It is too early for optimism in the corona crisis, warn scientists. The second wave of an epidemic could be far more devastating than the first.
© Photo: Robert Michael / dpa
Contact restrictions masks – all this will be necessary for a long time.
Charité virologist Christian Drosten and epidemiologist Michael Meyer-Hermann warn of the possibility of a second wave of Covid-19 infections, which could result in early loosening of existing measures.
As early as April 13, the Helmholtz Initiative issued a statement with an epidemiological analysis of the Covid 19 epidemic. In the Tagesspiegel interview, Meyer-Hermann explained why a reproduction number of 1 would also be problematic. A vaccine will not be available until next year, and herd immunity would take 25 years. So strict contact restrictions are now needed to dry out the virus over a short period of time.
In the ARD talk show “Anne Will” Meyer-Hermann, who is originally a mathematician and philosopher, confirmed this assessment. The past week would have confirmed him in this course, said Meyer-Hermann. Due to the announced easing, which the federal and state governments had decided, the population had the feeling that the problem had already been solved. “But that’s not the case,” said Meyer-Hermann.
Low reproduction number is “artifact of Easter week”
In addition, there was the reproduction number of 0.7, which the Robert Koch Institute reported on April 16. The number describes how many others infect an infected person who has been given the political goal to lower them below 1. Meyer-Hermann calls the number “nothing more than an artefact of Easter week”.
It was created artificially, since fewer cases were reported in Easter week and is already increasing again. It is now at 0.8. Meyer-Hermann assumes, however, that it will rise to 1 again, especially since there were probably more contacts than usual on Easter. So the number is no reason to be relieved.
The scientist named two possible ways of dealing with the epidemic. One way is to keep the number of reproductions at around 1. “If we do that, we will have to deal with restrictions over a very long period of time,” says Meyer-Hermann. According to calculations by the Helmholtz Initiative, the health system would then remain stable, but there could not be any major easing.
No clear decision from politics
“The moment we go above and beyond the easing, we will come back to the exponential growth of the virus,” explains the epidemiologist. Then you would have conditions like in Italy or New York, would be unable to act and would have to impose a lockdown again. So this option is a “permanent tightrope walk”.
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The second option that the epidemiologist prefers is to try to dry out the virus. This would require strict contact bans for several weeks. If radical measures in a relatively short time window reduced contacts so much that the virus could no longer spread, there would be a chance to control the remaining cases using methods such as contact tracing through apps and tests. The epidemic would then be a “controllable problem”, business and social life could “return to the old normal”.
The number of reproductions for this scenario must be 0.2 or 0.3. Meyer-Hermann criticized the federal and state governments for not making a fundamental decision as to which of these paths to take. “It looks like we want to coexist with the virus,” he said.
Support from Drosten and Karl Lauterbach
“We have to be extremely careful,” said Meyer-Hermann. The consequences of any easing could only be assessed two weeks after the introduction. Angela Merkel was “damn right” with her call for caution.
The Chancellor had calculated last week that a small increase in the number of reproductions could lead to an overload of the health system. “The scope is small,” she said. Saxony’s Prime Minister Michael Kretschmer (CDU) also spoke cautiously about “Anne Will”. The measures would “go to the limit of what is responsible,” he said.
Meyer-Hermann received support for his statements from Charité chief virologist Christian Drosten. The share a tweet by the SPD health politician Karl Lauterbach on Sunday. Lauterbach spoke in favor of the Helmholtz researcher’s way of now pressing the number of reproductions instead of having hard restrictions for up to two years. “He would have preferred the alternative just like me: Now down to 0.2, then pursue every new case,” Lauterbach wrote.
Drosten wrote on Twitter that it was not clear to him how much the current distance measures were being questioned on all sides. “With R = 1, the virus spreads under the blanket of the measures,” wrote Drosten. “Even now.”
In the NDR podcast, he used the Spanish flu to explain how the second wave of an epidemic could go. At the moment there are still clear regional differences in the number of cases in Germany, according to Drosten. But these will continue to blur.
With Spanish flu, which cost between 25 and 50 million lives worldwide between 1918 and 1920, it was the same at the beginning, said Drosten. In the United States, the disease was only noticed in some places in the spring. In summer, the disease weakened due to the warmer weather and was not noticed at all.
Infection chains in all places at the same time
“Under the blanket of this seasonal effect – we can perhaps imagine it now, under the blanket of the social distancing measures that are currently in effect – this disease spread much better evenly geographically unnoticed,” explained Drosten. “And when you got into a winter wave with the Spanish flu, the situation was suddenly very different.”
Infection chains had started in all locations at the same time, since the virus had spread unnoticed everywhere. This effect will also occur in Germany, according to Drosten. There are no complete curfews and travel barriers and therefore no zero transfer. The virus spreads further, with a reproductive number of around 1, sometimes even lower.
The Institute of Virology at the Charité has researched that the viruses in Germany are already mixing thoroughly and that all viruses are gradually being found in all locations. “The virus will now spread throughout Germany over the next few weeks and months and over the summer,” said Drosten. Also under the cover of measures that are already in place.
If the virus suddenly started from everywhere at the same time in winter, this wave of infection would have a “completely different force”, according to Drosten. That is one of the many dangers of controlled distribution that is rarely discussed. He did not want to make a strong plea for one side, said Drosten. “But there are changes in the background from such an epidemic that you have to take into account.”
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