COVID set to return to Germany?

The COVID-19 pandemic is officially over. The World Health Organization (WHO) has declared it finished. Other news have long superseded the coronavirus in the headlines.

However, some Germans are worried because the number of recorded infections has been rising in recent weeks

This is — still — no reason for concern, Professor Stefan Kluge, Director of the Clinic for Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf said.

“At the moment, we are treating 182 patients with COVID-19 in intensive care in Germany, half of those because they have pneumonia caused by the virus. That is one percent of all patients in intensive care. It is a very stable situation, even though we have observed more infections among staff and patients in recent weeks.” However, the shortage of skilled staff in the hospitals could become a problem, especially in winter, Kluge believed.

Pirola and Eris are coming

There are two new variants of the virus which are on the rise worldwide. One of them is BA.2.86, also known as Pirola, which the WHO has classified as a “variant under monitoring.” It reminds scientists of the early days of the Omicron variant because it is spreading so quickly. It was discovered in Denmark in late July and has already been detected in Switzerland, the US, Israel, and the UK. Because of this, London has brought forward its immunization schedule and in Israel people being admitted to hospital wards need to undergo a PCR test for the virus.

.2.86 has not yet been detected in Germany, according to the country’s agency for infectious diseases, the Robert Koch Institute. However, EG.5, also known as Eris, has. The subvariant of the hitherto predominant Omicron has displaced other variants and is responsible for about half the current infections in Germany. In the US, Eris is currently leading to more hospitalizations, with the WHO assuming this “variant of interest” will soon dominate worldwide.

Fears of bottlenecks in winter

This is why the situation could become critical in some regions of Germany this coming European winter, fears Professor Leif Erik Sander, Director of the Department of Infectious Diseases and head of the Research Group on Personalized Infectious Medicine at the Berlin Institute of Health at Charité hospital (BIH): “Especially in pediatrics, in children’s medicine, it will lead to bottlenecks relatively quickly again, including in the emergency departments. There can then be real problems in the delivery of care, especially in regions where the density of available hospital beds is perhaps not so high.”

That is because, along with COVID-19, the respiratory syncytial virus (RSV) also lurks in the colder seasons. According to European Union (EU) medical authorities, this respiratory illness is mild most of the time, but for small children, babies, and vulnerable older adults it can be life-threatening. 

Professor Sandra Ciesek, head of the Institute of Medical Virology based at the University Hospital Frankfurt, is sure that many Germans will contract COVID-19 again this winter. “Most of them will stay home sick for a week because they simply have a fever and cold symptoms. So long as Omicron is in circulation, I see no risk that it would become necessary again, for example, for the government to impose restrictive measures.”

It is primarily people aged over 60 with certain preexisting conditions, care workers and health personnel, as well as close contacts of at-risk patients who should receive a booster vaccination to weather winter well, the Standing Commission on Vaccination at the Robert Koch Institute (STIKO) recommends. The general guidelines are that at least 12 months should have passed since the previous vaccination or infection. The people who want to get their shots go to their family doctors, such as Markus Beier.

He is the federal chairperson of the Association of German General Practitioners told DW that doctors had again seen more of the virus recently. “For the past 1 to 2 weeks, more patients are coming to us with coronavirus infections. Now it is mostly people with many social contacts who are becoming infected more frequently.”

That is not a problem in itself, however, the doctors are already reaching their limits in terms of logistical challenges. That is because they receive vaccines not in single doses, but rather in containers containing 6 doses. They all need to be refrigerated and each container needs to be used on the same day, within 12 hours. The German Health Ministry was warned about this 2 years ago, Beier points out.

“The goal is that every person who comes to the doctor’s office needing and wanting a COVID vaccination can receive one straight away,” he explains “That means, if I do not want to produce any waste, I need five more people to be sitting there who also want a vaccination. That is simply a massive organizational challenge and always something to weigh up: Do I reschedule the vaccination if I do not have another 5 patients?”

Health Minister Karl Lauterbach has announced that the adapted vaccine from BioNTech and Pfizer will probably be available in doctors’ practices from September 18. The European Commission has just approved the new vaccine, and the European Medicines Agency (EMA) recommends immunization with the updated vaccine regardless of previous COVID-19 vaccinations.

That could be good news, but family doctor Beier is seeing an increase in inquiries by patients. “There is already uncertainty because it became known that the Health Ministry only bought the BioNTech vaccine,” says Beier. “I do not want to evaluate that from a technical perspective, but something like that needs to be communicated. Otherwise, patients get the impression that they have no choice, even though cross-vaccinations were still recommended only last year.”

This article was originally written in German.

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