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How many new corona infections do we have by Christmas? When are hospitals in Germany full? Researcher Thorsten Lehr has developed a simulator that can answer that. A conversation about the effect of school lockdowns and closures, a third wave, and protecting the elderly.
t-online: Mr. Lehr, you have developed an online simulator that can predict the future of the pandemic in Germany and it is freely available online to everyone. What is the forecast for the winter if the measures in Germany remain as before?
Thorsten Lehr: Of course, we don’t know exactly what will change in the coming weeks. But first of all it seems that Playback number R it doesn’t change much. In the short term, it is very possible that in two to three weeks the number of 20,000 new infections with the Coronavirus is reached. I hope, of course, that we are wrong with our forecasts. But that is the common of exponential growth, that at some point the numbers increase very quickly.
What if Germany immediately reintroduced stricter measures across the country?
Even if theoretically we are immediately very rigorous, one Emergency shutdown If similar measures were taken to push the R-value back below one, the number of infections would only change after a significant delay. But I’m still hopeful that people will become more wary of more and more new infections and Covid patients in the hospital, simply because of self-preservation.
Are we already in the dreaded second wave?
We are very likely to do so when we look at the number of infections. The question is whether there will be a third wave. But we still can’t say that.
Your simulator can predict the course of corona infections quite accurately. How does it work
Of the Covid-Simulator Based on a model, here we have also included the number of patients treated in clinics and we can differentiate between federal states, which in some cases have very different geographic conditions.
Thorsten Lehr, professor of clinical pharmacy at the University of Saarland, explains the graphs of the calculations from the online simulator Covid19. (Source: Pasquale d’Angiolillo)
Where do you get the data from?
We are busy with data research every day. Unlike other countries, Germany does not have a central database in which all data is collected. That is why we collect data from Robert Koch Institute, from health authorities, counties and ministries. We also receive data from hospitals on corona patients who are being treated as inpatients.
Do we have to expect a similar number of Covid-19 patients in intensive and normal care units again soon, like in the peak hours of the first wave in mid-April?
If the infection rate does not change and Covid-19 patients do not age on average, hospital occupancy figures can be expected in two to three weeks, as we saw at the height of the first wave. Existing intensive care beds could be full by the end of November. However, there is still an emergency reserve available that can be activated in a week.
That still sounds somewhat disturbing …
What worries me is that the number of infected older people is increasing again, currently those over 60 years old represent between 15 and 16 percent of those infected, and these people have a severe course much more frequently and end in the hospital much more frequently.
Should older and high-risk patients now protect themselves as much as possible for their own protection?
Generally yes. But it also has to do with quality of life. Of course, we must protect the elderly without isolating them. But it won’t be easy. It is important that those who have a closer contact with the elderly, such as family members, behave with the greatest possible care and stay away from symptoms.
How reliably can predictions really be derived from previous experience? After all, we are now experiencing the pandemic for the first time in the cold season for a long time. And temperatures not only influence the survival time of the virus, but also our daily behavior.
In fact, some things are not predictable yet. What can be predicted pretty well from the current infection rate is the number of Covid-19 patients in the hospital, the death rate, the number of people who have recovered.
But special situations like now in winter, where more people spend more time indoors, are harder to predict. We just don’t know the exact social interactions, such as the distance people maintain from one another in certain situations. That makes it difficult. We still cannot answer what happens when the flu wave starts and the corona and flu waves overlap.
Your model can run in several possible scenarios. What policy interventions could reduce the R-value particularly quickly, and which of the currently applicable measures are less effective?
Of course, measures like school closings, mandatory masking, and summer vacation have a statistical influence. What it shows is that the closure of schools had a fairly large effect, with a 40 percent reduction in the R-value. The effect of the closure was equally large.
But the effect of individual measures cannot be measured with certainty?
Of course, it is difficult that at the beginning of the pandemic several measures were introduced simultaneously or in rapid succession, whose effects overlap. School closures also mean more parents are staying home and fewer people use local public transportation.
I think the best way to lower the R-value right now is by cutting back on large group parties and going out at night and making sure not too many people are gathering in tight spaces.
So, are the current rules enough?
The measures currently in force should be sufficient if they are complied with. Life has to go on, but of course we have to see how we can live relatively well with the pandemic. Another lock is certainly not the solution.
Many researchers believe that people who wear mouth and nose protection when they come into contact with an infected person ingest smaller amounts of the virus, which in turn could lead to a milder infection. Can the simulator take these things into account?
As a pharmacist, I work with virologists and I also think: the dose produces the poison. This is known from animal experiments and can also be seen from the fact that severe courses were always there where people were exposed to a high dose of virus, that is, in narrow, closed rooms where people inhaled and they exhaled deeply. This is shown in the Ischgl example.
And this is also shown in our model: the rate of those treated in the hospital has decreased after the age structure was corrected. This may be because the gradients across the masks are less severe, but also at a higher test rate. Also, of course, healthcare workers now know how to better treat infected people and there are also drug treatment options like corticosteroids.
As a pharmacist, when do you expect a vaccine?
A lot of energy goes into the corona pandemic investigation, so I am quite optimistic. From a pharmaceutical point of view, a Corona vaccine but probably not before the middle of next year. In the end, safety alone is not enough, the vaccine must also be effective and without long-term consequences, and be available. Vaccines are organically produced; producing large quantities simply takes time, similar to brewing beer.
Your information is intended to help politicians and the health sector make decisions. Is that already happening?
Yes, we regularly inform the Saarland ministries and we also make our data available to the other ministries. We also want to further develop the simulator and make it usable for district levels as well as other countries.
Thanks for talking to us, Professor Lehr!
