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How Germany’s virus hunters are tracking down corona outbreaks

Painstaking detective work is needed in Germany to trace and stamp out coronavirus infection chains. This is how they've been doing it, and how they'll continue to work with the new tracing app.

How Germany's virus hunters are tracking down corona outbreaks
Two German Red Cross employees wearing protective suits. Photo: DPA

A team of medical students pressed into service by Cologne's public health office are scrambling to cut off potential new chains of coronavirus infections by endlessly repeating the same questions.

“What are your symptoms? Who have you met in the last few days?” they ask people with confirmed or suspected cases.

Such painstaking detective work is vital to avoid a second wave with more deaths and economic damage, as Germany eases the far-reaching lockdowns imposed in March to control the disease's spread.

From Tuesday, the human virus trackers are backed up by an official contact tracing app, aping other nations' efforts to automate identification of potentially infectious encounters.

 “It's not the first warning app to be launched worldwide, but I'm very convinced that it's the best,” Chancellor Angela Merkel's chief of staff Helge Braun – himself a doctor – said Tuesday.

For now, a fax dropping out of the machine in the Cologne office announcing another positive coronavirus test marks the start line for the team.

READ ALSO: 11 things to know about Germany's newly launched coronavirus tracing app

Relentless questioning

With not a minute to lose, the health office aims to call the new case within an hour.

Their task on that first call starts with warning the person they are sick and should quarantine themselves.

But the staff must also “manage emotions” that can range from a false sense of security to panic, says Andreas Gehlhar, one of the 200 students manning the phones since March.

For worse-afflicted neighbours Germany has proved to be an example, with fewer deaths, at around 8,800, than other European countries like France, Italy or Britain.

Medical students' training in taking a case history from a patient has proved “vital for tracking down the disease,” Gehlhar says.

From the initial case, they spread their net to all of the people they might have come into contact with in the 48 hours before the positive test.

Like detectives, the tracers often can't settle for the first answer they get.

Samples are sent to labs for testing. Photo: DPA

“An old person living in shared housing might tell us she's only seen her daughter in the last two days, and later you find out she spoke to the cleaning staff in the stairwell or sat for 30 minutes in the waiting room at the doctor's office where she was tested,” said Barbara Gruene.

A student doctor, Gruene has found herself at the head of one of the three “brigades” of contact trackers staffing the office.

Once the most extensive possible list of contacts for each case has been established, they must then call each person in turn.

Between them the students can check up on the contactees in more than 20 languages, vital among Cologne's million-strong multiethnic population.

The tracers hope to convince all first-degree contacts to place themselves under quarantine.

“The vast majority agrees,” says Gruene, allowing the office to “break the virus' chains of transmission”.

Second wave looms

In a microcosm of Germany as a whole, Cologne's toll from the virus remains limited, with 2,500 infections since  February and 100 deaths.

The daily tally of new cases is well below the peak of the pandemic in March.

READ ALSO: How will Germany's coronavirus tracing app work?

But “that's no reason to let our guards down,” warns doctor Johannes Niessen, the head of the public health office.

As lockdowns are eased, the federal government plans to step up testing in parallel to keep the virus' spread under control.

“We're prepared for the second wave of infections that could arrive in the autumn,” Niessen says.

Not all of Germany's 400 public health offices are as resilient as Cologne's, with the number of doctors recruited by the state down by a third in the past 15 years according to public health doctors' federation BVOeGD.

Many departing colleagues have not been replaced, as the public salaries on offer can't compete with the private sector.

The federal Health Ministry has vowed to spend €50 million ($56 million) digitising public health offices, and in the spring recruited 500 students as “containment scouts” deployed to virus hotspots around Germany.

Meanwhile the German army told AFP it has pressed 190 soldiers into service as contact tracers in health offices nationwide.

Even the new tracking app “cannot replace our contact work nor the advice we give to patients,” tracker Gruene believes.

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HEALTH

Could there be a new wave of Covid-19 in Germany this autumn?

It’s back again: amid sinking temperatures, the incidence of Covid-19 has been slowly rising in Germany. But is this enough to merit worrying about the virus?

Could there be a new wave of Covid-19 in Germany this autumn?

More people donning face masks in supermarkets, friends cancelling plans last minute due to getting sick with Covid-19. We might have seen some of those familiar reminders recently that the coronavirus is still around, but could there really be a resurgence of the virus like we experienced during the pandemic years?

According to virologists, the answer seems to be ‘maybe’: since July, the number of people newly infected with Covid-19 has been slowly rising from a very low level.

According to the Robert Koch Institute (RKI), nine people per 100,000 inhabitants became newly infected in Germany last week. A year ago, there were only around 270 reported cases.

Various Corona variants are currently on the loose in the country. According to the RKI,  the EG.5 (also called Eris) and XBB.1.16 lines were each detected in the week ending September 3rd with a share of just under 23 percent. 

The highly mutated variant BA.2.86 (Pirola), which is currently under observation by the World Health Organisation (WHO), also arrived in the country this week, according to RKI. 

High number of unreported case

The RKI epidemiologists also warned about a high number of unreported cases since hardly any testing is done. They pointed out that almost half of all registered sewage treatment plants report an increasing viral load in wastewater tests.

The number of hospital admissions has also increased slightly, but are still a far cry from the occupation rate amid the pandemic. Last week it was two per 100,000 inhabitants. In the intensive care units, only 1.2 percent of all beds are occupied by Covid-19 patients.

Still, a good three-quarters (76.4 percent) of people in Germany have been vaccinated at least twice and thus have basic immunity, reported RKI. 

Since Monday, doctors’ offices have been vaccinating with the adapted vaccine from Biontech/Pfizer, available to anyone over 12 years old, with a vaccine for small children set to be released the following week and one for those between 5 and 11 to come out October 2nd.

But Health Minister Karl Lauterbach has so far only recommended that people over 60 and those with pre-existing conditions get vaccinated.

READ ALSO: EXPLAINED: Who should get a Covid jab this autumn in Germany?

“The pandemic is over, the virus remains,” he said. “We cannot predict the course of coming waves of corona, but it is clear that older people and people with pre-existing conditions remain at higher risk of becoming severely ill from Covid-19”

The RKI also recommended that people with a cold voluntarily wear a mask. Anyone exhibiting cough, cold, sore throat or other symptoms of a respiratory illness should voluntarily stay at home for three to five days and take regular corona self-tests. 

However, further measures such as contact restrictions are not necessary, he said.

One of many diseases

As of this autumn, Covid-19 could be one of many respiratory diseases. As with influenza, there are no longer absolute infection figures for coronavirus.

Saarbrücken pharmacist Thorsten Lehr told German broadcaster ZDF that self-protection through vaccinations, wearing a mask and getting tested when symptoms appear are prerequisites for surviving the Covid autumn well. 

Only a new, more aggressive mutation could completely turn the game around, he added.

On April 7th of this year, Germany removed the last of its over two-year long coronavirus restrictions, including mask-wearing in some public places.

READ ALSO: German doctors recommend Covid-19 self-tests amid new variant

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