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EXPLAINED: What will the Covid situation look like in Germany this winter?

Covid infection numbers are currently falling in Germany, but this could change as temperatures begin to drop. Here’s what we know so far about what the coming winter will look like.

A woman wearing an FFP2 mask, thick cap and headphones sits at a bus station as a public bus passes by.
A woman wearing an FFP2 mask, thick cap and headphones sits at a bus station as a public bus passes by. Photo: picture alliance/dpa | Jonas Walzberg

Endemic rather than pandemic?

One factor that makes this winter different from the previous two years is that a much higher percentage of the population has now had some form of contact with the Covid virus.

A recent study funded by the German Federal Ministry of Education and Research, for example, detected Covid antibodies in the blood of more than 95 percent of study participants.

In an interview with Bavarian Radio last week, Thomas Mertens, chairman of the Standing Commission on Vaccination (Stiko), assessed the Covid-19 situation in Germany as an “endemic viral infection”.

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

A disease is considered endemic if it occurs permanently in a region with a relatively constant number of cases. In a pandemic, on the other hand, “an unknown pathogen encounters a human population that has no immunological experience with it”, Mertens explained.

Thomas Mertens, Chairman of the Standing Commission on Vaccination (STIKO), speaks during a press conference. Photo: picture alliance/dpa | David Young

As a large part of the German population has now developed basic immunity against Covid-19, this means that the situation in  Germany is becoming more endemic.

However, recent projections published by the Technical University (TU) in Berlin, have shown that Germany could still be hit with a new winter wave of Covid infections, even if no new dominant variant emerges.

Bremen epidemiologist Hajo Zeeb also told DPA that: “I don’t assume that the current wave – which appears to be waning slightly – is already the last one this autumn/winter”.

Vaccinations and medication

Since October 1st, a booster vaccination has been required in order to be considered fully vaccinated in Germany.

READ ALSO: What to know about getting a fourth Covid vaccination in Germany

There are currently several advanced vaccines available that have been adapted to the current Omicron virus variants BA.1 and BA.4/BA.5. Currently, the official recommendation from the Standing Commission on Vaccination (STIKO) stipulates that people over the age of 60 should get a further booster vaccination, as well as those over the age of 12 who have an underlying health conditions and residents and staff in nursing homes or long-term care facilities.

A steep increase in Covid cases could see Omicron vaccinations being recommended for all age groups, however.

Drug treatments for Covid patients will also be more widely promoted over the next few months and doctors’ offices are now able to dispense the drug Paxlovid directly without patients having to go to the pharmacy.

New variants

As reported by The Local, experts expect new sub-variants of the Omicron BA.5 to spread rapidly in the coming weeks. The European disease control agency (ECDC) expects case numbers to increase due to the Omicron sub-variants BQ.1 and BQ.1.1. 

Which rules might come back?

Under the current Covid regulations, which came into force on October 1st and apply nationwide, mask-wearing is only mandatory on long-distance trains and for residents and staff in nursing and care homes.  

READ ALSO: Are German states poised to bring back uniform Covid measures?

Whether or not to increase restrictions is up to the states. It’s likely that, in the event of rising numbers, states will broaden the mask-wearing rule, rather than reintroduce the so-called 2G and 3G rules, which set restrictions on public life based on vaccination and recovery status.

A notice indicating that masks are mandatory in doctors’ offices is posted at the entrance to a doctor’s office. Photo: picture alliance/dpa | Harald Tittel

Most states have already taken measures to enforce mask-wearing on their own transport networks, though some differ on whether passengers have to wear an FFP2 mask or if a surgical mask suffices. 

Last week, Johannes Nießen, chairman of the Federal Association of Public Health Physicians, urged ministers to establish a clear measure for what constitutes a “critical” situation after which Covid measures must be tightened.  

Speaking to ARD’s Morgenmagazin show, he said that it should be clear which rules will apply in both Hamburg and Munich “if the incidence reaches 500 or 1,000”.

Though some states, like Lower Saxony, have come up with their own thresholds for loosening and tightening measures, there is no clear guidance in the Infection Protection Act about what constitutes a “critical” situation. 

READ ALSO: German health minister urges states to bring back mask-wearing indoors

In mid-October, Federal Health Minister Karl Lauterbach also urged states to reintroduce the obligation to wear a mask in indoor spaces.

How will the situation look in hospitals?

Most researchers, experts and politicians no longer see the health threat posed by the virus itself as the biggest problem. What is a cause for concern, however, is the serious staffing problems in hospitals due to high infection numbers.

In Lower Saxony, for example, the incidence of weekly hospitalisations and the proportion of beds occupied by Covid patients – rather than Covid infection numbers – are the two key benchmarks for deciding which Covid measures to bring in. It could be that as the winter progresses, other states introduce such benchmarks. 

Hospital beds stand in a corridor at Großhadern Hospital in Munich. Photo: picture alliance/dpa | Lukas Barth

Intensive care physician and member of the German government’s Corona Expert Council, Christian Karagiannidis, warned that the already precarious situation in nursing is becoming even more dramatic because so many employees are catching Covid.

Speaking to the Rheinische Post on Monday he said: “Our main problem in the health care system is currently the multiple staff shortages and the associated bed closures.” 

“If the number of patients increases significantly in the winter, the system will come under extremely heavy strain. I can’t imagine this happening without limiting regular care,” Karagiannidis said.

Bremen epidemiologist Hajo Zeeb also said that he expects care facilities to be “under more or less permanent pressure this winter”. 

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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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