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Almost half of all regions in Germany have already exceeded the upper crown limit. The RKI warns that the situation runs the risk of spiraling out of control. So how do you deal with it? Charité Drosten’s virologist suggests looking for a new key figure who should allow a better assessment of the situation in the future.
Germany is colored red: 166 regions now exceed the upper limit of 50 new infections per 100,000 inhabitants within seven days agreed between the federal and state governments. 33 more than the day before. The president of the Robert Koch Institute (RKI), Lothar Wieler, recently described the situation in Germany as “very serious”: the virus is expected to spread strongly and also “uncontrolled” in some regions. If the trend continues, a large part of Germany will be above the upper limit above which more stringent measures such as contact restrictions must be taken.
Is there another threat of lockdown at the national level, as was the case recently in Berchtesgadener Land? Hard to say. However, there are increasing voices that, in view of the rapid development, the number of new infections should no longer be the sole measure of things to decide on measures.
Charité virologist Christian Drosten, for example, brought a new key figure into play earlier in the week: an “incidence of over 50.” By this he refers to an “age-specific incidence consideration”, that is, a look at new infections from a certain age, around 50 years. In an interview with the newspaper “Bild”, a spokeswoman for the Charité explained that the incidence of more than 50 “is a forecast of the most serious cases expected in the near future and, therefore, of the occupation of beds.” Because people of this age are at increasing risk of getting seriously ill with Covid-19.
Drosten also refers to a very similar proposal by epidemiologist Klaus Stöhr, who a few days ago in an interview with “Zeit” asked for a reorientation when looking at the situation of the crown. Stöhr criticized the fact that the focus was still on the number of new infections to decide on the “severity of measures”. However, if the whole of Germany is “paved with red circles”, the limit of 50 cases “is no longer an indicator that helps us.” The epidemiologist says it would have been more appropriate “to use an age-related drop and risk structure from the start.”
“So we are too late”
“In the case of young adults, we will no longer be able to avoid tolerating more than 50 cases per 100,000,” Stöhr said in an interview with “Die Zeit”. If, on the other hand, diseases increased among the elderly and those at risk, it was necessary to “pull the emergency brake”. It is true that the risk of a serious disease course with Covid-19 increases significantly with age, especially in an age group of 50 to 60 years.
According to RKI chief Wieler, a key figure affecting people over 50 might reflect the current picture somewhat better than, for example, hospital utilization and the number of free intensive care beds suggested by experts like alternative for new infections. Because, according to Wieler, you look back three to four weeks into the past when you look at the figures for vacant intensive care beds. “So we are too late,” he said, referring to the importance of these values in the fight against the pandemic.
A look at RKI’s management report from last Tuesday shows that more older people have recently been affected by a Sars-CoV-2 infection. From week 40 to the end of September, the incidence has increased dramatically in all age groups to a similar degree. However, from the 35th week of the calendar to the end of August, a shift towards the age groups over 50 can be seen. Its share of all Covid 19 cases increased from around a sixth to almost a third recently.
The implementation possibilities are not that good
“In particular, increases in the age groups 60 to 79 and those over 80 need to be carefully monitored,” says the RKI report. However, at the beginning of the pandemic, the proportion of people over 50 in total cases was significantly higher than today, up to two-thirds of all cases. At the same time, there were also significantly more intensive care patients and deaths in March and April.
What are the chances that Drosten’s suggestion of an “incidence greater than 50 years” will set a new benchmark for the pandemic? Not so good at the moment. The government probably does not want to implement the proposal, reports the daily “Bild”. A spokesperson for the Health Ministry said: “It is correct to react regionally to the outbreak and establish a national framework for this. The two levels of warning already provide guidance for this.” In addition to the upper limit of 50 new infections per 100,000 inhabitants in the last seven days, the warning threshold of 35 new infections is also included. If the latter is passed, the first measures should already take effect, according to an agreement between the federal and state governments last Wednesday.
