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On March 8, 2020, a German citizen died for the first time as a result of an infection with Sars-CoV-2. Thomas Falk, a 59-year-old firefighter from Hamburg, died of severe pneumonia while on vacation in Egypt. The first two deaths in Germany occurred a day later. A 78-year-old man from the German crown’s first hotspot, Heinsberg, and an 89-year-old woman from Essen died.
Now, at the end of October, the number of those who died in Germany “from or with the coronavirus” has passed the 10,000 mark. Since the middle of the year there were more than 9,000, but for a long time there were only comparatively few deaths. There were days when no one died from Sars-CoV-2. Currently, not only the number of infected is massively and unprecedentedly increasing, but intensive care units are also filling up every day. The trend in the number of people dying every day has also increased.
Do people die from or with the virus?
Almost from the beginning it is debated whether and to what extent all those who died officially in connection with an infection actually succumbed to the consequences of the virus. The fact is that the proportion of deceased who had previous serious illnesses or who were very old is high. But it is also a fact that Thomas Falk from Hamburg, for example, who probably had a previous unrecognized illness in the background, with a very high probability would still live without the virus and save lives as a firefighter.
Many of the deceased went through immeasurable agony, which would have been spared if their weak hearts had stopped beating in the near future. And in the phases with a high number of people infected in the spring, more people died overall than the usual average in the comparable period of previous years. So there was a measurable “excess mortality” that was almost certainly due to the virus.
Is the virus “less deadly” now?
Currently, the death toll is significantly lower than in the spring despite the high documented infection rates. That raises questions: Has the virus been genetically changed to be less deadly? Has it always been less fatal than the statistics seem to suggest? Have life-saving treatment options improved?
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In fact, it would not be unusual for the pathogen to weaken over time. Such a scenario simply makes sense from an evolutionary point of view: a germ that kills its victim very quickly and is clearly noticeable through severe symptoms is less likely to spread than one that allows the infected person to have contact with other people during the as long as possible. . Therefore, the corresponding mutations should prevail.
Currently, there is nothing to indicate that such a change in the virus has taken place on a significant scale. This may also be due to the fact that the virus generally does not cause life-threatening courses anyway and that it has enough time to spread in the non-symptomatic phase.
Why are mortality rates currently relatively low?
Germany was seen as a positive example in the spring, not least because fewer people died compared to Italy and France. However, even then, the average age of those identified as infected was significantly lower in this country than in these two neighboring countries. And old age is the most important risk factor for death. Today, risk groups are better protected than in spring, when they were not shielded at all in the initial phase and, for example, in nursing homes, there was not only no experience with this type of situation, but also almost no effective prevention of transmission.
The proportion of young people in the total number of infected people is currently even higher. The availability of more tests may also play a role: Fewer people were tested in the spring, including probably more those who were already showing severe symptoms and who might die later. That may have increased your share of the statistics.
[Alle aktuellen Entwicklungen in Folge der Coronavirus-Pandemie finden Sie hier in unserem Newsblog.]
And: already in the spring, infected people usually only died weeks after the infection was discovered. This delay effect could now be even more pronounced. Because precisely because more tests are done and earlier in the course of the disease, the period between testing and death is probably significantly longer on average this time.
This earlier test also means that treatment can be given earlier. In fact, improved therapies using steroid drugs, for example, and optimized ventilation procedures are a sure reason why an increasing number of patients were saved in the course of the first wave. And as Cologne intensive care physician Christian Karagiannidis says: “Routine with doctors and nurses contributes a lot to success, especially in intensive care medicine.”
However, using this routine becomes increasingly difficult the more intensive care units fill up. The more patients, the less “intensive” the individual man or woman can be cared for there.
What will the next few months bring?
If the numbers continue to develop similarly to the current situation, with the number of corona patients in intensive care doubling in less than two weeks, the following may happen: The health system capacity limits that have been faced with the mantra of “We have to take the curve from the beginning of the pandemic flatten” warning, which refers not only to beds and equipment, but also to available personnel, will arrive at Christmas.
Even earlier, if you follow a recently published opinion from the Society for Virology. Soon after, these limits could be broken, in the dead of winter and with no prospect of spring-like weather support, and death rates will rise again sharply.
A gap as a leader
In the spring, Germany had the great advantage that the number of infections increased much later than elsewhere. In Germany, young people were already infected. The chilling examples of countries like France or Italy were not only decisive in ensuring compliance with measures such as the blockade and mask requirements. But, and this was possibly even more important: they were crucial to the fact that many people took the situation very seriously and protected themselves and others.
Now, too, Germany is so late that it is an advantage. Against neighboring countries such as the Czech Republic, Belgium, France. Whether it will be enough to overcome this wave comparatively lightly and with significantly fewer deaths than others remains to be seen.
