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Covid fourth wave in Germany: Is it the calm before the storm?

Covid infections in Germany seem to be levelling off, but warnings from health experts about autumn and winter continue. Have we flattened the fourth wave or is there more to come?

Covid fourth wave in Germany: Is it the calm before the storm?
People relaxing in Wernigerode, Saxony-Anhalt, this September. Photo: picture alliance/dpa/dpa-Zentralbild | Matthias Bein

What’s happening?

For around two weeks, Covid infections in Germany have been relatively stable – and recently have even declined.

The 7-day incidence on Thursday stood at 76.3 cases per 100,000 people, down from 77.9 the previous day, and from 82.7 just over a week ago.

However, the number of Covid patients admitted to ICU wards has increased – although the situation is not at a critical level. 

READ MORE: Where Covid rates are dropping in Germany – and why

So what does it all mean? Are we over the fourth wave? Or should we be prepared for a difficult autumn? The picture is mixed but most health experts agree that it’s far too early to believe the pandemic is over. 

How can we explain the current situation?

Thorsten Lehr, a Saarbrücken-based expert on Covid forecasts, says the current development appears to be based on a few things. One factor is that the number of travellers coming back to Germany from abroad is dwindling now the summer holidays are over – and with it the number of infections, he told DPA. 

Secondly, Lehr says after schools returned from German states following the holidays, the number of infections among schoolchildren skyrocketed due to lots more regular testing. But the numbers in this age group are now stagnating. 

 “There is a certain amount of normalcy returning,” he said. 

Viola Priesemann, head of a research group at the Göttingen-based Max Planck Institute for Dynamics and Self-Organisation, said stagnating numbers of new infections in neighbouring countries could also be a reason for the drop in Germany. 

Cases in neighbouring places – such as Czech Republic, Austria and France – have heavily impacted border regions in Germany in the past where many commuters flit between countries. 

Now that numbers seem to be falling in some regions around Germany (although not Austria) this could be having a knock-on effect.

The Our World in Data chart below gives an idea of the cases per million people in some nearby countries.

Are we over the worst of the fourth wave?

Unfortunately, experts say we can’t give the all-clear at this stage.

“It is certainly too early to speak of a slowdown in the fourth wave,” said epidemiologist Hajo Zeeb of the Leibniz Institute for Prevention Research and Epidemiology.

Lehr also warns against jumping to conclusions. “We observed this trend of the incidence curve almost to the day last year,” he said. 

At that time, the incidence also dropped slightly or remained at a constant level, before rising sharply at the end of September. “With the current vaccination situation and the loosened contact restrictions, a similar increase can be expected again in late September, early October again,” Lehr said.

Lehr believes an increase is also likely due to the so-called seasonality effect; i.e., the influence of the time of year. If the seasonality in spring and summer acted as a a “tailwind” in the reduction of infections, it will probably become a “headwind” again from October, he argues.

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Mobility researcher Kai Nagel also believes that a significant spike in infections is likely when more activities move indoors as summer shifts to autumn.

But he can’t predict whether this will lead to an overload of hospitals. 

Nagel did, however, call for everyone to be tested when they are indoor at public gatherings – including the vaccinated. At the moment, Germany’s Covid health pass rules mean vaccinated and recovered people do not have to be tested to dine indoor at restaurants or visit the cinema, for instance. 

He said that’s because vaccinated people can still transmit the virus, even though being vaccinated protects the vast majority of people from getting seriously ill. 

Germany is set to change its strategy from October 11th, when people will then be charged for Covid rapid tests. So we are yet to see what that effect will have on the infection dynamics. 

READ ALSO: Who will still get free tests in Germany in October?

Priesemann said it’s too early to tell what will happen in the colder months.

“We still have the potential in Germany for the numbers to go up significantly in autumn. And so high, in fact, that even the hospitals could again get very burdened,” she said, adding that this would be because many people are still not vaccinated. 

With regard to people over 50, Priesemann said: “If more than 10 percent of the relevant age group are not immunised, then those 10 percent have the potential to fill hospitals.”

Last winter, she said, about 10 to 15 percent of people were infected, and that alone had stretched the hospitals to their limits for months. That’s why it’s necessary to keep precautionary measures in place – and continue to promote vaccination – “so that we can get through the winter without bottlenecks”, she said.

Is there any good news?

Yes. Epidemiologist Hajo Zeeb sees the stagnation of infections as a reason for cautious optimism.

“Hope is justified, especially in view of low hospitalisation and and death rates,” he said.

He added that the way things stand this year, the situation is much better – thanks to vaccinations. 

Last week Lothar Wieler, of the Robert Koch Institute said: “Vaccinations are the most powerful tool we have in the fight against the pandemic.”

The RKI estimates that vaccinations prevented 77,000 hospitalisations and 20,000 cases in intensive care units between January and July this year, as well as 38,000 deaths.

“That’s a really great success that we can attribute to the vaccinations,” he said during a press conference with Health Minister Jens Spahn. 

At the moment 66.9 percent of the population has received at least one jab, and 62.7 percent are fully vaccinated. 

Germany on Monday launched a vaccination week to help convince more people to get their jab. 

Zeeb added that the other hope is, of course, that new variants do not emerge and “upset the outlook”.

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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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