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Pensioners who carelessly pass other shoppers to the supermarket despite the crown crisis should await hateful comments. According to current knowledge, Covid-19 is particularly dangerous for older people: deaths counted in relation to the pandemic in Germany average 81 years. Contact restrictions apply to everyone.
Especially at a time when the world is looking for ways to live permanently with the pandemic: there will be a vaccine in a year and a half as soon as possible, if there is any, that measures are being taken to especially protect risk groups , while the rest of the population is almost normal. lives in. Whether the approach works depends on what is meant by “protection.”
British scientists pursue a radical concept in a recent study. Accordingly, the crown measures for millions of Britons could be relaxed if those over 70 and their direct contacts were protected. That would mean not leaving the house, not attending any gatherings, not even family celebrations, and avoiding contact with anyone who may be infected.
“Unlike a general strategy for all, we focus on protecting those who are most in need of public health care,” said one of the authors, Mark Woolhouse, the “Guardian.” Covid-19 is a dangerous condition, emphasizes the epidemiology of the University of Edinburgh. “But for 80 percent of the population, it’s not so bad that one should consider paralyzing the entire country.”
The principle of segmentation and shielding.
The researchers call their concept “Segmentation and Shielding”, in German “Segmentation and Shielding”. The idea: the population is divided into those who are particularly at risk, their direct contacts, and everyone else. The researchers included all people over the age of 70 in the risk group, as well as people who were asked by the UK government to protect themselves and need care; a total of about 20 percent of the UK population.
To this end, British researchers generally expect another person who will inevitably be in direct contact with these particularly vulnerable people, either from their own family or in a medical facility. According to this rough estimate, it is about 40 percent of the population to prevent serious Covid-19 disease. The rest could allow for more freedom: as long as they follow hygiene standards, all infections are constantly tracked and suspicious cases are quarantined.
The 20 percent of the population serving people at risk would not even have to meet strict contact restrictions if they are regularly tested for the new coronavirus. Ideally every day.
The researchers went through the effects of segmentation and shielding in various scenarios. Therefore, relaxation would lead to a second wave of infections, peaking 141 days after the end of the strict closure, that is, after approximately four and a half months. However, the course of infection would be different in the individual groups (see graph).
Even at the height of this outbreak, according to the calculation, there would not be as many people at risk as at the peak of the first wave. After all, Britain has experience with the concept, and it’s not a good one. Britain has already tried to control the pandemic by adjusting to contact restrictions, especially for high-risk groups, and keeping life almost normal for the rest.
The plan, now known as “collective immunity” (why the term is misleading, read here). It failed with an accident. As the number of cases increased rapidly, the British healthcare system was quickly overwhelmed. The disaster peaked when Prime Minister Boris Johnson of all places ended up in a London intensive care unit because he had Covid-19. Shortly before, he had bragged about shaking hands with Corona patients. The number of infections did not decrease until Britain was in a hurry to impose strict contact restrictions.
Despite the reversal, Britain has now had more Covid-19 related deaths than any other country in Europe. For the British government, this is not evidence of political failure. The number of deaths is not comparable internationally, said Foreign Minister Dominic Raab. But who likes to admit mistakes?
The new start of immunization also awaits a number of infected people. Based on the model’s calculation, of the remaining 80 percent of the population that the study believes is not at acute risk, significantly more people would become infected than in the first wave. But because they are less likely to become seriously ill, the health system is unlikely to collapse. After 141 days, the infection curve would gradually flatten, provided that once infected, at least for a certain time, they are immune.
Among the authors of the current analysis is Graham Medley, who leads a group of scientists advising the British government on pandemic issues. He was one of the first researchers to reflect on how the UK population could achieve herd immunity when the epidemic spread across the country.
The current study seems like an attempt to get the idea back. The epidemic part two: with additional protection measures, but with the old basic idea: the young continue to live almost normally, only the old have to be permanently quarantined.
In the document, investigators deny the suspicion. “We expressly believe that no level of infection in a population group is acceptable,” they write. Covid-19 could be a serious disease in all age and risk groups. “However, we believe that Covid-19 can be controlled in the non-vulnerable population with conventional measures, including good clinical care and appropriate public health measures, without resorting to general population blockade.”
Also in Germany, there are increasing demands to relax contact restrictions for everyone and to specifically protect at-risk groups. A corresponding petition has been collecting signatures since early May, with little response so far.
“Paternalistic guardianship”
Constitutionalists also warn that the restrictions may not apply to everyone in the long term. “Of course, in the medium term there will be a lot to be said to differentiate between risk groups and those groups that are particularly at risk from the coronavirus to demand more of their own freedom restrictions than others,” wrote Hanno Kube, professor. of public law of the University of Heidelberg in a blog for constitutional questions, which was also quoted by the Bundestag scientific service.
But not everyone is convinced. A preventive segregation of individual population groups, for example the elderly, “only for its own protection can be rejected as paternalistic paternalism,” says a well-considered statement from the Leopoldina National Academy of Sciences. (Read more about the concerns here.)
Whether it is legally and ethically justifiable to shift the burden of restrictions primarily to risk groups depends on the rules that apply to them. If more than 70 years of age were to stay home, as the British study predicts, approximately every sixth person in Germany would have a state-prescribed window seat, at least 13.2 million people.
But is there only a way to permanently lock up high-risk groups, possibly for the next year and a half, until there is a vaccine?
Virologist Alexander Kekulé recently warned in a guest post for “time” that it is ethically unacceptable to decide for further relaxation without protecting the elderly. However, the British model goes too far for him, he said at the request of SPIEGEL. “I think it is questionable to protect risk groups primarily by delimitation,” said Kekulé.
Freedoms would be greatly reduced, although a milder medium would be possible. Hygiene concepts and preventive tests for the coronavirus could make visits to care centers possible again. “Equipped with professional infection protection masks (FFP2 masks),” argues the virologist, “older people could leave the house and go with people without risking their lives through Covid-19.”
