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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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COVID-19 RULES

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

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