The new corona infections are rising steeply, the summer wave is picking up speed. It will probably not be critical for the health system, but studies show, among other things, that almost nobody is safe from infection and reinfection can also be problematic.
Although it is summer, the Covid-19 incidences are increasing again quickly and significantly in Germany. The main reason for this is the spread of the highly contagious subvariants Omicron BA.5, which is responsible for every second infection. So far, hardly any expert expects serious problems, but studies show that this wave should not be taken too lightly.
With a 7-day R value of around 1.3, the number of new infections has increased by almost 23 percent compared to the previous week, and the nationwide 7-day incidence is almost 620 cases per 100,000 inhabitants. In fact, there could be a lot more. In view of a test positive rate of around 42 percent and the fact that many infected people do not do a PCR test, the number of unreported cases is probably very high.
Schleswig-Holstein shows that vaccinations protect against serious illnesses, but hardly against an infection. 80 percent of the population there are basic immunized, 70 percent boosted - these are top values. Nevertheless, Schleswig-Holstein currently has the highest incidence among the federal states with 883 new infections. Lower Saxony and Saarland follow with 861 and 836 cases respectively.
Despite relatively poor vaccination rates, Thuringia (241), Saxony (317) and Saxony-Anhalt (340) have the lowest number of cases. So the wave is rolling from West to East through the Federal Republic.
The rising incidences are also noticeable in hospitals. After a low of almost 600 patients on June 11, around 790 people infected with Covid 19 are now in German intensive care units, 3.7 percent of the operable beds for adults there are occupied by corona patients. The 7-day incidence of hospitalizations has increased to 5.16 cases per 100,000 population.
So far, however, the number of very serious illnesses is still in areas that are far from placing a heavy burden on the healthcare system. Last winter, up to 5,000 Covid-19 patients had to be treated intensively and the number of registered corona deaths has so far remained at a relatively low level of around 70 victims a day. At the beginning of May, around 180 people died in Germany from or with Covid-19. However, only the effects of the beginning of the wave can currently be observed.
Even if the incidences should increase significantly, the situation in the hospitals will probably not deteriorate significantly. A look at Portugal, among other things, gives hope for this, where BA.5 led to a spring wave with up to 2000 new infections per week and 100,000 inhabitants.
Hospitalizations there increased significantly and at their peak reached almost 2000 hospitalized Covid 19 patients. But the situation in the intensive care units remained relaxed throughout and never approached the critical value of 255 patients. Less than 70 people in Portugal are currently receiving intensive care because of Corona. The increased mortality is more likely due to a decreasing vaccination effect, especially in over 80-year-olds.
Federal Minister of Health Lauterbach has also remained relatively calm so far. In the case of the omicron variants, the course of the disease is milder than in the case of delta-type variants. In addition, many people have been vaccinated or have recovered, he said last week.
Virologist Klaus Stöhr sees no reason to avoid infections through masks and keeping your distance during the summer wave. “You won’t prevent them anyway. This increases the risk that the peak will get bigger in winter,” said the scientist, who is a member of the expert committee for assessing the corona restrictions.
His predecessor on the committee, Christian Drosten, also thinks it is unlikely that there will be bottlenecks in the intensive care units again now or next winter. However, he sees the problem of many illness-related failures in the health system and in companies.
In addition, BA.5 may again affect the lower airways more, he told the "Spiegel". "The wheel is turning more in the direction of illness again." It is not true that a virus automatically becomes more and more harmless in the course of evolution. Drosten warns against willfully becoming infected. "You should continue to avoid that as much as possible, also because of the risk of Long Covid."
When it comes to the possibility that BA.5 could be more dangerous again, Drosten, like other scientists, probably refers to a Japanese study (preprint). Laboratory experiments with hamsters led to the conclusion that the subvariants BA.5 or BA.4 could be more pathogenic again, i.e. cause more severe disease progressions than BA.1 or BA.2.
According to the summary of the NDR Corona podcast with Sandra Ciesek, mutations at key points in the spike protein of BA.4 and BA.5 indicate that more lung cells could be infected again and thus more severe courses could be caused. "I think it's possible that BA.5 could be a little more pathogenic again, but that hasn't been finally clarified," said the virologist.
Observations by the pulmonologist Cihan Çelik are an indication, but also no proof, of a greater burden on the lungs from BA.5. "Current impression of the normal Covid ward (not representative): beds are filling up again and the burden of disease is increasing significantly," he tweeted. "Almost all patients here need oxygen, which had become rare 4 weeks ago. We are coping, but this is not just a 'wave of reports'."
Even if the new subvariants are not deadlier, they can obviously have much more unpleasant consequences than BA.1 and BA.2. Findings from the French health authorities speak for this. Accordingly, BA.4/BA.5 are more likely to experience loss of smell and taste, nausea/vomiting and diarrhea than their predecessors. Infected people also reported a longer duration of clinical symptoms.
Even those who have recovered should not take the summer wave too lightly and perhaps better avoid reinfection. A current US study (preprint) confirms the assumption that reinfection can improve immunity, but there is always a certain risk of severe symptoms.
The risk of developing Long Covid cannot really be determined with BA.5, but it can be assumed that there is at least a residual risk here as well. According to a recent British study, 4.4 percent of previous omicron cases suffer from long-term consequences, with Delta it was significantly more at 10.8 percent. Socially, this is still a major problem, since the number of long-Covid patients can become very large due to the sheer mass of omicron infections.
However, avoiding infection with BA.4 or BA.5 is anything but easy, as another recently published US study (preprint) shows. The data obtained indicate that 'BA.4 and BA.5 essentially evade neutralizing antibodies induced by both vaccination and infection,' the authors write. In addition, the neutralizing antibody titers against BA.4/5 and are lower than the titers against BA.1 and BA.2.
