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ANALYSIS: Where (and how) are Germany’s Delta variant Covid-19 infections spreading?

The share of Delta variant Covid infections in Germany among new cases is going up. But where are they being detected and what do experts think about it?

ANALYSIS: Where (and how) are Germany's Delta variant Covid-19 infections spreading?
A sign for a vaccination station in Weimar. Photo: picture alliance/dpa/dpa-Zentralbild | Bodo Schackow

What’s the latest?

Although Covid rates in Germany have been going down, the proportion of the Delta variant first detected in India (B.1.617.2) is growing significantly.

Analysis by the Robert Koch Institute (RKI) found the share of the Delta variant almost doubled within a week – and it now accounts for about 15 percent of new Covid infections nationwide.

READ ALSO: Share of Delta variant Covid cases in Germany almost doubles in a week

Chancellor Angela Merkel on Thursday said Europe needed to remain “vigilant”. 

“In particular the newly arising variants, especially now the Delta variant, are a warning for us to continue to be careful,” said Merkel in the Bundestag.

Health Minister Jens Spahn (CDU) urged people to be cautious.

“I appeal to all travellers to inform themselves carefully about the incidence of infection, to accept test offers and to take the quarantine obligations seriously,” Spahn told the Handelsblatt newspaper.

Asked if people could book their vacations without worry despite the Delta variant, he said, “In principle, yes. However, it looks different for countries that are already heavily affected by the delta variant.” There, he said, the risk of contracting the virus and bringing it home is much higher. A vacation summer should not be followed by an “autumn of worry”, he said. 

The tweet below by German data journalist Olaf Gersemann shows how the proportion of the Delta variant has increased in Germany, particularly in the last three weeks. 

Where are Delta infections happening?

The Alpha variant (B.1.1.7), which was discovered in the UK, still dominates the incidence of infection in Germany, but its share of positive cases in the sample has now shrunk to 74 percent after weeks of hovering around 90 percent. As before, the proportions of Beta (discovered in South Africa) and Gamma (discovered in Brazil), which are also variants of concern, are very low.

Delta has been detected in all German states in the past four weeks, RKI data shows. Information from the reporting system was available for around 1,440 cases during this period. The absolute number of weekly Delta cases has increased since the 21st calendar week (May 24th), from about 270 to about 470 in the 23rd reporting week.

The map below by the RKI represents the number of reported Delta cases (suspected or detected) per district transmitted to the RKI from around the end of May to mid-June. 

As The Local has been reporting, some areas have detected a surge in Delta cases. In Hesse, it already accounts for more than 20 percent of new infections.

READ ALSO: ‘Vaccinate quickly’: German states see surge in Delta variant cases

According to the RKI, the majority of infections are taking place in Germany rather than connected to travel. Most transmissions have happened in private households, and there have also been larger outbreaks involving more than five people in workplaces and schools with up to 24 people.

The most frequently cited countries in connection with introductions from the Delta variant are Afghanistan (19 cases), Russia (16) and Italy (14).

About nine out of 10 people infected with Delta are under the age of 60, according to the report, and this age group accounts for 77 percent of hospitalisations.

Germany takes strict action against regions that are deemed ‘virus variant areas of concerns’, including the UK. Travel is banned from these countries except for residents and citizens. 

However, Chancellor Merkel has spoken out against the patchwork of travel rules across EU countries.

She called on all countries to quarantine arrivals from the UK. Some countries, such as Spain, have no restrictions on people coming from the UK.

READ ALSO: Merkel wants to see all European countries quarantine UK arrivals

Is this a critical time?

Dortmund immunologist Carsten Watzl said this development doesn’t mean people should panic, but called for vigilance.

“The case numbers of Alpha (the dominating variant in Germany) are quite well-behaved and clearly declining, but those of Delta are rising slightly,” he told DPA.

As Delta still accounts for the much smaller share of infection incidence, there has been no overall rebound in infection rates so far, he said.

“We’re still in the balance. But it could be that this is a tipping point now,” Watzl added.

READ ALSO: Nearly a quarter of new Covid infections in Munich area ’caused by Delta variant’

There are fears that Germany will see a steep rise in cases like the current wave in the UK. 

In the UK, Delta accounts for almost 90 percent of all new infections, even though about 60 percent of people there are already fully vaccinated, while 82.5 percent have had at least one initial dose.

Germany has fully jabbed about 33.5 percent of the population, and around 52.5 percent of people have been partially vaccinated. 

Research shows that full vaccination provides high protection against the variant, but preliminary data suggests that Delta can infect people that have received only one dose.

The Our World in Data chart below shows the increasing infections in the UK compared to Germany’s downward trend.

If there are further relaxations of rules or if Delta is imported from abroad through travel opening up, the situation could worsen again, said Watzl, who is secretary general of the German Society for Immunology.

“The good thing is we (Germany) have a buffer, we are at a very low 7-day incidence,” he said. 

EU health officials predicted on Wednesday that the Delta variant will make up 90 percent of all cases across the bloc by the end of August, and urged countries to fully vaccinate people as quickly as possible.

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COVID-19 STATS

EXPLAINED: Where Covid infections are rising rapidly in Germany

Covid numbers throughout Germany are rising, with the states of Saarland, Bavaria and some regions of Hesse seeing particularly high numbers of infections. We look at recent stats, and explore what they mean.

EXPLAINED: Where Covid infections are rising rapidly in Germany

What’s the overall picture?

On Monday, Germany’s Robert Koch Institute (RKI) reported a nationwide incidence of 598.1 infections per 100,000 people within seven days – an increase of over 100 from the previous week, when the incidence was at 471.1.

According to the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), as of Sunday there were 1,468 Covid-19 patients in intensive care units throughout the country – an increase of nearly 50 percent from the previous week when 996 people were reported to be in ICUs with Covid.

But the numbers of infections and hospitalisations vary greatly throughout the country.

States like Berlin and Hamburg, for example, have currently relatively low Covid incidence rates, with 351.6 and 219.0 confirmed infections per 100,000 residents respectively.

One thing to keep in mind though, is that because rapid Covid tests are no longer free for everyone, fewer positive tests are being reported to authorities. 

These are the areas which are currently being hardest hit by the autumn wave.

READ ALSO: KEY POINTS: Germany’s new Covid-19 rules from October

Saarland

The Covid case volume in the southwestern state of Saarland has been far above the national average since the end of September.

On Monday, the RKI reported an incidence of 1248.5  infections per 100,000 people in seven days – more than twice as high as in Germany as a whole.

Saarland’s health minister Magnus Jung (SPD) called the rapid development of infections “worrying”  and said that the situation is tense for both the healthcare system and critical infrastructure in the region. He said that the situation in hospitals was “alarming”, as many planned operations were having to be cancelled or rescheduled due to staffing and occupancy issues. 

READ ALSO: What to know about getting a fourth Covid vaccination in Germany

As a result, the state government is currently considering all options for improving the situation – including amending the state’s Covid regulations to introduce stricter measures, such as mask-wearing in public authority buildings, the health minister said.  

The state health minister has appealed to people to wear masks indoors and to test themselves before attending events and before private meetings. 

As far as the care of Covid patients in intensive care units is concerned, the Saarbrücken Regional Association is currently in eighth place in a nationwide comparison of counties. Here, the proportion of all Covid patients requiring intensive care is 26 percent.

Bavaria

The Covid autumn wave is resulting in 7-day incidences of over 1,000 infections per 100,000 people in more and more Bavarian cities and counties, and is putting a strain on hospitals. On Friday morning, the RKI reported official figures above 1,000 for nine counties and the state capital Munich.

Guests celebrate in the Schützenzelt at the start of the 187th Munich Oktoberfest. Covid infections rose significantly in Munich since the start of the event. Photo: picture alliance/dpa | Felix Hörhager

On Monday, the 7-day incidence for the whole of Bavaria stood at 810.5 infections per 100,000 people – an increase of almost 25 percent within one week and the second-highest figure of all German states.

READ ALSO: Munich sees sharp rise in Covid cases after Oktoberfest

The increasing infection numbers are being felt in hospitals in Bavaria too. On Friday, the city of Munich reported an occupancy of 552 patients with Covid in regular, intensive care and transitional care units – a 47 percent increase from the previous week.

Hesse

The central state of Hesse, where the city of Frankfurt is located, currently has the third highest 7-day incidence in the country – with 746.1 cases per 100,000.

The district of Vogelsbergkreis is currently experiencing particularly high numbers of Covid infections, and as of Monday had an incidence of 1,115.7.

As a result, three of the main hospitals in the district announced a ban on visitors to the hospital last week.

Hygiene and safety expert at the Eichhof hospital in the Vogelsbergkreis, Dr. Gerhard Holzberger, told a local newspaper: “There is no alternative to the measure, the situation is again clearly tense in all areas of life – but especially in the healthcare system.” 

Thuringia

Although the incidence in Thuringia is currently below the national average (475.8 infections per 100,000 people in seven days on Monday) the state currently has the highest number of Covid patients in intensive care in the country. 

In the district of Eisenach in Thuringia, the percentage of Covid patients in intensive care is currently at 47 percent.

What do the rising numbers mean for Germany?

In its weekly report released last Thursday, the Robert Koch Institute (RKI) pointed out that it’s difficult to interpret how dangerous Covid infections really are just by looking at the data.

READ ALSO: When – and how – people can get the new Omicron vaccine in Germany

That’s because the figures relating to Covid-positive patients in intensive care don’t make clear whether a patient is in intensive care due to a Covid infection, or if they require treatment for another illness and happen to have Covid too.

A nurse stands in the Covid isolation area of a hospital intensive care unit in Niedersachsen. Photo: picture alliance/dpa | Friso Gentsch

As for the increasing 7-day incidence of cases per 100,000 residents, many medical experts have said that, with 76.3 percent of the population now fully vaccinated, they expect most people to experience mild cases of Covid this autumn and winter.

The main concern related to rising Covid numbers, however, is that – as is currently the case in Saarland – rising infections will mean staff shortages in hospitals and other critical services.

People have to isolate for at least five days or a maximum of 10 days in Germany if they get a positive test result.

In an interview last week with the German Medical Journal, Christian Karagiannidis, president of the German Society for Internal Intensive Care and Emergency Medicine (DGIIN), said that the mood amongst hospital staff up and down the country is currently tense.

“Staffing levels are thin,” he said. “If there are also severe absences due to Covid or other infectious diseases such as influenza, the atmosphere quickly deteriorates. The system is no longer resilient.”

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