” says Zeeb. “The biggest problem we have is the lack of personnel to work in these ICUs.”

The situation is complex, says the professor, with several factors explaining the situation in Germany now. “But unfortunately we are going in the wrong direction.”

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