[ad_1]
In Germany, health authorities reported 21,866 new corona infections to the Robert Koch Institute (RKI) on Thursday in 24 hours. Compared to the previous day (18,487 new infections), the value has increased significantly again, also compared to Thursday of last week: on November 5, 19,990 new infections were reported.
The numbers only show a small section of an infection process that is subject to fluctuations. If you choose the key figures from Tuesday this week, the picture is different: while 15,332 new infections were reported on Tuesday (an increase compared to the day before in 1969 cases), the number was a week earlier, on Tuesday, March 3. November, even slightly higher (15,352 new infections).
Rapid growth is weakening
Depending on the section you are looking at, this can quickly generate fear or hope. Is the spread in Germany already weakening? Are the closure measures already in force? Can we expect relaxation soon?
There is still much open, but one thing is clear: according to the RKI, it will take two to three weeks until the effect of the partial closure, which began last Monday (November 2), with the closure of several facilities becomes clear. This roughly corresponds to the length of time between infection, the appearance of the first symptoms, testing, and detection. However, data from the corona monitor from the Federal Institute for Risk Assessment (BfR) had shown that respondents were already more cautious before the shutdown. This effect, like certain measures, such as the regional curfew, could already be felt.
However, looking at the evolution of the figures since the end of September, it is clear that the rapid growth is currently weakening. The following example may illustrate this: On September 23, the RKI reported new infections according to Nowcasting 2009. This number had doubled after 13 days, after another 9 days, and after 11 days, and on October 26 it was 16,455 new infections. If the pandemic continued to spread at this speed, we would have had around 33,000 new infections in Germany a few days ago.
But that’s not the case, the previous high was reached on Saturday with 23,399 reported cases. So the numbers continue to grow, but currently not as fast as in October – the curve is flattening out. Therefore, RKI chief Wieler was “cautiously optimistic” at a press conference on Thursday. It is true that you do not know if it is a stable development, but “that shows that we are not at the mercy of this virus,” said Wieler.
Possibility of post-registration of positive tests
Another indicator also gives hope: the so-called 7-day R-value. The R-value given by the RKI in your daily situation reports indicates how many people are infected by an infected person. Because the R-value is subject to strong fluctuations, for example due to late reports, the RKI also gives the R-value of 7 days, which reflects the infection process 8 to 16 days ago and is more accurate.
Over the past nine days, the 7-day R-value was seven times below one according to the RKI’s daily situation reports, most recently on Wednesday night at 0.81. This means that 100 infected people infect 81 more people. If the 7-day R-value is below 1 for a longer period of time, the infection rate decreases. According to the TAZ, the RKI had to repeatedly correct up the 7-day R-value due to late reports of positive tests. It remains to be seen whether this will also be the case for the values of the last few days.
“No trend change yet”
Another restriction is that laboratories are currently reaching their capacity limits with increasing frequency and corona tests are stalling. That could explain the delay in reporting. However, Federal Minister of Health Jens Spahn (CDU) sees signs that the infection situation is improving, even if he cannot ask for a trend reversal. “What we can see is that the dynamics has slowed down significantly in the last few days. It continues to increase, but it is increasing less strongly,” Spahn told RTL. Ute Rexrodt, who analyzes the infection rate at RKI, also underlined this fact: “The numbers could skyrocket much worse.” The fact that this does not happen is a great success, thanks to the population, to all those who abide by the rules. “Is not sufficient”.
Because even if the 7-day R-value falls and new daily infections no longer rise as strongly, there remains a decisive factor that has a significant influence on current development: the number of seriously ill people, which is usually only visible with delay . How many people must be treated in the hospital, how many even in intensive care units? How old are people who are currently seriously ill? And how many die from Covid-19?
“There is still no change in trend at the level of normal wards,” says Clemens Wendtner, chief physician for infectious diseases at the Munich Clinic Schwabing. “There, the number of patients you have to see is continually increasing.” Some of those affected come with symptoms of Covid 19 diagnosed at an early stage, so an intensive stay can be prevented with the right treatment. In addition, there are now some drugs available to doctors whose effectiveness has not yet been proven in the spring. “With the active ingredient dexamethasone, I have the impression that the time in the intensive care unit is shortened a bit,” says Matthias Kochanek, head of internal intensive care medicine at the University Hospital Cologne. But it is still too early to draw reliable conclusions from current figures.
Warning looking outside
In general, beds in intensive care units also fill up at least less quickly than feared. The weekly increase in the number of intensive care beds occupied by Covid 19 patients was around 65 percent on Oct. 26, but on Nov. 10 it was “only” around 30 percent.
This is not entirely clear, because the absolute number of patients who must be treated in intensive care units continues to increase. One important reason: “What we are currently seeing in intensive care units shows the infection process from two weeks ago,” Wieler said, because if a person is seriously ill it only becomes apparent after some time after infection. According to the Divi (German Interdisciplinary Association for Intensive and Emergency Medicine) registry, 3168 intensive care beds are currently occupied (as of November 12), 29 more than the previous day. More than half of the patients are artificially civilized. Thus, the number of free intensive care beds reported by hospitals has now been reduced to 6652. Hospitals also reported an emergency reserve of another 12,305 intensive care beds that could be installed in a week. However, there is a lack of nursing staff to attend to them.
“We are currently observing that the median age of onset has increased markedly since early September,” said Divi President Uwe Janssens. “The proportion of people over 60 years of age is now increasing again disproportionately. Therefore, it is to be feared that the proportion of cases of hospital treatment will also increase and consequently the number of cases of intensive hospital treatment will also increase.” .
Data on the age distribution of patients would be important to assess how the situation is developing in intensive care units. “Unfortunately, these are not open access,” criticizes Viola Priesemann, director of the Neural Systems Theory Research Group at the Max Planck Institute for Dynamics and Self-Organization in Göttingen.
In simple terms, this means: neither doctors nor other experts can currently predict how the situation in Germany will develop in the coming weeks and whether the partial shutdown can actually be lifted by the end of November. “We still have spare capacity in intensive care units in Germany, but this is finite both in terms of beds and staff,” Wendtner said. “European neighbors should be a warning to us: even at the beginning there was only a slow occupation of intensive care capacities in late summer, before the system as regards intensive care beds appears to be overloaded in November.”
