Germany’s Covid incidence sinks – but experts warn of under-reporting

Germany's 7-day incidence of Covid infections is falling, sparking hope. But experts say health officials are struggling to report all cases, suggesting the downwards trend may be artificial.

A sign at a shop in Magdeburg, Saxony-Anhalt says entry is only for people who are vaccinated or have recovered from Covid.
A sign at a shop in Magdeburg, Saxony-Anhalt says entry is only for people who are vaccinated or have recovered from Covid. Photo: picture alliance/dpa/dpa-Zentralbild | Klaus-Dietmar Gabbert

The Covid incidence dropped to 432.2 infections per 100,000 people within a seven day period on Tuesday. The incidence was 441.9 the day before, and a week ago it was 452.2 (a month ago it was 191.5).

According to the Robert Koch Institute (RKI), there were 36,059 Covid infections reported throughout Germany in the last 24 hours – significantly fewer than in the previous week, when there were 45,753 daily infections logged on the same day. 

There are hopes that these are signs of a trend reversal that shows Germany is finally gaining some control over the fourth wave. 


However, experts say there is significant under-reporting which could be skewing the picture. They say one of the main reasons is because health authorities and clinics  – at least in some areas – cannot keep up with the sheer number of cases.

This is shown by the latest figures in Saxony. Covid cases appeared to fall sharply on Tuesday to 949 daily cases. Yet on Monday, authorities in Saxony reported around 4,242 cases, and a week ago there were 6,627 new infections, raising questions about incomplete reporting. 

For comparison, the neighbouring state of Saxony-Anhalt, which has a much smaller population, registered 3,009 new infections Tuesday.

Data journalist Olaf Gersemann says this suggests the falling numbers may unfortunately be “too good to be true”.

RKI chief Lothar Wieler said on Friday that the number of infections was “still far too high” and that it was “far too soon to talk of a trend reversal and avoid stricter measures”.

Wieler added that health authorities were no longer able to keep track of all the infections.

“In some states we may be seeing the early effects of new Covid measures, in others the capacity has been exhausted,” Wieler said.

Deaths still at a high level 

The number of Covid-related deaths in Germany remains at a high level. Nationwide, 399 deaths were recorded within 24 hours. 

Meanwhile, the number of Covid patients admitted to hospitals in Germany per 100,000 people in seven days was 5.32 on Monday (on Friday it was 5.52). 

Around 4,900 patients are currently in intensive care wards across Germany with a Covid infection, according to the DIVI intensive care register. Of those, just over half are receiving ventilation treatment.

Doctors have repeatedly told how some hospitals are overwhelmed, with many having to cancel planned operations or even transfer Covid patients elsewhere for treatment.

Bundestag debates Covid measures and mandates

On Tuesday, the Bundestag was set to discuss planned compulsory Covid-19 vaccinations for staff in hospitals and nursing homes.

MPs will also discuss plans to ramp up vaccinations in Germany and possible amendments to the Infection Protection Act that would see German states get more power to bring in stricter Covid measures such as restaurant closures. 

READ ALSO: Could German states order bar and restaurant closures under new Covid laws?

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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.