Why Ger­many’s top vi­rol­o­gist says Covid strat­egy has be­come alarmist

Ber­lin has over­seen the most suc­cess­ful virus re­sponse in the West. We should take note

The Daily Telegraph - Business - - Business Comment - Am­brose evans-pritchard

Ger­many’s top vi­rol­o­gist has some tren­chant ad­vice for coun­tries con­tem­plat­ing a sec­ond na­tional lock­down: hold your nerve, and don’t suc­cumb to the per­va­sive mood of mass hys­te­ria. “It is time to stop all this alarmism. We can out­smart the virus us­ing all our knowl­edge,” said Prof Hen­drik Streeck, di­rec­tor of Ger­many’s In­sti­tute of Virol­ogy at Bonn Univer­sity.

“We have to re­alise that Covid-19 is go­ing to be with us for a long time and we have to learn to live with it. We can’t keep shut­ting down our daily lives and paralysing ev­ery­thing,” he said. Prof Streeck sup­ported the first lock­down in Ger­many. At that point the early case data from Italy was shock­ing and sci­en­tists were only just start­ing to grap­ple with Covid-19. The pre­cau­tion­ary prin­ci­ple de­manded dra­co­nian ac­tion.

But the cal­cu­lus has shifted over the suc­ceed­ing months as the pan­demic evolves. The virus is less dan­ger­ous for a host of rea­sons. The pre­cau­tion­ary prin­ci­ple now pulls in the op­po­site di­rec­tion, call­ing for cal­i­brated mea­sures and a cool head. “I nei­ther triv­i­alise the virus, nor do I drama­tise it. We must find a proper bal­ance,” he said.

Prof Streeck did not wish to be drawn on the Bri­tish drama, but he warned against the bad habit of mis­read­ing ris­ing case num­bers. “I am con­vinced that changes in be­hav­iour have had a huge im­pact on the dis­ease,” he said.

“Peo­ple are get­ting in­fected with a lower dose be­cause of so­cial dis­tanc­ing, and they are get­ting a less se­vere ill­ness. Bet­ter hy­giene and mea­sures like masks have brought down the vi­ral load. This is hard to prove but we have had case stud­ies sug­gest­ing this in other viruses,” he said.

“It is no good look­ing at just case num­bers any more. You have to look at what is hap­pen­ing in the med­i­cal wards and in­ten­sive care beds. That is a much bet­ter guide to this pan­demic.”

So far the strain on crit­i­cal care is noth­ing like the tor­nado that swept through hos­pi­tals in March, al­though one has to be very care­ful of time-lag ef­fects and the op­po­site fal­lacy of snap­shot epi­demi­ol­ogy.

Prof Streeck said the ev­i­dence on vi­ral spread from so­cial in­ter­ac­tion was by now fairly con­clu­sive: big gath­er­ings in closed spa­ces am­plify the spread, but go­ing to the shops or hair­dressers are man­age­able lev­els of risk. Ger­many has been the Covid suc­cess story among the large Western na­tions, with a death toll of 113 per mil­lion pop­u­la­tion, com­pared to Spain (652), the US (615), the UK (614), Italy (591) and France (479).

The de­cen­tralised Ger­man model – 16 Lan­der each jeal­ously guard­ing its own ju­ris­dic­tion – tack­led the first wave of Covid with re­mark­able speed and ef­fi­ciency, lim­it­ing the eco­nomic dam­age.

Prof Streeck says the se­crets seem to have been early test­ing and sur­veil­lance; a high de­gree of so­cial dis­ci­pline and con­form­ity; the tight re­la­tion­ship be­tween the Ger­man peo­ple and their lo­cal doc­tors; and the Ger­man prac­tice of stay­ing home if you are ill, so dif­fer­ent from An­glo-Saxon work­place pres­sures to tough it out and go to work, thereby in­fect­ing oth­ers.

Ger­many had a quar­ter of Swe­den’s death rate (580) while suf­fer­ing com­pa­ra­ble eco­nomic dam­age, and it achieved this with a light-touch lock­down that was not so dif­fer­ent from Swe­den’s ap­proach to so­cial dis­tanc­ing. It is pe­cu­liar that so many peo­ple in the UK have latched on to the Swedish model but missed the bet­ter and more rel­e­vant Ger­man les­son.

Prof Streeck, who cut his teeth on HIV and T-cell re­search in the US, pro­poses a “traf­fic light” sys­tem to cope with the risk of a sec­ond wave. It en­tails a pol­icy of tight­en­ing coun­ter­mea­sures in lo­calised ar­eas as hos­pi­tals start to fill up, and as colours move from green to yel­low, orange, and then to red.

Aus­tria in­tro­duced a ver­sion of this in early Septem­ber. Vi­enna and Inns­bruck are cur­rently un­der orange alert (high risk), but large parts of the coun­try are green and largely carry on as nor­mal. Red (acute) means school clo­sures and a gen­eral lock­down. The sys­tem is based on a blend of case num­bers, hos­pi­tal oc­cu­pancy and the char­ac­ter of each clus­ter.

Prof Streeck said the es­ti­mated case fa­tal­ity rate of the Heins­berg out­break in­ves­ti­gated by his team was around 0.37pc. This is roughly four times sea­sonal flu but lower than the 1.0pc feared in the spring based on cruise ships, the Berg­amo saga and early test data.

Clin­i­cal treat­ment is get­ting bet­ter with new drugs, an­ti­co­ag­u­lants, ear­lier use of oxy­gen, and tighter sur­veil­lance, to­gether grad­u­ally pulling down the death ra­tios. He thinks the rate may al­ready be down to 0.3pc.

Lock­down “hawks” ar­gue that Covid im­mu­nity fades rapidly and there­fore the pur­suit of herd im­mu­nity is a chimera. They rely heav­ily on stud­ies sug­gest­ing that peo­ple can lose their pro­tec­tive an­ti­bod­ies within three months af­ter get­ting the dis­ease. Prof Streeck says these claims are vastly overblown.

“Look, we’ve had over 30 mil­lion cases world­wide and only two de­scribed cases of re­in­fec­tion. That tells you there must be more last­ing im­mu­nity. We know from other coron­aviruses that you get one or two years of pro­tec­tion, and if you do get the dis­eases again you’ll still have par­tial im­mu­nity from T-cells so it won’t be as bad. I don’t think Covid-19 is go­ing to be dif­fer­ent,” he said

“It will be very in­ter­est­ing to watch what hap­pens in cities that have al­ready had a lot of in­fec­tions. It would not sur­prise me if New York has al­ready reached ef­fec­tive herd im­mu­nity, and maybe even Swe­den too,” he said.

Prof Streeck says there is no “right or wrong way” for gov­ern­ments to tackle this pan­demic so long as they stick to com­mon sense and rig­or­ous anal­y­sis of what con­sti­tutes least harm.

Right now, the pen­du­lum has swung too far to­wards Covid neu­ro­sis. As a re­sult, crit­i­cal UN pro­grammes fight­ing HIV and hunger in the de­vel­op­ing world have been run down, lead­ing to un­told deaths.

“Fear is of­ten a use­ful re­flex but in this sit­u­a­tion it is bad coun­sel. Peo­ple have be­come ir­ra­tional,” he said.

A young Ber­liner wear­ing a sparkling face mask dur­ing yes­ter­day’s “Love World Peace Pa­rade” in the Ger­man cap­i­tal

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