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COVID-19 RULES

KEY POINTS: German Health Ministry lays out autumn Covid plan

The German Health Ministry has put together a seven-point-plan to combat Covid in autumn. Here's a look at the proposals which are being discussed this week.

People sit outside in Hamburg's Schanzenviertel in April near a sign for Covid tests.
People sit outside in Hamburg's Schanzenviertel in April near a sign for Covid tests. Photo: picture alliance/dpa | Axel Heimken

Health Minister Karl Lauterbach, of the Social Democrats, is presenting Germany’s proposed Covid-19 autumn strategy this week to the states. In seven points, the plan outlines the federal government’s course of action in the expected autumn wave.

Three scenarios for autumn

According to the strategy paper, the government’s Covid Council of Experts sees three possible scenarios for the development of the pandemic in autumn.

– In the most favourable scenario, a less severe Covid variant than the currently widespread Omicron variant would become dominant in autumn. In this case, the Health Ministry says that stronger infection control measures would then no longer be necessary, or would only be needed to protect risk groups. 

– However, a moderately severe scenario is considered more likely, with a disease burden comparable to the current Omicron variants. In this outcome, infections and sick leave from work are expected to increase throughout the colder season. “Despite the moderate Covid-19 burden in critical care, work absences could again require area-wide transmission protection measures (masks and indoor distancing), as well as contact reduction measures on a regional basis,” the ministry’s strategy paper says.

READ ALSO: The Covid rules in place across German states

– In the worst-case scenario, “a new virus variant with a combination of increased immunity escape or transmissibility, and increased disease severity” would spread and become the dominant strain. In this case, the healthcare system would be severely burdened and protective measures such as mandatory masks and distance requirements could only be scaled back in spring 2023 at the earliest, the ministry says. 

But even in the moderately severe scenario, the Health Ministry estimates that without further measures Germany could see about 1,500 Covid deaths per week.

What’s the seven-point plan for Germany to get through autumn?

1. New vaccination campaign

The Health Ministry wants to purchase vaccines that are adapted to the Omicron variant from the manufacturers Moderna and BioNTech/Pfizer, depending on the availability.

From September onwards, a fresh vaccination campaign is to be launched to promote the fourth vaccination (or second booster shot). The aim is to “close the vaccination gap and promote the fourth vaccination; especially in the older population group”.

A man receives his second booster vaccination against Covid in Springe. Lower Saxony in February.

A man receives his second booster vaccination against Covid in Springe. Lower Saxony in February. Photo: picture alliance/dpa | Ole Spata

2. Testing strategy

People in Germany should have access to a PCR test after a positive rapid test. For symptomatic patients, a PCR test should also be possible in doctors’ surgeries without a prior rapid test, as is currently the case.

However, under the plans, there would no longer be free rapid tests – Bürgertests – for everyone. Instead, they would be restricted. Lauterbach wants to continue to offer free tests to people with Covid symptoms and for certain groups.

READ ALSO: German Health Minister wants to scrap free Covid tests for all

The proposals state that there should be preventive rapid tests in nursing homes and hospitals, and for children as well as for people coming into contact with lots of people, for instance before a large event. 

Furthermore, people who can’t get vaccinated for medical reasons should also be entitled to free rapid tests. 

Lauterbach also wants to continue to make free rapid tests available to refugees fleeing war in Ukraine, as well as to people in Covid hotspots.

An easily accessible testing infrastructure, including in pharmacies, should be kept in place, says the paper. 

However, the federal government wants to pay the test centres less money per rapid antigen test and PCR test in future. “The total costs are to be reduced by about half,” the ministry writes in its strategy paper.

The amendment of the test regulation is to be completed by the end of June, the Health Ministry states. Free rapid tests are available in Germany until the end of this month.

A sign for a Covid test centre in Hamburg.

A sign for a Covid test centre in Hamburg. Photo: picture alliance/dpa | Christian Charisius

3. Optimisation of treatment

The German government’s Health Ministry wants to promote more treatment options for Covid.

“Since mortality can be significantly reduced by adequate and timely treatment, a treatment strategy (including for oral antiviral pill Paxlovid) is essential,” the ministry said, adding that effective drugs are not being used enough at the moment. The expert council has been asked to develop an appropriate treatment concept.

4. Protection of vulnerable groups

The Health Ministry considers a comprehensive care and safety concept for nursing facilities and care services essential in preparation for the expected autumn wave.

Lauterbach wants to see that all care facilities establish a ‘hygiene officer’, as is already the case in hospitals. For early treatment with medication, the appointment of a specialised care coordinator should also be put in place.

The aim is to keep nursing homes open for visits from members of the public. However, visiting and hygiene rules need to be established, says the paper. In this context, “the three effective protective measures ‘vaccination, testing, masks’ for staff, residents and visitors are to be enforced”.

5. Daily data

Lauterbach wants to order all hospitals to report the data that is necessary for pandemic management via the German Electronic Reporting and Information System for Infection Prevention (DEMIS) on a daily basis.

The reports should include intensive care capacity, the number of Covid patients in regular wards and intensive care units, and the numbers of free beds. According to Lauterbach’s plans, health care facilities that don’t comply with these reports would be sanctioned.

6. Protection plan for children and youths

The aim is to keep schools and nurseries open throughout autumn and winter. 

“Daycare centres and schools must remain open,” the strategy paper states. But in order to protect children and young people, a nationwide recommendation is to be developed by health and education ministers. Meanwhile, youngsters should also be a particular focus in the vaccination campaign.

An FFP2 mask hangs on a coat hanger at a school in Stuttgart.

An FFP2 mask hangs on a coat hanger at a school in Stuttgart. Photo: picture alliance/dpa | Marijan Murat

7. Changes to the Infection Protection Act

Germany’s Covid infection protection laws allow for rules such as mandatory masks. However, the law expires on September 23rd, and states have been pushing for the government to extend and strengthen it in case they need to put in place tougher measures, like contact restrictions.

READ ALSO: German states seek powers to enforce tougher Covid rules in autumn

According to the paper, the law is to be “further developed in good time before 23rd September 2022”. The Health Ministry said the findings of the expert council’s statement would be taken into account, as well as those of the expert commission evaluating the previous Covid protection measures, by the end of June.

However, a decision on exactly which measures the Infection Protection Act will contain after this date is to be made only after the evaluation reports have been presented on June 30th.

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HEALTH

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. 

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