"Accept infection": How bad will the summer wave be?

The corona pandemic is once again leaving familiar paths: unlike in previous years, a summer wave is emerging.

"Accept infection": How bad will the summer wave be?

The corona pandemic is once again leaving familiar paths: unlike in previous years, a summer wave is emerging. The incidence is increasing, but at the same time there are hardly any precautionary measures. However, experts explain why the situation is less dramatic than it used to be.

The coronavirus always seems to be one step ahead of humanity. If you had already gotten used to the pandemic rule of thumb that the virus takes a break in the summer months, this apparently no longer applies: unlike in 2020 and 2021, a summer wave is emerging in Germany. "I assume that this time we will get a real summer wave," said Federal Minister of Health Karl Lauterbach ntv.

What is the situation at the moment? The nationwide seven-day incidence of new infections per 100,000 inhabitants recently rose to 472.4, as reported by the Robert Koch Institute (RKI). The previous day the value was 447.3 and a week ago it was significantly lower at 238.1. A month earlier it was similarly high at 452.4, but back then the trend was down. In addition, the current incidence is probably even higher in reality: experts have been assuming for some time that there have been a large number of cases not recorded by the RKI - mainly because by far not all infected people have a PCR test done. But only positive PCR tests are included in the statistics.

But why are the numbers going up again - and of all times in the summer? There are currently three omicron sub-variants that determine what happens, explains virologist Hendrik Streeck in an interview with ntv: BA.4, BA.5 and the variant BA.2.12.1. "All three have in common that they have a slightly increased transmissibility, but above all an immune escape. Which means that vaccinated or recovered people no longer recognize the virus with their immune responses quite as well." Epidemiologist Timo Ulrichs from the Akkon University of Human Sciences in Berlin also sees the omicron subtype BA.5 as the driving force at the moment: "The BA.5 subtype is even more contagious than all previous variants, so it can also spread under adverse conditions for the virus spread in summer."

The Association of Accredited Laboratories in Medicine (ALM) assumes that the sub-variants BA.5 currently account for 40 to 50 percent of the infection process. The omicron subline BA.4 is therefore around 15 to 16 percent. However, ALM chairman Michael Müller assumes that BA.4 could still prevail over BA.5 in the next few weeks. According to the most recent data on virus variants published by the RKI, the proportion of BA.5 was only ten percent, but this data relates to a period of two weeks ago.

How far will the incidence go up? Lauterbach told ntv that he thinks "four-digit incidence numbers are possible". There is no reason to panic, but after the number of deaths will increase again in the future. The development of the number of infections is very difficult to predict because "several factors come together," said Streeck: "On the one hand the spreading omicron subvariant BA.5, on the other hand our different behavior compared to the first waves." In addition, the school holidays would come, which in turn could have an effect on the infection process.

The Secretary General of the German Society for Immunology, Carsten Watzl, is convinced that the single-digit incidences of the past summer will no longer exist this year. "As can currently be seen, the incidences will be in the hundreds. Omicron is too contagious for that." Watzl assumes that around half of the population has not yet been infected with omicron. "Since the vaccination does not protect so well against pure infection, the virus still has sufficient potential to infect people."

The Jena infectiologist Mathias Pletz also expects the numbers to increase further: "It may well be that a new wave will come," he told the "Bild" newspaper. Intensive care physician Stefan Kluge from the University Hospital Hamburg-Eppendorf speaks of a current “moderate” increase in the number of infections. Hajo Zeeb from the Leibniz Institute for Prevention Research and Epidemiology in Bremen expects the number of infections to rise and fall in the coming weeks.

How bad will the summer wave be? Infectiologist Pletz refers to data from other countries with a high proportion of BA.5 infections, according to which the omicron subvariants do not result in an overload of the health systems. In Portugal and South Africa, for example, the incidences went up significantly, but the number of deaths remained low. "There is currently no evidence that the infections are more severe than with variants BA.1 or BA.2," says Pletz.

The number of intensive care patients with Covid-19 in Germany is currently less than 700, but is showing a slight upward trend. Last December, almost 5,000 patients were in the intensive care units at the same time on some days. 245 corona patients in German clinics currently have to be ventilated. The number of deaths in Germany has averaged 70 in the past seven days. At the peak of the delta wave in December, the average was almost 400.

If the number of infections now increases significantly, epidemiologist Zeeb expects a slight increase in hospitalizations and deaths. But since, according to the current state of knowledge, BA.5 clinically takes a similar course to previous omicron variants, the courses should usually remain mild. From his point of view, the healthcare system is not about to be overburdened. "In the current situation, it has to be about preventing illness and not so much pure infection. Therefore, a summer wave is initially not a concern," said Watzl.

With a view to normal and intensive care units, Kluge also believes that because of the rather mild courses caused by omicron sublines, a significant burden on the health system is rather unlikely in the summer. Nevertheless, a high number of corona-positive patients also means a significant additional burden for normal wards - especially for the nursing staff. Watzl also refers to possible failures at companies due to many minor infections.

How to deal with the summer wave? "It's important to remember that anyone can still get infected," said Streeck. But if you are boosted, i.e. vaccinated three times, you can "put up with this infection if necessary". With all currently dominant variants such as BA.5 and BA.4, vaccination does not protect against infection, but does protect against a severe course. However, it is different for those who are not vaccinated and for risk groups. In old people's and nursing homes, wearing masks and increased testing is therefore advisable for protection, according to the virologist.

Minister of Health Lauterbach strongly recommends that older people and those with previous illnesses be vaccinated again. Already on Tuesday he had called for protective masks to be worn indoors again because of the skyrocketing number of corona. This and a fourth vaccination are the most effective antidotes. According to the Federal Ministry of Health, 5.3 million people in Germany have received a second booster vaccination - that's 6.4 percent of the population.

It must be clear "that Corona is among us, there is no security there," emphasizes Zeeb. Since comprehensive regulations were largely eliminated, everyone now has to think about protection with masks and also keep vaccination protection up to date, even in situations with many people, especially indoors and on public transport. Ulrichs advises: "A little more caution would be helpful."

Lauterbach told ntv that this was not a summer wave that “must or should spoil our vacation”, but this summer will not be as relaxed as the last: “We will have more cases and you have to live with that.” And virologist Streeck is already turning his attention to major events such as the Munich Oktoberfest and the World Cup: "I think we shouldn't let the summer distract us so much and focus on autumn and winter."

Here you will find current data on the development of the corona pandemic in Germany.

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