German public health authority warns of Omicron subtype risk

As Germany plans its phased reopening of public life, the Robert Koch Insitute (RKI) has warned that a resurgence of infections - partly due to a subtype of Omicron - cannot be ruled out.

Covid-19 laboratory
A laboratory worker in Hamlin, Lower Saxony, works with Covid-19 testing samples. Photo: picture alliance/dpa | Julian Stratenschulte

Writing in its weekly report, the Robert Koch Institute (RKI) said that the wave appeared to have peaked but noted that infection rates remained high in the population. 

The proportion of positive tests remained high, it said, with around one in two tests confirming an infection last week. The RKI also estimates that around 1.4 to 2.3 million people in Germany fell ill with acute respiratory symptoms caused by Covid-19 last week, resulting in around 380,000 Covid-related visits to doctors.

READ ALSO: KEY POINTS: What you need to know about Germany’s Covid reopening plan

As analyses of virus variants show, a worrying subtype of Omicron known as BA.2 is spreading continuously in Germany. According to the latest available data for the week ending February 13th, the BA.2 accounted for just under 24 percent of positive samples, according to the report. In the preceding weeks, the share of the subtype has grown from five to 16 percent. Since BA.2 is believed to be even more infectious than the current dominant subtype (BA.1) in Germany, experts expect this positive trend to continue. 

Referencing developments in neighbouring Denmark, a team at Berlin Technical University warned that Germany could see a resurgence in infections at the end of February because of the BA.2 subtype.

Due to the easier transmissibility of BA.2, “a significantly slower decrease or renewed rise in the number of cases cannot be ruled out”, the RKI said. The further development also depends strongly on the impact of increased social contact as Germany eases its Covid restrictions. 

So far in the Omicron wave, the sub-variant BA.1 has dominated. Its share is declining in the RKI evaluations and currently stands at 75 percent.

“In populations with high immunity due to vaccinations or infections, no differences in the severity of the illnesses between BA.1 and BA.2 were found,” the weekly report states.

READ ALSO: Health Minister urges German states not to relax Covid rules too quickly

Demographic changes

In addition, the report indicates that Omicron is increasingly reaching older people, who are more vulnerable to severe courses of illness.

“While seven-day incidences decreased in all age groups up to 69 years, there was a further increase in those aged 70 years and older last week,” it said. There are also increasing outbreaks in old people’s homes and nursing homes. However, the level of outbreaks this winter is significantly lower than last winter.

At schools, on the other hand, outbreak reports have risen to peak levels since the beginning of the pandemic in the wake of the Omicron wave. The maximum value was reached in the third week of January, with 1,089 outbreaks reported so far. Among children and adolescents aged 5 to 14, the number of recorded infections is still by far the highest among all age groups.

“The high number of outbreaks may be related to the Omicron variant that has been circulating dominantly since 2022, the temporarily expanded testing activities and varying effectiveness of the hygiene concepts in schools,” the RKI explained. 

On Friday, the RKI reported a 7-day incidence of Covid infections of 1,259.5 per 100,000 people – down from 1,265 the previous day and 1,371.7 the previous week. 

Local authorities in Germany reported 210,743 new Covid infections and 226 deaths within the last 24-hour period. 

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Five things to know about the Covid pandemic in Germany right now

As the weather warms up and tourism returns to Germany, this spring feels more normal than the last two years. So what is the pandemic situation in Germany - and how will it develop?

Five things to know about the Covid pandemic in Germany right now

Covid cases falling – but lots of unreported infections

The number of Covid infections in Germany has been falling recently, according to official figures. On Tuesday, 107,568 Covid infections were logged within the latest 24 hour period, as well as 218 deaths. The 7-day incidence fell to 522.7 infections per 100,000 people. 

The Robert Koch Institute’s weekly report from May 5th stated: “The peak of the current wave has clearly been passed, many hospitalisation indicators and and deaths continue to decrease.”

But experts warned that “the infection pressure remains high with almost 600,000 Covid-19 cases transmitted to the RKI within the last week”.

It’s worth keeping in mind that many cases of Covid are going unreported. 

Johannes Nießen, chairman of the Federal Association of Public Health Service Physicians, told Tagesschau: “Many rapid tests are not confirmed by PCR testing. And since only PCR testing is included in the incidence-value calculation, we assume that the incidence value is at least twice as high as reported.”

READ ALSO: Germany reports no Covid deaths: What does it mean?

Changes to testing 

There was a time a few months ago when you had to queue for a long time to get a Covid test in Germany. But after the testing priorities changed (with a focus on PCR testing for key workers and vulnerable groups) and Covid restrictions were eased, test stations became quieter. 

And at the end of May, there will be another key change – government-funded Schnelltests will no longer be free to the public. So it won’t be possible to run to your nearest test station to check on your infection status if you think you have Covid. You’ll either need to buy a self-test or pay for a test at the centre. 

A pop-up Covid testing station in Münich.

A pop-up Covid testing station in Münich. Photo: picture alliance/dpa | Sven Hoppe

… but there are still Covid restrictions in place 

The so-called 3G and 2G rules – meaning people had to show some kind of proof to enter a venue like a restaurant – are no longer in place across Germany. 

Mask rules were also relaxed around the beginning of April.

But people in Germany still have to wear a Covid mask on public transport as well as long-distance trains and planes. They also remain in places where there are lots of vulnerable people such as hospitals, care homes and shelters for the homeless.

Some independent businesses and organisations can, however, ask visitors to wear a mask or take a test. 

Covid isolation rules are still in place but they have changed, too.

Now people who get a positive Covid test have to isolate for at least five days. They have the possibility to end it after five days if they haven’t had symptoms for 48 hours, or with a negative test (depending on the state rules). If symptoms or positive test results persist, isolation can last a maximum of 10 days. 

READ ALSO: Germany sets out new Covid isolation rules

Reinfections on the rise

It is unclear exactly how many people have been infected more than once. But figures from the Baden-Württemberg state health office show that cases of reinfection are increasing. In December 2021, the share of reinfections in the south-west state stood at 0.5 percent, and in April it rose to 3.6 percent. However, these are only the numbers that have been reported. 

Experts say the reason for the increase in reinfections since the beginning of the year is the Omicron variant. Virologist Martin Stürmer told Tagesschau: “In the beginning, we had the variants Alpha to Delta. The variants were so similar that the antibodies continued to provide good protection against infection or reinfection after vaccination or infection.

“With the Omicron variant, however, the virus has changed so much that this is no longer the case, so that reinfections occur more frequently despite vaccination, boosting or recovery status.”

However, Stürmer said vaccination does protect against severe illness. 

Within the Omicron variant, reinfection with the BA.2 sub-variant after an infection with BA.1 is rare, according to Stürmer. 

Although Omicron has been shown to cause less severe illness in the population in general, ‘long Covid’ – where symptoms persist for a longer period of time – is still a concern and something experts in Germany are watching closely. 

What about new variants?

Experts are urging people to be aware that new variants could emerge in the current climate. 

Stürmer said it’s important to keep in mind that “by allowing a lot of infection, we also allow the emergence of new variants, because basically the mutation rate is higher if we allow a lot of infection”.

“The virus changes,” he added, “and it may be that at some point there will be another variant that challenges us more.”

Health Minister Karl Lauterbach said in April that he expected the pandemic situation to be more relaxed in the summer. But he warned of possible waves and future variants in autumn.