Covid-19 variant: Is the Flensburg outbreak a red flag for Germany?

The northern German city of Flensburg is going into a tough lockdown after a huge rise in Covid-19 cases - many of them stemming from the B.1.1.7 variant that originated in the UK. What does this mean for Germany?

Covid-19 variant: Is the Flensburg outbreak a red flag for Germany?
The city of Flensburg. Photo: DPA

Residents in the Schleswig-Holstein city, which lies close to the Danish border, will face a night time curfew, while contact restrictions will be tightened.

The area is seeing a large Covid outbreak fuelled by the more contagious variant discovered in Britain.

On Friday there were on average just over 177 coronavirus cases per 100,000 residents within a seven-day period in Flensburg – while the overall number for the state of Schleswig-Holstein was 49.1.

The 7-day incidence for Germany on Friday stood at 56.8. The number has been falling in the previous weeks, but has stagnated slightly in recent days, leading experts to worry that the spread of coronavirus variants will push up infections.

READ ALSO: How and why Germany tightened its target for lifting lockdown measures

Schleswig-Holstein's state premier Daniel Günther, of Angela Merkel's Christian Democrats, said the infection figures in Flensburg, which has a population of around 89,500, were a “cause for great concern”.

Flensburg's mayor Simone Lange, of the Social Democrats, said the “constantly high incidence rate and a share of mutations in the infections of well over 33 percent,” meant the city needed to take swift and strong action.

A study by the Robert Koch Institute (RKI) even suggests that mutations could now be responsible for more than half of the cases in Flensburg. For comparison, the British variant of the virus accounts for around 22 per cent of cases in Germany, federal Health Minister Jens Spahn announced this week.

Does Flensburg show what could be in store for Germany?

SPD health expert Karl Lauterbach said the Flensburg cases is the “first example of what we could face with further spread of UK B.1.1.7”.

Lauterbach said a strict lockdown until the incidence is below 35 again was needed.

For at least a week and possibly longer, Flensburg residents will only be allowed to leave their homes from 9pm to 5am if they have a valid reason to do so. Visits to the doctor and to go to work are allowed.

Contact restrictions will also be tightened: a household in Flensburg won't be allowed to meet with anyone outside the household. Exceptions apply to visits to hospitals, couples who live apart, and children with separated parents.

At the moment across Germany, households are allowed to meet with one other person and they should have a social bubble to avoid meeting lots of different people.

IN NUMBERS: What is the coronavirus situation around Germany?

What's happening in Denmark?

There are concerns about the British variant spreading in Denmark, which lies just a few kilometres from Flensburg. Tighter border controls were brought in this week in Denmark's border regions, including with Germany.

According to preliminary figures from the Danish Statens Serum Institut (SSI), which are updated daily, the British Covid mutant was detected in 47.4 percent of the sequenced coronavirus samples from the previous week.

The share was reportedly just under two percent at the end of December.

The SSI expects the variant to account for more than 80 percent of all Covid cases in Denmark as early as the beginning of March. As a result, the reproductive number, which shows how many people an infected person goes onto infect, is likely to increase to 1.1, according to experts – even without relaxing measures.

When the R number is above 1, the number of infection goes up quickly.

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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.