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ANALYSIS

ANALYSIS: Why are Germany’s coronavirus numbers coming down so sharply?

Since the end of April the number of cases of the coronavirus have been sinking continuously in Germany. So what has been the game changer - is it tougher restrictions or an improvement in the weather, or a combination of a few factors?

ANALYSIS: Why are Germany’s coronavirus numbers coming down so sharply?
A sign for the city of Hoffnung (Hope) on May 2nd in North Rhine-Westphalia, where numbers have also sunken recently. Photo: picture alliance/dpa | Oliver Berg

When exactly the third wave of coronavirus cases peaked in Germany is hard to tell. Delayed reporting over Easter muddied the picture considerably. 

What we know though is that the steep rise in cases reported to the Robert Koch Institute (RKI) came to an abrupt halt on April 15th when the 7-day incidence hit a level of 172 cases per 100,000 inhabitants.

After that it flatlined for 13 days, peaking at 177 on April 27th before falling back steadily to its current level of 133.

These numbers are considerably lower than the forecasts published by modellers. The RKI predicted a 7-day incidence of 350 by mid-April, while a team at the Technical University in Berlin predicted an alarmingly high incidence of 2,000 in May

So what has happened to make the third wave less severe than expected? 

Experts say that there are a few possible factors contributing to falling cases, such as people staying at home over Easter, greater caution among the general public, sharpened lockdown measures as part of the nationwide ’emergency brake’… and the weather.

READ ALSO: 

Easter break for schools lowers mobility

According to the Süddeutsche Zeitung (SZ), one major factor behind the initial slowdown in the level of infection was the Easter holiday, when children stopped going to school.

Infections have been particularly high among school aged children and their parents’ generation. As schools were closed children could not take the virus into school and inadvertently spread it.

Mobility data published by the RKI shows that movement declined sharply over the Easter break, indicating that lots of people stayed at home during the four-day weekend at the start of April. This could have had an important impact in pausing the spread of the virus.

But mobility increased again after Easter and case started to rise again… so there are likely to be other factors at play.

Tougher lockdowns taking effect?

Advocates of lockdowns say that these have been the most significant factor in breaking through the third wave.

Karl Lauterbach, SPD health spokesperson and a leading advocate of strict lockdown measures, said on Twitter that “without an emergency brake, there would have been openings [of shops, restaurants etc] during rising case numbers. That didn’t happen. Curfews also reduced contacts.”

Lauterbach also said that although vaccinations are helping to prevent severe courses of infections in the elderly population, the impact of vaccines on the general situation won’t be felt until more people get the jab.

He said: “The current corona numbers are so far due to the functioning emergency brake and not to the vaccinations.

“That will only change when the quota of those vaccinated with at least one injection is between 40 and 60 percent.” This is likely to happen in Germany by the third or fourth week of May.

Gernot Marx, head of the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI), said this week that a recent improvement in the situation on intensive care stations is “immediately connected to the national emergency brake” which came into force on April 24th.

These comments have caused some controversy as they contradict a statement he made in January when he said that it would take two to three weeks before the effects of a national lockdown would be seen on intensive care wards.

However, some German states began introducing emergency brake measures before the nationwide rule came into place.

According to the newspaper Bild, the number of new Covid cases being dealt with on Germany’s intensive care stations had already started to slow down by mid to late March, indicating that the worst of the third wave was already over by Easter.

This slow down could have had something to do with the local lockdowns that some states were implementing by late March.

Hamburg for instance introduced a strict curfew on March 19th.

Whether that really worked for the Hanseatic city isn’t so clear though. Its current 7-day incidence of 101 is not significantly lower though than that of Berlin (104) which largely resisted tougher measures until the national emergency brake came into force at the end of April.

However, Hamburg did get numbers down faster in the first place.

READ ALSO: Is Hamburg proof that an ’emergency brake’ can get Covid-19 cases down?

Greater caution among the public

Another likely explanation for the slowing of the spread of the virus is greater caution among the public, who heeded the message that the third wave was leading to strain on intensive care wards.

Hans-Georg Kräusslich, head of virology at Heidelberg University Hospital, told the SZ that “people’s personal reactions should not be underestimated”.

“Fortunately, the majority of people still believe that coronavirus is a threat,” he added.

Mobility data is a good indicator of how much personal contact people have had in recent weeks. Here though the data is also not completely clear.

In Hamburg mobility dropped significantly and the spread of the virus also dropped. But in Brandenburg, where there has been no significant drop in mobility, the level of infection has also dropped back. 

Better weather

Noticeable in the data is the fact that the steep decline in the third wave is happening more or less at the same time of year as when the first wave in the spring of 2020 also went into retreat.

The first wave in Germany peaked on April 2nd, before declining steadily throughout that month.

The peak of the third wave came at the end of April. So can we expect an improvement in the weather to play a role.

“We expect that seasonality will have an effect of about 20 percent on the R-value (reproductive number),” physicist Viola Priesemann told the SZ. “We should see this effect at the moment or soon.”

Jan Fuhrmann of Forschungszentrum Jülich agrees. he told RND newspapers: “The weather is likely to contribute in that, for example, private meetings can increasingly be moved outdoors and people are less likely to refrain from ventilating indoors because outside temperatures are too low.”

Other experts caution against putting too much emphasis on seasonality.

Epidemiologist Hajo Zeeb told broadcaster ZDF that there will be a “certain seasonality” before adding that “this could be made irrelevant by the high infectiousness of the virus variants”.

Criticism of the modelling

Another important aspect that needs to be considered is the simple fact that a lot of experts have not been terribly accurate in their past predictions of what will happen next.

Olaf Gersemann, who writes the daily coronavirus update for Die Welt newspaper, recently criticised many of the experts who are asked for answers to the question of why cases are currently rising or falling. 

Showing that the main forecast published by the RKI and other research centres failed to pick up the recent turn around, he asked: “who needs forecasts that only perform well if existing trends simply continue? Gut feelings or the wisdom of Uncle Egon are just as good.”

In other words, in a time of crisis it is understandable that the general public wants answers from scientists to the most pressing questions of the day – that doesn’t mean scientists are always capable of providing accurate answers.

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COVID-19

Pandemic in Germany unlikely to end this year, says top virologist

High profile German virologist Christian Drosten believes Germany will see a severe spike in Covid infections after summer, and that the pandemic will not become endemic this year.

Pandemic in Germany unlikely to end this year, says top virologist

Drosten previously said that Germany would probably be able to declare the end of the pandemic this year.

But in an interview with Spiegel, Drosten said he had reevaluated his opinion. 

“When the Alpha variant came, it was very surprising for me. When Delta appeared I was sceptical at first, then with Omicron we had to reorient ourselves again. And since January there have already been new Omicron subtypes.

“So I would actually like to correct myself: I no longer believe that by the end of the year we will have the impression that the pandemic is over.”

READ ALSO: End is in sight for pandemic in Germany, says virologist 

Drosten also said that Germany will not see a largely Covid-free summer, which has been the case in previous years, and a further increase in infections in autumn. 

“We are actually already seeing an exponential increase in case numbers again,” Drosten said.

“The BA.5 variant (of Omicron) is simply very transmissible, and people are losing their transmission protection from the last vaccination at the same time.”

In other countries, he said, when the number of cases become high, hospitalisation and death rates also rise again. “Unfortunately, that will also be the case here,” said Drosten, but added: “Overall, however, far fewer people will become seriously ill and die than in 2021.”

Drosten said he expected many more infections from September.

“I hope that the school holidays will dampen the increase in cases somewhat. But from September, I fear we will have very high case numbers,” the head of the virology department at Berlin’s Charité hospital told Spiegel.

READ ALSO: German Health Minister lays out autumn Covid plan

Virologist Christian Drosten at a Covid press conference in 2021.

Virologist Christian Drosten at a Covid press conference in 2021. Photo: picture alliance/dpa | Kay Nietfeld

If the government does not take any action, he predicted there would be a lot of sick leave across all industries. “That will become a real problem,” he said.

Drosten said he did not expect overcrowded intensive care units in Germany.

But the new BA.5 sub-variant, which is becoming dominant in Germany, may affect people more strongly. 

“The wheel is turning more towards disease again,” said Drosten. It is not true that a virus automatically becomes more and more harmless in the course of evolution. “That makes me even more worried about the autumn,” he said.

Drosten recommends wearing masks indoors during the colder months, saying it is “the least painful” measure.

If, in addition, “up to 40 million people could be immunised or given a booster vaccination” before winter, for example by urgently calling for company vaccinations, that would “really make a difference”, Drosten said.

In the long term, he said it’s inevitable that people will become infected with coronavirus.

He said the population immunity due to vaccinations and infections will at some point be so strong that the virus will become less important. “Then we will be in an endemic state,” said Drosten. In the worst case, however, this could take “several more winters”.

However, Drosten warned against people trying to deliberately infect themselves with Covid, saying getting the infection in summer doesn’t mean people will be protected in winter. 

Drosten himself said he has not yet contracted Covid-19.

“So far, I guess I’ve just been lucky,” he said. “I rarely put myself in risky situations, but I’m not overly cautious either.”

‘Pandemic depends on behaviour’

According to the Robert Koch Institute (RKI)’s latest weekly report, more outbreaks are occurring in care homes, and the number of patients in intensive care units is slightly rising as infections go up. 

The institute said there had been a 23 percent increase in the 7-day incidence compared to the previous week. On Friday the 7-day incidence stood at 618.2 infections per 100,000 people. There were 108,190 infections within the latest 24 hour period and 90 deaths. 

“The further course of the pandemic depends not only on the occurrence of new virus variants and the uptake of vaccinations on offer, it also depends to a large extent on the behaviour of the population,” said the RKI.

According to the DIVI intensive care register, the number of Covid-19 patients in ICUs had increased to 810 on Thursday this week, from about 600 at the beginning of the month.

However, that number is still low compared to previous Covid peaks when thousands of people were in intensive care in Germany. 

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