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Divi’s intensive care registry reported about 8,600 free intensive care beds on Friday, plus an emergency reserve of 12,260 beds. The intensive care situation in Germany is comparatively good, it already looks more dramatic in France. There, the infection situation is serious in the regions of Marseille, Bordeaux and Paris, and intensive care beds are again scarce in the south. Does Germany now threaten a similar development with delay?
What are the pros?
If the reported infection figures and trends are compared, it is plausible that Germany is currently only at an earlier stage of the same development. That was also the case in the spring.
In Germany, however, it was possible to influence development in such a way that an overload of supply systems could be avoided as in France, Italy and Spain. The national blockade probably made a significant contribution to this by drastically reducing the number of contacts and thus the transmission options.
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At this time, much of the population was behind the measures and, due to the dramatic reports and images from those countries, was ready, and motivated by its own interests, to protect itself and others to the best of its ability.
A new blockade across the country is currently out of the question, mainly due to its negative economic and social implications. It is largely unclear whether local or regional lockdowns will occur in areas with particularly high numbers of new infections and to what extent they will be enforced, contagious, and effective.
Regarding the will of the population to limit and constantly reduce the probability of transmission of the virus, the panorama is mixed. According to surveys, the acceptance of new highly restrictive measures would be significantly lower than in the spring.
One factor that develops in exactly the opposite direction from spring is the weather-related possibility of being outdoors. According to studies, “external” infections are at least 20 times less likely than “internal” ones. However, in colder temperatures, people spend more time indoors. Here, Germany is even at a disadvantage compared to countries with a milder climate.
Virologist Christian Drosten sees a risk in space spread probably much higher from the virus than in the spring. Therefore, it is likely that significantly more clusters of infections, still unnoticed, are forming today as a result of transmission within Germany than before. This new starting point for further spread of the virus is probably comparable to the situation in the other European countries that are currently being hit the hardest.
The contribution of children to the infection process is the subject of ongoing studies and discussions. In Germany, they are now being taught again under conditions that only slightly reduce the chance of infection with each other. This also happens without a preventive testing system that can be used to find early-developing clusters and initiate containment measures.
Children with symptoms of respiratory illness are also not routinely tested and allowed to continue in school if the symptoms are not severe or clearly indicate Covid-19. This is a clear difference from the spring, when schools were closed as a precaution, with negative consequences for education and the situation of families. However, this could also have helped contain the epidemic.
What speaks against?
In Germany, many precautions have become routine and are integrated into the daily life of the vast majority of the population: keep your distance, wash your hands and wear mouth and nose covers. Masks are also recognized as effective protection by the Robert Koch Institute, which has long described them as largely ineffective. And they are available.
Now working in the home office has been established for people who do not necessarily have to be present in the workplace. The extent to which there are relevant differences in these factors for future development in Germany compared to countries where the number of cases is again significantly higher is not quantified. Virologists and medical professionals are also discussing the possibility that the use of masks and possible social distancing could contribute to immunizing the population.
The reasoning is based on the assumption that protective measures could reduce the amount of virus that people ingest in case of infection, and that this favors an easier course of the disease. However, this could still lead to people developing immunity to Sars-CoV-2. This reduces their own risk of infection and the risk of them spreading the virus.
What can still be improved?
Detecting infected people at an early stage through testing and limiting their contact with healthy people remains at the core of protection against infection. Rapid tests that give a result in a few minutes could help if widely used. The methods detect molecular traces of the virus, antigens, for example, in saliva.
However, they are criticized for their high error rate. They recognize infected people less reliably than the PCR tests that are mainly used today on throat swabs. False negative rapid test results that say “no infection” when there is one are more common in people with low viral loads.
Antigen-based tests could more reliably identify people with a high viral load “who are more likely to be contagious,” said Marion Koopmans, a virologist at the Dutch University of Rotterdam, on nature.com. Until another test result is available, they could be isolated as a precaution and possible infections could be prevented.
So far it has not been clear at what viral load the line between “contagious” and “non-contagious” runs, but rapid and inexpensive tests could usefully supplement the arsenal of protection against infections, especially in times of rapid increase in the number of cases.
