‘These clusters will continue to occur’: Can Germany keep on top of new coronavirus outbreaks?

Germany is currently dealing with a number of localised outbreaks. We spoke to a top epidemiologist to find out why the disease is spreading in some locations and what the country is doing about it.

'These clusters will continue to occur': Can Germany keep on top of new coronavirus outbreaks?
Two grocery store employees deliver food to residents in quarantine in Verl, North Rhine-Westphalia. Photo: DPA

It may feel to many people like the coronavirus pandemic is over. But there’s a new battle in the fight against the virus in Germany: cluster outbreaks. 

There are fears that these large number of infections in regions will lead to the virus spreading to the wider population, creating a second coronavirus wave resulting in future major lockdowns.

The largest outbreak began at the Tönnies meat processing plant in the Gütersloh district in North Rhine-Westphalia. 

Authorities have ordered a lockdown in the districts of Gütersloh and neighbouring Warendorf in a bid to control the situation. 

READ ALSO: What you need to know about Germany's new local coronavirus lockdowns

Why is the outbreak at the meat factory so large?

More than 1,500 workers at Tönnies are confirmed to have contracted the virus. 

“It’s not the first time we’ve seen it in the meat processing industry but this time it’s particularly bad,” Tobias Kurth, professor of public health and epidemiology at the Charité in Berlin, told The Local.

Kurth said it's due to “combination of several factors”, such as people living and working in close proximity to each other which creates an environment where the virus can thrive.

The spread could have been made worse by the conditions in the meat processing plant, such as cool air and poor ventilation, added Kurth.

Germany has also seen new coronavirus clusters in residential buildings in Lower Saxony and in Berlin, where 370 families living in high-rise flats were placed under quarantine in one neighbourhood last week.

Kurth said the issue was linked to people living in close proximity to each other.

“That’s why we’ll have several of these clusters and I’m sure we’ll continue to see clusters like this, not only in Germany but the rest of the world,” he said.

Is testing and quarantining people the best way to control local outbreaks?

Around 7,000 meat factory workers have been ordered to self-isolate. Fencing has been put up around residential buildings where the Tönnies workers live and authorities are distributing food.

Virologists, contact tracing teams, the German army (Bundeswehr) and police have all been drafted in to help carry out widespread testing and to ensure people carry out the quarantine. 

“What we know from many regions in the world is if you quarantine, it’s the best way of controlling the spread of the virus,” said Kurth. 

However, authorities have now decided to impose lockdowns in two districts. 

“Officials are watching very closely to see who else is getting infected,” said Kurth. “Does it stay within the workforce of Tönnies or does it go outside?”

Members of the German army in Warendorf where a lockdown has been imposed. Photo: DPA

The latest numbers say 24 people not connected to the meat plant have contracted coronavirus. 

Kurth said the fear is that more people outside the factory circle could pick up the virus and tougher measures are being introduced to stop this from getting any worse.

Could Germany do more to stop these outbreaks?

Kurth said inequalities regarding living and working conditions would have to be addressed to get to the root of the problem. But this will take time.

The working and living conditions of meat processing plant workers in Germany, many of whom come from eastern European countries and are on short-term contracts, are under the spotlight.

“Now this is maybe a chance, as sad as it is right now, to change the situation,” Kurth said. “For the housing situation that is something we also have to change in the long run: to offer affordable housing in a different way.”

In the short term, the only way to control the spread is for people to take measures, such as wearing masks, keeping distance, avoiding closed rooms with a lack of air and ventilation and rooms with a lot of people in them. 

Plus widespread free testing should continue to be available as part of Germany's comprehensive 'test, track and trace' system.

Kurth added that special programmes providing information to communities, or giving out free masks could also be helpful.

READ ALSO: Fears grow of social conflict as virus spreads in immigrant housing

How difficult will it be to avoid a major lockdown?

No-one wants to see public life closed down across the holiday, like what happened in March. So can this be avoided?

The developments have pushed Germany's four-day reproduction number (R0) above the critical value of 1 to 2.02, meaning 1 person with Covid-19 infects on average more than two others. The 7 day R0 is slightly lower but still not ideal at 1.67.

Experts say the localised outbreaks have contributed to this high increase. However, the overall number of new cases in Germany, according to data from the Robert Koch Institute, is not going up dramatically.

A total of 190,862 people have contracted coronavirus in Germany so far, figures from June 23rd show – an increase of around 500 people from the previous 24 hours. At the peak of the pandemic, Germany was recording more than 6,000 new cases a day.

Around 8,800 people have died in Germany from coronavirus.

So for now it's about controlling these localised oubreaks – which is no easy task, according to scientists.

“These clusters will continue to occur,” said Kurth. “The question is: do we have a larger spread?

“I think if we are prepared for these clusters, going in and testing people, trying to trace people, trying to identify those who have been in contact and isolating them for a specific time, then we’ll be able to control it.

“That’s everything that we can do right now and we have to absolutely focus on this – there’s no medication or vaccine available. Identify these clusters as quickly as possible and isolate people to avoid a major lockdown. That I think is going to be very difficult to achieve.”



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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.