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ANALYSIS

Germany’s coronavirus R number rockets above 2. What does that mean?

Authorities are desperate to keep the coronavirus reproduction number under 1. But on Sunday, it climbed to 2.88. Why, and what does it mean for Germany?

Germany's coronavirus R number rockets above 2. What does that mean?
A Red Cross worker hands over food to a quarantined resident in Verl, NRW, after the outbreak at a meat processing plant. Photo: DPA

We've been repeatedly told how important is to keep the basic reproduction number – R number or R0 – under 1.

An R0 of 1 means that each person infected with the virus is passing it on to one other person.

On Sunday night, Germany's Robert Koch Institute (RKI) for disease control reported that the four-day R number, the average number of new cases which reflects the infection situation about one to two weeks ago, stood at 2.88.

It's a large increase from the days before: On Saturday it was 1.79 and on Friday it was 1.06.

The RKI also estimates a 7-day R number aimed at providing a more accurate picture of the situation. On Sunday this value was 2.03.

It means that a person with coronavirus goes onto infect more than two other people.

READ ALSO: IN NUMBERS: What we know about the coronavirus situation in Germany

Why are the R numbers going up?

The RKI says the four-day R number “reacts sensitively to short-term changes in case numbers, such as those caused by individual outbreaks”.

Germany has in the last two weeks been hit with large localised outbreaks.

“Estimates of the reproduction numbers (R-value and 7-day R-value) were between 2 and 3 during the last few days,” said the RKI in its daily report published Sunday night.”This is mainly related to local outbreaks.”

The RKI said there had been a high 7-day incidence rate in four districts in Germany due to these outbreaks. The districts of Gütersloh and Warendorf (both North Rhine-Westphalia (NRW)) and the cities of Magdeburg (Saxony Anhalt) and Neukölln (city district of Berlin) are particularly affected.

In Gütersloh, near Bielefeld, more than 1,000 employees of a meat processing plant have contracted coronavirus. 

READ ALSO:

The authorities have introduced strict measures to try and stem the spread. The affected plant, run by German meat giant Tönnies, has been temporarily closed at short notice and all employees are being quarantined as well as their household members.

Meanwhile, all schools and daycare centres (Kitas) in the district have been closed since June 18th and will remain shut until the end of summer holidays on August 11th.

The town of Verl, located in the affected district, has enforced a quarantine zone for those areas where high numbers of the processing plant’s employees live.

The outbreak in Gütersloh is also linked to an outbreak in Warendorf. Employees of the meat processing company are residents of neighbouring districts.

The centre of the outbreak is the Tönnies meat processing plant in the Gütersloh district. Photo: DPA

In Magdeburg, an outbreak affecting several now closed schools has led to an increase in the 7-day incidence, the RKI said.

There's also been a large outbreak in Neukölln, a district of Berlin. It is linked to members of a religious community, said health experts. So far 85 cases are linked to this outbreak.

The RKI also said there have been major outbreaks in retirement and nursing homes.

“In the district of Verden residents and nursing staff have been tested positive for SARS-CoV-2. Further outbreaks were reported among members of religious communities, eg. from Berlin, Hesse and and Mecklenburg-Western Pomerania,” said the RKI.

Should we be worried?

Back in May as Germany was tentatively easing lockdown measures,  Lars Schaade, of the RKI, said that the fewer the overall number of infections, the greater the impact of a localised outbreak.

As of Sunday June 21st there were around 189,822 confirmed coronavirus cases in Germany, according to the RKI, – that's around 680 new cases compared to the day before. Of the total around 8,822 people have died, and 174,900 people are estimated to have recovered.

Meanwhile, as of Monday June 22nd, there were 191,584 confirmed cases, according to Johns Hopkins University, which calculates the numbers in real time and therefore the data differs slightly from the RKI. Of that total, around 8,897 people have died and around 175,038 people are reported to have recovered from Covid-19.

Schade said he would become more concerned if there were R values above 1 over a longer period of time.

“If the second decimal digit were above 1 that would not yet be critical. But the higher it goes above 1, like 1.2 or 1.3 and over a longer period of time, it would create a situation where we would pay very close attention and think about measures on how to counteract that,” Schaade said.

In the RKI report, health experts also urged people to view the numbers with caution.

“Since case numbers in Germany are generally low, these local outbreaks have a relatively strong influence on the value of the reproduction number,” the RKI said.

“Further developments need to be monitored closely during the upcoming days, especially in regard to whether case numbers are increasing outside of outbreak contexts.”

READ ALSO: Why Germany has coronavirus infections under control despite relaxing measures

What happens now?

In order to contain the disease in Germany, a R number of less than 1 is needed.

READ ALSO: How worried should we be when Germany reports a higher coronavirus infection rate?

However, localised outbreaks are to be expected and authorities are taking measures to try and contain these situations.

Authorities will monitor situation closely over the coming days and further measures will likely be taken if the R number stays above 1.

 

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HEALTH

EXPLAINED: The new rules around getting a sick note over the phone in Germany

Due to high Covid infection numbers throughout the summer, it’s now possible to get a sick note from a doctor over the phone again for some illnesses. Here’s what you need to know.

EXPLAINED: The new rules around getting a sick note over the phone in Germany

What’s happened?

In spring 2020, German authorities changed the law so that people with a mild upper respiratory tract illness, such as the common cold, were able to get an incapacity to work certificate or AU-Bescheinigung by simply calling and speaking to their GP.

The rule was extended several times and finally reversed on June 1st this year due to falling infection figures. Since then people have had to go back to the practice – or do a video call if the doctor’s office has that system in place – to get a sick note.

Now, due to a decision by the Joint Federal Committee, the regulation has been reintroduced and patients can call their GP again for a sick note.

Can I get a sick note over the phone for any illness?

No. As before, the regulation only applies to patients suffering from a mild upper respiratory tract illness. Though Covid has not explicitly been named in the announcement, it seems that it is intended to be covered by the regulation.

If the doctor is convinced that the patient is unfit for work after a telephone consultation, then they can issue a sick note for up to seven days.

READ ALSO: EXPLAINED: The changes around doctor’s notes in Germany you should know

If the symptoms persist after seven days, the certificate can be extended once more for another week.

Why now?

According to the Chairman of the G-BA, Josef Hecken, the regulation has been introduced now as a response to rising Covid numbers and in anticipation of the cold and flu season in the coming months: “We want to avoid full waiting rooms in doctors’ offices and the emergence of new infection chains,” he said.

The telephone sick leave rule is a simple, proven and uniform nationwide solution for that, he said. The rule is also necessary because video consultation hours are not yet available everywhere.

What else should I know?

The health insurer DAK is calling for telephone sick leave in the case of light respiratory diseases to be made possible on a permanent basis in Germany. DAK’s CEO Andreas Storm said that this should “not always be up for debate, because it has proven itself.” 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

The social association VdK also welcomed the reintroduction of the rule. The VdK’s President Verena Bentele said that the regulation would help to protect high-risk groups in particular from potential infections.

What are the rules to know about sick notes in Germany?

Germany has a strict system in place. If you are sick, you need to give your employer a Krankmeldung (notification of sickness) before the start of work on the first day (of your illness).

However, you also need to hand in a Krankschreibung (doctor’s note) on the fourth day of your illness. Some employments contracts, however, require you to submit a sick not earlier than the fourth day so check with your boss or HR on that point. 

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