domingo, 13 de diciembre de 2020

domingo, diciembre 13, 2020

Countdown to Lockdown

Germany Is Faring Poorly in the Second Wave of the Coronavirus

Germany has squandered the gains it made this spring in dealing with the coronavirus. A series of miscalculations by politicians in the fall has contributed to a sharp increase in COVID-19 infections in recent days. A second lockdown is coming.

By Lukas Eberle, Markus Feldenkirchen, Milena Hassenkamp, Martin Knobbe, Veit Medick, Marcel Rosenbach, Lydia Rosenfelder und Gerald Traufetter

The intensive care unit at Essen's university hospital: It's increasingly looking like Germany's "lockdown light" in November was lost time. Foto: Fabian Strauch / dpa


Three headlines from recent days: The Collm Hospital in the town of Oschatz in northern Saxony is filling up. It is only admitting patients who fall into the triage category "red,” meaning people whose lives are acutely threatened.

At the Arberlandklinik hospital in the Bavarian town of Zwiesel, dozens of nursing staff are infected. The hospital had to stop admitting patients into emergency care.

Meanwhile, hospitals in the district of Görlitz in the state of Saxony, the morgue was overflowing due to the high number of coronavirus deaths this week. A provisional room has been set up for people to bid farewell to the deceased as an emergency solution.

This is Germany in December 2020, a country where a "wave-breaking shutdown” was meant to allow for a relaxed Christmas holiday. Now politicians are discussing a second shutdown, but this time a much firmer one, with closed shops and extended school holidays to contain the spread of the coronavirus.

Only a few weeks ago, the situation looked a lot different. When Germany’s state governors and the chancellor agreed to a four-week "shutdown light” on Oct. 28, they were all pleased with the solution. It looked as though the state and federal governments had a plan.



Even Karl Lauterbach of the center-left Social Democrats, a widely respected health expert in parliament for whom few containment measures go far enough, was pleased with a decision that he had championed. 

He said the lockdown would "break the second heavy wave.” 

He said the containment measures adopted were "a great success,” indeed "a milestone.”

Of course, hindsight is always 20-20. But looking back, the determination and confidence with which the country’s leading politicians praised their plan to combat the second wave of the coronavirus at the end of October seems downright absurd.

"Today was a decisive day,” announced Armin Laschet, the governor of the state of North Rhine-Westphalia. A member of Merkel's Christian Democrats (CDU), he noted that a clear timetable had been set for the restrictions. "We won’t need to discuss afterward what to reopen or what to close,” he said.

"The measures that have now been decided are due to end on Nov. 30,” insisted Bavarian Governor Markus Söder, a member of the Christian Social Union (CSU), the Bavarian sister party to the CDU. He spoke of a "four-week therapy” and added: "We understand all the concerns. But we would rather be resolute now than get stuck in an endless cycle later.” 

His colleague from Baden-Württemberg, Winfried Kretschmann of the Green Party, announced that the "emergency brake" would give us the chance "to ease the situation and celebrate Christmas together with our families." Even Merkel, who is said to have pressed for a more decisive approach, left no doubt that the decisions made were the right ones. 

"This all serves the purpose of enabling us to improve public life again in December," Merkel said at the time.

It was probably the biggest political miscalculation of the year. Politicians made a promise to the people that they couldn’t keep. They raised hopes that will now be dashed. 

More than that, the false optimism will now make it difficult to get public acceptance for the more drastic measures that are now needed – because in order to save the health system from collapse and prevent more deaths, Germany is likely going to have to go back into full lockdown. 

Lauterbach is now calling for the closure of everything, including shops and schools. Merkel has similar ideas, as do many of the state governors.

German Health Minister Jens Spahn: Many who use the country's coronavirus warning app aren't registering their positive test results. Foto: Sven Darmer / Davids


On Wednesday, the daily death toll in Germany reached a sad new record of 590. Since Wednesday of last week, more people have died from COVID-19 than in traffic-related accidents during all of 2019. 

On Friday, the Robert Koch Institute (RKI), Germany’s center for disease control, reported a record 29,875 new infections. Of the 412 districts in RKI’s daily situation report, 386 are now considered hotspots. More than 4,000 patients with the coronavirus are currently in intensive care units, considerably more than during the first wave in the spring.

As recently as just a few months ago, Germany was still being praised worldwide as a model pupil in the fight to contain the pandemic, but the country has failed to live up to that reputation this fall. German Interior Minister Horst Seehofer of the CSU says he is furious. 

He says the advantage that Germany gained in the pandemic in the spring has been squandered, adding that it’s not due to a lack of discipline among the population, "but above all to inadequate measures.” 

He says he already had the feeling at the end of October that not all of Germany’s governors had recognized the seriousness of the situation. "I slept badly after that," he says.

November will go down in pandemic history as a wasted month. An evaluation conducted by the authorities shows that the 7-day incidence has only decreased in six German states since Nov. 2, including Bremen, Saarland and North Rhine-Westphalia. 

The greatest increase, by contrast, was in Saxony, where over 200 more people per 100,000 inhabitants were infected over seven days compared to the beginning of November. In the state of Thuringia, it was 126 people, and 49 in Bavaria. The evaluation is based on figures published by the RKI on Dec. 9.

But it’s not only the number of infections that has increased. The government has also failed to make progress in key areas of containing the spread of the coronavirus. "The opportunity was missed in the summer to bring the disease under control,” epidemiologist Maria Van Kerkhove of the World Health Organization says, critically.

PCR and rapid antigen tests are scarce, and there is no meaningful test strategy. The state of Bavaria overwhelmed its public health offices when it offered to provide all residents with a test free of charge. 

In the state of Hesse, there are tests for teachers, but not enough for hospital staff and it's a similar story elsewhere. And that’s precisely what is so disastrous. For weeks, the virus has been spreading in senior homes and convalescent hospitals. Experts agree that mass rapid tests of nursing staffs would have minimized the risk of SARS-CoV-2 slipping into homes undetected.

Berlin Mayor Michael Müller is the current chair of the national conference of German state governors. Foto: Markus Schreiber / ap


When it comes to the protection of risk groups, the German government is still far too lax. Still, there have been some successful approaches. The university town of Tübingen has had very few COVID-19 cases in retirement and nursing homes. 

Mayor Boris Palmer, a member of the Green Party, is relying on mass testing and also helps protect risk groups by providing taxi rides for the cost of a bus fare, special shop opening hours and free masks. 

Even fellow party members who normally find Palmer to be a thorn in the side have been impressed. "Better protection and more measures for the elderly saves lives,” says Dieter Janecek, a Green Party member of the federal parliament from Bavaria. "Why aren’t we doing much more of this?”

The coronavirus warning app, which is supposed to alert users if they have been exposed to a person who tested positive for COVID-19, has also fallen well short of expectations. It was supposed to become a central element in the fight against the pandemic, but it still isn’t playing a critical role. 

Although another 5 million people have downloaded the app to their smartphones since the beginning of October, the total number of downloads is still only 23.5 million. And the app includes only a fraction of the new daily infections. 

Even those who are already using the app seldom report that they have tested positive. Recently, it has been estimated that a little more than half of people who test positive are reporting their tests in the app.

The problem has been known for months. And potential solutions have been under discussion for just as long. The government officials responsible could have modified the app such that test results would automatically be reported – a move that the Association of Laboratory Physicians (BLD) called for as far back as September. 

Under that system, anyone who explicitly didn’t want their positive test to be included in the app could opt out. The proposal was discussed, but was ultimately rejected.

Furthermore, Germany’s public health departments aren’t even connected to the app. 

They’re also lacking in technology in general. Work is often still done with pen, paper and a fax machine. Hybrid teaching in schools isn’t feasible in many places because the technology is lacking to provide pupils with digital instruction at home.

But the biggest mistake was not making the November shutdown, which has since been extended, tougher. Voices in the scientific community were calling for stricter measures at the time. Earlier this autumn, researchers recommended Germany should take its cue from New Zealand and many countries in east Asia that succeeded in containing the virus through tough measure. 

Experts like Viola Priesemann of the Max Planck Institute called early on for a "hard lockdown” for three weeks in order to get infections back down below the threshold of 50 infections per 100,000 people, an upper ceiling after which point contact tracing becomes extremely difficult.

Saxony Governor Michael Kretschmer: "We underestimated this virus." Foto: Martin Lengemann / Welt / ullstein bild


Even the National Academy of Sciences Leopoldina started calling for "effective rules for autumn and winter” in late September. The scientists there considered November to be the decisive month to still stop the second wave. 

A further statement, issued together with five other research organizations, pushed for more stringent restrictions. They argued that social contacts needed to be reduced by 75 percent. 

But the rules approved by politicians didn’t go far enough to ensure that happened. People only reduced their range of movement by just over 10 percent. During the first lockdown in March, mobility fell by around 40 percent.

What shocked the scientists a Leopoldina even more was the spirited discussions among governors over how to relax coronavirus restrictions over the Christmas holidays. 

"The developments in the pandemic don’t even really allow for such considerations,” says Leopoldina President Gerald Haug. If people were to meet with their families on Christmas and friends on New Year’s Eve as they normally would, the number of new infections would go through the roof again, he argued.

Chancellor Merkel’s office has also had its own share of failures in recent weeks. 

Through mistakes in communication and strategy, Merkel and Helge Braun, the head of the Chancellery, have even managed to alienate governors who would normally support them. 

That was quite apparent in mid-November. Merkel and Braun were urgent in their warnings to the governors in a video conference call about the rising number of infections. They also pointed out the danger of infection in schools. But the governors stalled.

A number of governors were upset because Braun’s office had sent the draft notes for the meeting too late. Furthermore, they included new rules that had not been discussed with anyone in advance. Among them was a rule that schoolchildren could only meet up with one friend in their free time. 

Merkel and Braun also wanted to impose a quarantine for people who had common cold symptoms. Some of the governors were angered by the proposals. Sources say the chancellor defended herself and emphasized that the quarantine for colds was a recommendation made by the Robert Koch Institute.

North Rhine-Westphalia Governor Laschet then held an RKI diagram on his iPad up to the camera and pointed out that this wasn’t true. He said the recommendation was to follow instructions from your doctor if you have the sniffles. 

In the end, Merkel’s proposal was deleted, like most of the others she made. What was left were minimal compromises.

North Rhine-Westphalia Governor Armin Laschet: "We won’t need to discuss afterward what to reopen or what to close." Foto: Niels Starnick / Bild am Sonntag


There were different reasons for the failure. They included differing interests of the different governors in the group, but also growing fatigue among the populace for the corona measures. Merkel and the governors feared that taking action that was too drastic would further undermine trust. 

Now, though, Germany's politicians are likely looking much worse than they would have. And it has become a question of whether they will acknowledge their failures and draw the right conclusions.

Bavarian Governor Markus Söder was one of the first to admit failure. Last Sunday, he convened a special session of his cabinet in Bavaria. The aim of the meeting was to pivot the state’s policies for containing COVID-19. November’s "soft lockdown,” the governor said afterward, had unfortunately only had a "modest” effect. 

"It's just not enough. We need to do more. We must act." Söder then declared a state of emergency for Bavaria. He doesn’t want people to leave their homes without a good reason - and not at all after 9 p.m., especially in the state's hardest-hit regions.

"We underestimated this virus, all of us together,” acknowledges Saxony Governor Michael Kretschmer of the CDU. With infection numbers particularly bad in his state, Kretschmer has begun moving to impose a stricter lockdown. 

He wants to close schools and daycare centers starting next week. Söder and Kretschmer triggered a dynamic that was further fueled by the chancellor’s emotional appearance earlier this week before the federal parliament. 

There is no longer any question about whether the country is going into another lockdown. The only question is about what will still be allowed to remain open.

The state governors are nervous because they are fully aware that the course correction that is now imminent also has to work. But they are facing a dilemma: If the situation is really so dramatic, then shouldn’t action be taken immediately? 

But a hard shutdown before Christmas is a difficult sell to many families and especially the retail industry.

If, however, they wait until after the holiday, they could also be creating a virus risk, because it would be difficult to control the run on shops that would happen in the run-up to Christmas. 

"The only chance we have of getting the situation under control again is a lockdown, but this would have to be done immediately,” says Interior Minister Seehofer. "If we wait until Christmas, we will have to struggle with the high numbers for months to come."

A conflict is also brewing over the question of compensation for the retail industry. One idea from the states is that shops could be closed from after Christmas until Jan. 10. This would mean closing ships during one of the busiest times of the year. 

The government could cover operating and fixed costs, but leading CDU politicians, in particular, want to avoid new injections of billions of euros from the federal government beyond the January aid that has already been agreed – in part for tactical partisan reasons. 

For the past several months, the crisis has offered Finance Minister Olaf Scholz, who is also the SPD’s chancellor candidate, the chance to position himself as the savior of the economy. Sources within the Christian Democrats say they would like to put an end to that.

It seems to be clear to everyone involved that a hard shutdown will only bring relief for a short time. After the November failure, it would be difficult to face the public again and have to note with regret that there is no leeway for loosening the rules. 

As such, politicians really need to step up to the plate and clarify now how things are going to be looking between now and spring. There is an urgent need for studies, figures and insights: Which areas are the real drivers of infections?

When politicians don’t get the job done, then others need to step in. A few days ago, the Niederlausitz Hospital in the town of Senftenberg in Brandenburg issued a call for help because of an acute shortage of staff. 

The resonance created by that call was "overwhelming,” a spokeswoman said. She said around 90 volunteers have already answered the call.  

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