Federal Health Minister Karl Lauterbach (SPD), on the other hand, does not expect the peak of the fifth wave until mid-February, he told RTL. If the number of infections continues to rise at the current rate, the number of new infections should then be well over 400,000 a day. Most recently, the number of cases had doubled about every two weeks.
The big question now is what this immense number says about the pandemic in the fifth wave. Although it is worrying, it does not show the complete picture – which also explains why no stricter corona measures are being discussed before the federal-state meeting next Monday. On the contrary: In Bavaria, the administrative court overturned the 2G rule in retail.
The number of cases alone lost significance in the third and fourth waves, since the number of infections continued to decouple from the number of severe cases due to the increasing vaccination rate. RKI boss Lothar Wieler recently spoke of a “new phase of the pandemic”. The case numbers are less decisive thanks to Omikron – and also less reliable.
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“With the mass of infections, we have to expect that the number of infections will be recorded less well,” he said. The health authorities are so busy that they can no longer keep up with contact tracing and reporting cases.
Laboratories at the limit
In addition, the PCR test capacities are reaching their limits, so that not everyone with a risky contact is receiving such a test. At the peak of the wave, the seven-day incidence was “less complete,” explained Wieler. The same applies to the hospitalization rate and the information on the vaccination status.
In other words, the number of cases should currently be well above the 112,323 infected reported by the RKI on Wednesday. The health policy spokeswoman for the FDP, Christine Aschenberg-Dugnus, spoke to the Handelsblatt of a “high number of unreported cases”.
Because in vaccinated and boosted people, the course of an infection is often asymptomatic. “This means that those affected often do not notice it at all and sometimes only discover it by accident,” warned Aschenberg-Dugnus.
So are we flying blind through the fifth wave? “I would not speak of that,” said Markus Scholz, epidemiologist at the University of Leipzig, the Handelsblatt. “But there are clear difficulties in assessing the situation.” Timo Ulrichs, epidemiologist at the Akkon University Berlin, agrees with this assessment: “The situation becomes more and more difficult to assess the closer we get to the peak of omicron propagation. “
Above all, it is unclear how the high number of infections will affect the clinics and the critical infrastructure by then. Schools are preparing for the impending staff shortage with emergency plans. The police, fire brigade and other facilities such as gas and water works are faced with a similar situation.
Figures published on Wednesday by the Scientific Institute of the AOK health insurance companies give an idea of which sectors are particularly affected by sick leave. In the areas of education, medical and practice assistance as well as in non-medical therapy, in relative comparison most employees had to take sick leave due to an infection.
However, the data refer to the period from March 2020 to November 2021, when the omicron variant was not yet widespread. However, experts expect a similar picture in the current situation.
Staff shortages in the health sector could become an acute problem in the next few days and weeks, said epidemiologist Ulrichs. However, the overload point is difficult to determine. There is no indicator for this, especially since there is no data on the load limit of the facilities. So blind flight prevails here too.
Clinic utilization difficult to predict
On the other hand, there is quite good data for the utilization of hospitals with corona patients. So far, the infection process has not been reflected here. According to the intensive care medicine association Divi, intensive care bed occupancy has fallen from around 5,000 patients to 2,664 since the first half of December. The number of corona deaths officially reported by the RKI has also fallen in the past few days.
According to the new information, 239 deaths with or due to Corona were recorded across Germany within 24 hours. A week ago it was 384. High infection numbers are only reflected in the clinics with a delay because it takes time for a patient to be admitted. According to the RKI, only about half as many people had to go to a clinic because of Corona as at the end of November – with a slight upward trend.
“Nationwide, the Omikron variant has not yet had a significant impact on the utilization of the normal wards,” said the head of the German Hospital Society, Gerald Gass, to the Handelsblatt. Occupancy is even declining in most federal states. So there is reason to hope “that we won’t get into a situation like the delta wave or like in Great Britain, where many clinics had to declare a disaster”.
According to experts, however, the overburdening of the healthcare system during the fifth wave cannot be ruled out. In countries like the UK, hospital occupancy was well below that of the delta wave. However, since the population there is better immunized than in Germany, the development cannot be transferred one-to-one to Germany.
It is also unclear how the milder course of Omikron affects the length of stay in the hospital and thus the occupancy figures. “There is initial data here, but it is still insufficient,” said epidemiologist Scholz. In addition, the age spectrum is shifting towards younger patients. “Although they are less likely to become seriously ill, they have longer stays in the intensive care units, for example.”
differences between age groups
In fact, the seven-day incidence in the group of 5 to 14 year olds is currently 1227.7 and in the 15 to 34 year old group it is 929.8 according to the RKI. This may also be related to the end of the Christmas holidays. Students are tested regularly.
However, comparatively few older people who are particularly susceptible to severe courses become infected. The most recent incidence here was 122.1. If significantly more older people become infected, this could lead to a significant increase in the number of seriously ill people and thus also in intensive care bed occupancy.
“Especially with the high number of cases from Omikron, it would now be particularly important to know how large the proportion of dangerous courses is,” said the Union’s health policy spokesman, Tino Sorge (CDU), the Handelsblatt.
In view of the unclear data situation, he calls for the hospital incidence “to be supplemented with further parameters”. The number is considered the most important indicator for the pandemic, but is “may not be good enough” for Omikron.
“We need a continuous overview of the utilization of normal inpatient capacities as quickly as possible,” said Sorge. “It has to offer a digital and regionally differentiated overview that is updated daily.” In this way, impending bottlenecks can be identified in good time.
The Divi register can serve as a model. “In addition, we will have to record more precisely where the medical practices are reaching their limits,” said Sorge. The outpatient sector is also likely to be more challenged than before due to the high Omicron case numbers. An overview of the functionality of the critical infrastructure is just as important.
“Whether energy supply, security authorities or the health sector: if there are high numbers of cases and quarantines, we will need a precise picture of the situation regarding staff shortages in critical infrastructures,” demanded the CDU politician. Experience has shown that the individual countries have the best data on this. “It would make sense to bundle them in a nationwide situation report.”
A significantly higher vaccination rate should also be decisive for the coming waves, which dramatically reduces the probability of severe courses. However, the number of daily vaccine doses is declining, as the RKI announced on Wednesday. Around 73 percent of the population are fully vaccinated, 48.3 percent have received a so-called booster.
According to Health Minister Lauterbach, this is not enough for the coming autumn and winter. The SPD politician is pushing for a general obligation to vaccinate. This must be implemented by May at the latest in order to still have an effect in the cold season, he said.
It is all the more surprising that the federal government’s advertising expenditure was cut back drastically at the end of last year. While the Ministry of Health spent 26.4 million euros on advertising measures in September 2021, it was just under five million euros in October and just under ten million euros in November.
For the first quarter of 2022, however, the ministry again requested a budget totaling 60 million euros. This emerges from a request from left-wing politician Christian Görke to the Federal Ministry of Health, which is available to the Handelsblatt. “It was a criminal mistake by the grand coalition to cut back the advertising campaign so drastically at the beginning of the fourth wave,” said Görke. “It was long overdue for the traffic light to change that and invest in advertising and education again.”
With regard to the use of the funds, however, one has not yet arrived in the 21st century. Almost 20 times more money was spent on posters and print in 2021 than on digital and social media. This is also one of the reasons why the vaccination campaign failed, said Görke. “If vaccination is the way out of the crisis, then the traffic light campaign must now be tailored much more to those who have not yet been reached.”
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