Boosters, tests and quarantine: German health ministers’ plans to fight fourth Covid wave

The federal and state health minsters will meet this week to thrash out a strategy for the colder months.

People queue for a Covid vaccine in Rostock
Shoppers queue up for a Covid jab at the Impfstützpunkt in Rostock, Mecklenburg Western-Pomerania. Photo: picture alliance/dpa | Danny Gohlke

The Covid situation has been deteriorating in Germany as the infection rate goes up, along with the number of deaths and the number of patients being admitted to intensive care. 

According to German media site Business Insider, the federal and state health ministers (Conference of Health Ministers or GMK) will meet this Thursday and Friday to discuss the next steps. 

Among other proposals, health ministers want to discuss tightening quarantine regulations for close contacts of people who have contracted Covid.

Furthermore – after nearly two years of pandemic – they are also to discuss better protection for elderly people in nursing homes. The proposals also highlight a broader booster campaign, more mobile vaccination teams in the community and comprehensive testing.

On Wednesday there were 20,398 Covid cases over the past 24 hours, according to the Robert Koch health institute, while another 194 people died.

The number of Covid patients in intensive care on Wednesday rose to 2,226 – up almost 26 percent on the previous week, according to Germany’s DIVI registry.

Here’s a look at some of the points in the draft paper ahead of the health ministers’ meeting: 

Vaccinations: The health ministers will be discussing how to encourage people who are still vaccine-hesitant to get their Covid jab. They will also consider whether to reopen closed vaccination centres. 

Booster vaccinations: The federal and state governments want booster vaccinations – especially in care facilities – to be offered at a faster pace by doctors, including family GPs. “To ensure the vaccination offer, supplementary state vaccination offers, in particular mobile vaccination teams, will be used if necessary,” says the draft paper. 

The doctors’ union Marburger Bund also called for booster vaccinations to be offered more quickly. “We need to push the pace more on booster vaccinations,” said chairwoman Susanne Johna. “The health ministries of the states should now inform everyone over 70 by letter specifically about the possibility of booster vaccination,” she said. “You can’t just assume that people already know about it.”

Health Minister Jens Spahn earlier on Wednesday urged states to be proactive about the booster campaign. 

READ ALSO: Germany seeing a ‘massive pandemic of the unvaccinated’

Information campaign: the Associations of Statutory Health Insurance Physicians in the states, as well as family doctors, are asked to actively inform people about the recommendation and the offer of booster vaccinations, the paper says. It goes on to say: “The federal government and the states will increasingly inform people about the possibility and benefits of taking up booster vaccinations as part of their public relations work and will also specifically approach certain vulnerable groups of people for this purpose, for example by writing to citizens over 70 years of age.”

That could even be reduced to the over 60s since Spahn has spoken out in favour of giving all the over 60s a booster jab as soon as possible.

Everyone offered a booster: In fact, health ministers are going a big step further – and essentially want to offer a top-up jab to everyone half a year after their last dose. They say: “In addition, within the framework of existing capacities and after medical assessment and decision, booster vaccinations can in principle be offered to all persons who wish to have them after the expiry of six months after completion of the first vaccination series.”

This plea for all vaccinated Germans to get a booster jab after six months is at odds with the nation’s STIKO vaccine commission, which at the moment is only recommending booster shots for the elderly and certain at-risk groups. However, STIKO announced on Tuesday that it was in the process of researching whether to issue a general recommendation for everyone to be given a top-up. This will depend on how far boosters are shown to be successful in limiting Covid infections, STIKO president Thomas Mertens told DPA.


Covid-19 tests: According to the health ministers, there needs to be a larger focus on testing in care homes. “The federal government and the states say they will work towards ensuring that a sufficient range of tests is available in care facilities,” the draft paper says. “If this turns out to be insufficient, the Federation will examine an adjustment of the testing strategy and expansion of testing opportunities for staff and visitors in a timely manner and adapt the legal and financial framework and ensure sustainable funding.” Test concepts are to be reviewed “closely” by the supervisory authorities of the care facilities.

Rhineland Palatinate and Brandenburg have recently introduced mandatory daily tests for staff who work in care homes.

Costs: The federal government will continue to ensure that care facilities are reimbursed for the personnel and material costs of testing without burdening those in need of care, the paper says. 

What else should I know?

Some states are now beginning to tighten their Covid measures, with pressure being piled on those eligible for vaccination who choose not to get it. 

READ ALSO: How German states are tightening Covid rules for winter

Outgoing Chancellor Angela Merkel, said she was in favour of stricter curbs focussed on the unvaccinated.

“If the pandemic situations in hospitals worsens… then further restrictions for unvaccinated people are possible,” Merkel’s spokesman Steffen Seibert said on behalf of the chancellor.

Meanwhile, there are calls for a meeting between the caretaker government and the regional leaders of the 16 states to discuss a nationwide approach to the Covid surge. 

Under Germany’s federal system, regional states have significant powers to decide their own Covid approach, at times leading to a confusing patchwork of regulations.

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Bavaria signals end to compulsory masks on public transport

Bavaria's state premier Markus Söder (CSU) has announced plans for a "prompt" end to mandatory masks on buses and trains.

Bavaria signals end to compulsory masks on public transport

If infection levels and hospitalisations remain low, the end of the mask-wearing rule could come as soon as December or January.

“We are convinced that the mask requirement in public transport could also be phased out either in mid-December or early next year, if the numbers remain reasonably stable and there are no new mutations,” Söder explained on Monday, following a meeting with the CSU executive committee. 

A decision on when to end the measure would be made “promptly”, he added.

The CSU politician had said last week that the sinking infection rates meant that compulsory masks were no longer appropriate and that the mandate could be changed to a recommendation. 

No set date for change

The latest version of Bavaria’s Infection Protection Act – which lays out an obligation to wear masks on public transport as one of the few remaining Covid rules – is currently due to expire on December 9th.

State ministers could decide whether to let obligatory masks on buses and trains lapse on this date as early as next week, or they could decide to initially extend the legislation and set an alternative date for ending the rule.

Regardless of their decision, FFP2 masks will continue to be mandatory on long-distance public transport until at least April next year, when the nationwide Infection Protection Act is due to expire.

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

Speaking to Süddeutsche Zeitung on Monday after the meeting of the Council of Ministers, Florian Herrmann (CSU), head of the State Chancellery, confirmed that Covid-19 had been discussed in passing.

However, no decisions or discussions were made on how to proceed after the expiry of the regulation, he said.

According to Herrmann, the fact that Covid was no longer the “dominant topic” in the cabinet under “enormous tension” shows “that we are returning to normality” in a gradual transition from pandemic to endemic. 

As of Wednesday, the 7-day incidence of Covid infections per 100,000 people stood at 108 in Bavaria, down from 111 the previous day. However, experts have cast doubt on how meaningful the incidence is in light of the fact that fewer people are taking tests.

Nevertheless, the 133 hospital beds occupied by Covid patients in the Free State falls well below the 600 threshold for a ‘red alert’. With Omicron causing less severe courses of illness than previous variants, politicians have increasingly focussed on hospitalisation statistics to gauge the severity of the situation.

‘A risk-benefit trade-off’

Bavaria is the second federal state to announce plans to relax its mask-wearing rules in recent weeks.

On November 14th, the northern state of Schleswig-Holstein announced that it would be ending obligatory FFP2 masks on public transport and urged other states to do the same. From January 2023, masks on public transport will only be recommended rather than mandated for passengers on local buses and trains. 

However, the Federal Ministry of Health has urged states not to loosen their rules too quickly.

Given that infection rates are likely to spike again in winter, “there’s no basis for loosening restrictions”, said Health Minister Karl Lauterbach (SPD).

Physicians are also split on whether an end to masks on public transport is appropriate.

READ ALSO: Will Germany get rid of masks on public transport?

Health Minister Karl Lauterbach

Health Minister Karl Lauterbach (SPD) speaks at the German Hospital Day in Düsseldorf on November 14th. Lauterbach is against the lifting of the mask-wearing rule. Photo: picture alliance/dpa | Roberto Pfeil

Christoph Spinner, a virologist at the University Hospital in Munich, told Süddeutsche Zeitung he believed it was time to put the decision on mask-wearing back into the hands of individuals.

“Why not? The incidences are low, the danger of Covid-19 has dropped significantly and mortality has also decreased,” he said. 

But the Bavarian General Practitioners’ Association spoke out against the move, arguing that – unlike a trip to a restaurant or cinema – people often have no choice but to travel on public transport.

“If the obligation to wear a mask in public transport is maintained, this will help to protect against a Covid infection on the way to work by bus or train – especially in view of the discontinuation of the obligation to isolate in the event of a Covid infection,” they explained.

Bavaria is one of four states to have recently ended mandatory isolation for people who test positive for Covid. Baden-Württemberg and Schleswig-Holstein both scrapped their isolation mandate last week, while Hesse removed its obligation on Tuesday. 

READ ALSO: Four German states call for end to mandatory Covid isolation