“We have to lower the cases now. Otherwise we will not make it” TIME ONLINE

"We have to lower the cases now. Otherwise we will not make it" TIME ONLINE

What seemed impossible a week ago is now a reality: the corona pandemic is fundamentally changing life in Germany. For the first time in the history of the Federal Republic, a worldwide travel warning applies. Citizens should stay at home. Cinemas, pubs and shops are closed, daycare centers and schools are closed. It is the beginning of a hard time of which no one knows exactly how long it will last. In this period of uncertainty, we need facts to hold on to and serious scientists to explain to us. Virologist Christian Drosten has explained this outbreak. Tens of thousands listen to his podcast on NDR every day. ZEIT ONLINE met Drosten in his office at the Institute of Virology at the Charité in Berlin.

ZEIT ONLINE: Life as we know it stops more and more. Mr. Drosten, are you actually worried?

Christian Drosten: In fact, like many others, I’m just partially repressing the situation. I hope for my family and me that it won’t happen to us. But what can come quite differently. And still others completely hide the new reality.

ZEIT ONLINE: But the people of the country are listening to you, their word is currently weighty. What does this role do to you?

In the Berlin laboratory on the Charité-Campus Virchow site, a large part of the throat swabs from Berlin patients are examined for the new corona virus. On the left, an employee records the request form with information about the patient. Samples are kept in the molecular diagnostic platform (right picture) that still need to be examined.
© Jacobia Dahm for ZEIT ONLINE

Drosten: I just got in there. And it’s getting a little too much for me: media inquiries, political advice. I’m not a politician, I’m a scientist. I like to explain what I know about. Scientific knowledge must be communicated transparently for everyone so that everyone can get an idea of ​​the situation. But I also clearly state where the limits of my knowledge are. I’ve always done that.

ZEIT ONLINE: The country is driving down. Kindergartens and schools have been closed nationwide since this week. Is politics responding appropriately at the moment?

Drosten: Few of the decisions of the past few days were purely evidence-based, and many were above all politically and definitely right. Some of them have certainly come about under the impression of strict measures in neighboring countries. But anyway: I have the impression that a switch has now been flipped in all federal states. Now a decision has been made against events and a decision against daycare and school operations.

ZEIT ONLINE: As you can hear, they played a large advisory role in the fact that the schools were closed. Was it the right decision to do that now?

Drosten: I do not know that. It will probably only become clear later if it was the right time. I have always warned that scientists from other disciplines must also be heard. And that such a decision is beyond the competence of an epidemiologically educated virologist that I am. I don’t see my job in shortening the truth, but in explaining the truth’s aspects, but also to allow uncertainties and to say: You don’t know that – and that a political decision is then necessary. And as long as it’s communicated as a political decision, I think that’s okay.

ZEIT ONLINE: Will the measures work?

Drosten: Hopefully you will change the dynamics of the transmission drastically. It may be possible to judge that by Easter. Perhaps we will already see that we have fewer infected people than one would expect from the current exponential growth. That the curve becomes flatter. This will have less of an impact on the death rate. Because the people who will die in the period up to Easter are now partially infected or will become infected in the next few days. In addition: The decisions that have now been made do not have an immediate effect, but only after a few days. Certain things are slowly coming in, people have organized childcare for their children, more and more people have understood that one should no longer meet in groups. It will take a while for this to get used to.

ZEIT ONLINE: Now a curfew is also being discussed. Also because maybe not everyone has understood that they should stay at home and reduce social contacts, also to protect others.

Drosten: I think the penny is falling these days. The measures are still fairly fresh, but now most will understand. There will always be some incorrigible people. Sure, they don’t exist in China – they will be improved there. But I’m glad that we don’t live in such a society. And I’m also not sure whether it is necessary for the overall picture of the epidemic to still fish out the very least incorrigible.

ZEIT ONLINE: In view of corona parties, you wouldn’t say: No one is allowed out now.

Drosten: Who am I to say something like that? As a virologist in my field I can say up to a certain point, it is so. Other things are no longer in my area. I’m no longer a scientist, I’m just a private individual. I have no mandate from any voter. However, I believe that a lot has already been achieved by closing pubs and restaurants, canceling major events and closing daycare centers and schools in combination. The aim is to prevent the largest proportion of contacts.

Christian Drosten, head of virology at the Berlin Charité and Germany’s best-known corona explainer
© Jacobia Dahm for ZEIT ONLINE

ZEIT ONLINE: How do you judge how Germany managed to start this outbreak?

Drosten: I believe that Germany recognized its outbreak early on. We are two or three weeks earlier than a few neighboring countries. We did it because we do so much diagnostics, test so much. We certainly missed cases in this first phase, that’s always the case. But I don’t think we missed a major outbreak. This thesis also speaks for the fact that, as expected, we see cases in Germany increasing. But we also see that we have fewer deaths than other countries. So you might think that we are not too far from the whole of the cases. We certainly don’t see all cases by a long shot, but in proportion more than other countries that test less.

ZEIT ONLINE: For example Italy?

Drosten: In Italy, it is probably tested above all who is admitted to the hospital. Because people there know that there aren’t enough tests anyway, they stay at home with symptoms, and when they get worse, they go straight to the hospital. There they arrive with shortness of breath and actually have to go to the intensive care unit. And this is when they are tested for the first time. Therefore, the average age of the recorded cases in Italy is much higher than ours. I assume that a large number of younger Italians are infected or have been infected without having been recorded. This also explains the supposedly higher mortality from the virus there.

ZEIT ONLINE: How long will we be able to keep up with testing in this country?

Drosten: At some point this will no longer be possible. We simply cannot increase test capacities as quickly as the number of cases increases. Then two things come together: Some of those who are already ill will die from Covid-19. And because we can’t test everyone anymore, we won’t have everyone in the statistics. Then our case mortality will also increase. It will look like the virus has become more dangerous, but it’s a statistical artifact, a distortion. It shows what is already beginning: we are missing more and more infections.

ZEIT ONLINE: What can you do about it?

Drosten: You have to take shortcuts. If one person in the household tested positive, we could define the whole household as positive – even without a test. Because you simply know that it will happen like this: if one family member is infected, it infects everyone else. If you say the same, they are all positive, you save a lot of testing. Imagine that you are infected and the next day your wife has to queue up. And then the test may not work and it has to come again. It doesn’t make sense. It is better that the whole family stays in home insulation directly. This path is already being followed in the Netherlands and I will now suggest this in discussions with health authorities in Germany.

ZEIT ONLINE: What are the possibilities?

Drosten: At some point, suspected cases will only be reported on the basis of symptoms and the statistics will then be used to orientate them more. At the same time, you will have to focus the tests you have on risk groups. If an otherwise healthy student watches Netflix in their quarantine on the sofa, I, as a family doctor, do not have to know whether she is positive or not. She should just sit there and get well again. But if my patient gets sick at 70 and is isolated at home, I would like to test him and then call every two days and ask how it is with the air. So that he can be admitted to the hospital early enough and does not come to the ambulance with his lungs still stuck together, from where he then has to go directly to the intensive care unit.

ZEIT ONLINE: Will we soon have tests that are faster than the current ones?

Drosten: Some are already commercially available, mostly those that detect antibodies. They are likely to be of very variable quality. And they only start to work after ten days, because only then do the patients develop antibodies. For the first ten days, these tests are, so to speak, blind. You will have to wait until antigen tests are developed that directly detect a viral protein. You can imagine that in terms of format, like a pregnancy test – and the evaluation will go as quickly. If the tests work well, you can completely replace the current ones. Then the queues are gone. I hope that maybe it will happen in May.


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