The autumn wave is here, but the situation remains difficult to assess. The number of unreported cases of new infections is likely to be high. The picture in the clinics also seems ambiguous. However, modelers see indications of a manageable winter - but the virus is still good for surprises.
In the third year of the pandemic, the autumn wave is appearing with frightening reliability. The new infections with Sars-CoV-2 have been increasing for a month and recently with significantly more momentum. The nationwide seven-day incidence increased by almost a quarter in the past week and is now approaching the 600 mark. It was last higher at the end of July. But it should not reflect the true extent: For a long time, experts have been assuming that the number of unreported cases is huge.
The known numbers are alarmingly high: the seven-day average is around 73,000 new corona cases per day. Nevertheless, this is now being received with composure by the public, after all, corona fatigue is great. In addition, three quarters of the population are vaccinated and the predominant omicron variant is considered milder.
While it is assumed that new infections are underreported, the numbers from the clinics were considered more reliable for assessing the corona situation. But that no longer applies unconditionally. According to the DIVI intensive care register, there has been a steep increase in intensive care cases with Covid-19 by around 50 percent compared to the previous week. However, the interpretation of the data is difficult, writes the Robert Koch Institute (RKI) in its current weekly report. The statistics would also include cases “that come to the hospital due to another illness or need intensive care treatment and in which the Sars-CoV-2 diagnosis is not the focus of the illness or treatment”.
The increase in hospitals can be seen in Bavaria, among other places: the number of patients admitted with or because of Corona within a week rose to an all-time high of 1849, according to figures from the State Office for Health and Food Safety. Munich reported 47 percent more patients with corona in normal, intensive care and transitional wards than a week ago. But even there, several hospitals see the patients who come with and not because of Corona in the majority.
The problem that the data on the number of intensive care patients does not allow a distinction between patients who are being treated for Covid-19 or only with Sars-CoV-2 evidence has been known for a long time. Improvements have been announced for months. However, clinics also argued that the effort required for isolation was the same for all patients who tested positive.
Some clinics in Bavaria have already spoken of a tense situation, partly because of many employees who have contracted Covid-19 themselves. There are restrictions on operations that can be planned and in individual cases there are station closures, according to the clinics of the Ludwig Maximilian University. The Helios Kliniken Oberbayern also report more infected employees. Across Germany, the number of intensive care units reporting restricted operation recently rose to around 38 percent. For comparison: At the end of 2021, more than half of the intensive care units were at their limit.
According to expert estimates, the comparatively high number of cases in Bavaria in particular can also be traced back to the Oktoberfest, which ended at the beginning of the week. A certain agglomeration around Munich is striking when comparing the seven-day incidences: Both the city and three of the four directly adjacent districts are now over 1000, the district of Munich only relatively slightly below. Overall, the RKI reported values over 1000 for nine Bavarian districts and the state capital Munich.
So far, the upward trend in new infections and hospital stays cannot be read from the number of corona deaths - experience has shown that these only follow waves of infection three weeks apart. Most recently, 65 corona deaths per day were recorded on a seven-day average. At the darkest time of the pandemic in January 2021, this value was more than ten times higher.
But what happens next? That should also depend on whether new variants of the corona virus can prevail. Possible candidates are sublines of the omicron variant such as BA.2.75.2 or BQ.1.1. In Germany, however, according to the RKI, the omicron subline BA.5 dominated events at least until last week. For weeks, their shares have been 95 to 97 percent. According to the RKI, increasing spread has been observed worldwide in the subline BA.2.75 and its descendants since June. However, the share in the sample for Germany is still less than one percent.
If no new, problematic variants continue to appear, the winter should have few unpleasant surprises in store - at least that's the conclusion of a study by researchers from the German "modeling network". In this case, "the incidence of the current autumn/winter wave will probably be similar to that of the first omicron wave," wrote physicist Viola Priesemann, who was involved in the study, on Twitter. The hospital burden could even be less. "I'm very happy that we can be (relatively) positive for this winter."
However, should a new virus variant prevail, which partially bypasses the immune protection but does not have a higher risk of serious illnesses, the health system can be expected to be burdened "in the order of magnitude of the previous peak values during the omicron wave at the beginning of 2022". , says Priesemann. In the worst case - a variant that also triggers severe courses - "the peak values of hospital exposure achieved so far in the pandemic could be significantly exceeded". So far, however, there is no "strong evidence" that this will occur, according to Priesemann, who also sits on the federal government's Corona Expert Council. "But that can change at any time."
