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LIVING IN GERMANY

EXPLAINED: What is Germany’s new coronavirus test strategy for winter?

Germany has changed its testing criteria for winter. We explain what you should know.

EXPLAINED: What is Germany's new coronavirus test strategy for winter?
A man getting a Covid-19 test in Berlin. Photo: DPA

What's happening?

Germany's Robert Koch Institute (RKI) has changed its recommendations to doctors on who should be tested for Covid-19 in order for laboratories to cope during the winter season, and to avoid overloading doctors' surgeries.

The changes came into force on November 11th.

What's different?

Previously, anyone who had any kind of Covid-19 symptoms (which can be similar to other illnesses) could be tested in Germany, with the cost covered by their health insurance. The final decision on testing was at the discretion of a doctor.

However, now there's a special focus on patients with more pronounced coronavirus symptoms.

“Due to currently limited testing capacities, and the frequency of colds in the winter months, it is not possible to confirm all Covid-19 diseases in Germany by testing,” writes the RKI in its situation report, reported Welt.

Test capacities should be used “efficiently”, says the RKI.

Therefore, testing should only be carried out if people have “severe symptoms”, i.e. respiratory distress, bronchitis or pneumonia, or relatively clear Covid-19 symptoms such as loss of sense of smell or taste, says the RKI.

Other factors will be taken into account when deciding on testing, such as if the patient has had contact with an infected person, possible clusters or if the person works in close contact with people on a regular basis (for example teachers).

People with “acute respiratory symptoms of any severity” who belong to risk groups, care for vulnerable people or work in the medical field will also be tested.

READ ALSO: 'Nip the virus in the bud': How Germany has shown Europe the way on testing

Anyone with possible Covid-19 symptoms who is unsure should contact their doctor who will advise them – but they shouldn't visit the surgery.

Why the change?

Germany has been praised throughout the crisis for its widespread testing.

However, the reason for adjusting the test criteria now is due to autumn and winter's common cold season. As more people pick up colds, the number of people with potential Covid-19 symptoms is also high.

“This is to avoid overloading in the event of a change in the epidemiological situation (greatly increased incidence in the autumn/winter season) and insufficient capacity and resources in terms of implementation (doctors' surgeries, test centres, hospitals) and evaluation of tests (laboratory capacity),” said the RKI when explaining the changes.

The backlog of non-evaluated tests for coronavirus, which accumulated in laboratories, grew steadily over autumn, reported Welt. The peak was reached in the first week of November, with over 98,000 unprocessed tests.

And it could get worse, with the RKI warning of up to 2.5 to 3 million people having cold symptoms every week. The current “real” test capacity of laboratories in Germany is 1,677,221 tests per week.

Under optimal conditions, up to two million tests are possible, but 54 laboratories alone report delivery problems for reagents, plastic consumables and pipette tips. In addition, there is more staff sickness at this time of year across the board, including in labs and elsewhere in the health sector.

READ ALSO: Germany sees new record of daily Covid-19 cases

So the justification is that not every patient with cold symptoms can be tested due to limited lab capacity.

Instead, the German government and states earlier this week said that anyone with cold symptoms should stay at home and self-isolate.

The RKI says people with “should isolate at home for at least five days in the event of any respiratory symptoms and only end the isolation after a further 48 hours without symptoms”.

They can contact their doctor and receive a sick note without going to the surgery. Their doctor can also decide if a coronavirus test is needed.

READ ALSO: What you need to know about Germany's new Covid-19 recommendations

How has it affected overall numbers?

The RKI reported 65,413 new coronavirus cases in the first four days of the current week. In the previous week, 69,048 new infections were reported in the same period.

Although it's possible that the infection curve is flattening slightly, the other explanation could be because the new testing strategy is having an impact on the numbers.

Last week the number of PCR tests recorded fell for the first time in weeks by around 200,000 to 1,384,943. At the same time, the positive rate rose from 7.86 per cent to 9 per cent.

Meanwhile, the introduction of antigen rapid tests should also have an impact on figures in the coming weeks.

READ ALSO: How Germany hopes to prevent care home deaths with rapid test strategy

Are there any risks, or positives of this move?

The risk of testing fewer people with symptoms does mean that there could be some difficulties in assessing the overall situation.

Experts believe that the higher the positive rate, the higher the estimated number of unreported cases, i.e. the number of undetected infected people in the population. And the higher the number of undetected cases, the easier it is for the virus to spread undetected.

“It may be that the number of undetected cases is now increasing somewhat,” said RKI boss Lothar Wieler at a press conference on Thursday.

Studies have shown that the number of unreported cases in Germany is four to five times higher than the number of reported infections, said Wieler.

But he also pointed out that there are other indicators for the current outbreak: incidences and hospital occupancy rates. “From all this we can conclude that the under-recording is not significantly higher than a few weeks ago,” said Wieler.

The shift in testing strategy may also have advantages in containing the pandemic because there will be less of a backlog of tests to get through.

That means contact tracing can become more efficient.

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COVID-19 RULES

EXPLAINED: The Covid rules in place across German states

Many Covid restrictions have been dropped in Germany, but some rules remain in place. And as infections increase again, it's important to be aware of what you should do if you get Covid.

EXPLAINED: The Covid rules in place across German states

Germany has relaxed or changed many Covid restrictions in recent months. However, with Covid infections rocketing again, people are reminding themselves of what rules remain in place, and what they have to do if they get a positive test.

Here’s a quick roundup of what you should know. 

Face masks

Covid masks have to be worn when travelling on public transport, including planes departing to and from Germany. 

They also have to be worn in places where there are more vulnerable people, such as care homes, hospitals and doctor offices. 

Masks are not mandatory anymore in shops (including supermarkets) and restaurants, but individual businesses can enforce the rule so watch out for signs on the door. 

READ ALSO: Germany’s current Covid mask rules

FFP2 masks have become the standard in Germany, but in some cases other medical masks are sufficient.

There are no longer any entry rules to public venues such as the 3G or 2G rule, meaning that people had to show proof of vaccination, recovery or a negative test. 

However, they could return in autumn if the infection protection laws are adapted, and if the Covid situation gets worse.

Mandatory isolation 

The rules on isolation differ from state to state, but there is one general requirement: those who test positive for Covid have to go into isolation at home and avoid all contact with people outside the household. The isolation period lasts at least five days or a maximum of 10 days.

If you get a positive result at home, you should go to a test centre and undergo a rapid antigen test. If it is positive, the quarantine obligation kicks in. If it is negative, you have to get a PCR test.

If you have Covid symptoms, you should contact your doctor, local health authorities or the non-emergency medical on-call service on 116 117. They can advise or whether you should get a PCR test. 

Across German states, the isolation period lasts 10 days, but – as we mentioned above – there are differences on how it can end earlier. 

In Berlin, for instance, it can be shortened from the fifth day with a negative test if you have been symptom free for 48 hours. If this isn’t the case, the isolation is extended until you have been symptom-free for 48 hours and tested negative. But you can leave without a negative test after 10 days. 

A positive Covid test.

A positive Covid test. Photo: picture alliance/dpa | Sebastian Gollnow

Anyone who tests positive for Covid using a rapid test at a testing centre can have a free PCR test to confirm whether they have Covid-19. If the PCR test is negative, there is no obligation to go into quarantine.

In Bavaria, the isolation period is five days after the first positive test. For isolation to end on day five you must be symptom free for at least 48 hours. Otherwise, isolation is extended for 48 hours at a time until the maximum of 10 days. 

A test-to-release is not needed to end the isolation, unless the person works in a medical setting. 

READ ALSO: Germany sets out new Covid isolation rules

After isolation, Bavaria recommends that you wear an FFP2 mask in public places indoors and reduce contact for an extra five days. 

The state of Hesse has a similar system to Bavaria where a test is not needed to end the isolation early (unless the person works in a medical setting).

In North Rhine-Westphalia and Hamburg, residents can end their Covid isolation on the fifth day if they get a negative test (carried out at a testing centre). Otherwise the isolation period continues until the 10th day, or until they get a negative test.

Close contacts of people infected with Covid (including household contacts) no longer have to quarantine in Germany, but they are advised to get tested regularly and monitor for symptoms, as well as reduce contacts for five days. 

As ever, check with your local authority for the detailed rules.

Travel

Germany recently provisionally dropped almost all of its Covid travel restrictions, making it much easier to enter the country. 

The changes mean that entry into Germany is now allowed for all travel purposes, including tourism. The move makes travel easier – and cheaper – for people coming from non-EU countries, particularly families who may have needed multiple Covid tests for children. 

People also no longer have to show proof of vaccination, recovery or a negative test against Covid before coming to Germany – the so-called 3G rule. 

However, if a country is classed as a ‘virus variant’ region, tougher rules are brought in. 

It is likely that travel rules could be reinstated again after summer or if the Covid situation gets worse so keep an eye on any developments. 

READ ALSO: Germany drops Covid entry restrictions for non-EU travellers

Vaccine mandate

The mandate making Covid vaccinations compulsory for medical staff remains in place. A vaccine mandate that would have affected more of the population in Germany was rejected by the Bundestag in a vote in April

READ ALSO: Germany’s top court approves Covid vaccine mandate for health care workers

Workplaces

Masks are no longer mandatory in workplaces, unless it is in a setting where more risks groups are, such as hospitals or care homes. 

The government no longer requires people to work from home, but employers and employees can reach their own ‘home office’ arrangement.

Tests are also no longer mandatory, but workplaces can offer their employees regular tests. 

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