Germanyʼs most celebrated virologist has some trenchant advice for countries contemplating a second national lockdown: hold your nerve, and donʼt succumb to the pervasive mood of mass hysteria, reports The Daily Telegraph.
“It is time to stop all this alarmism. We can outsmart the virus using all our knowledge,” said Professor 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 must learn to live with it. We canʼt keep shutting down our daily lives and paralysing everything,” he said.
The report says 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 a dramatise it. We must find a proper balance,” he said.
According to the report, Streeck 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.”
The Telegraph says 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.
Streeck said the evidence on viral spread from social interaction is by now fairly conclusive: big gatherings in closed spaces amplify the spread, but going to the shops or hairdressers are manageable levels of risk.
The Telegraph says 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.
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 AngloSaxon workplace pressures to tough it out and go to work, thereby infecting others.
Germany had a quarter of Swedenʼs death rate (580) while suffering comparable economic damage, and it achieved this with a light-touch lockdown that was not so different from Swedenʼs approach to social distancing. According to The Telegraph, it is peculiar that so many people in the UK have latched onto the Swedish model but missed the better and more relevant German lesson.
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 counter-measures 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 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.
Streeck said the estimated case fatality rate of the Heinsberg outbreak investigated by his team was about 0.37%. This is roughly four times seasonal flu but lower than the 1% 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 0.3%.
The report says 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 the getting the disease.
But, the report notes, Streeck believed these claims were vastly overblown. “Weʼve had over 30m 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 youʼll still have partial immunity from T-cells so it wonʼt be as bad. I donʼt 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.”
Streeck said there was 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.
[link url="https://www.telegraph.co.uk/business/2020/09/21/can-beat-covid-without-lockdowns-says-top-german-virologist/?"]Full report in The Daily Telegraph[/link]
See also:
[link url="https://www.medicalbrief.co.za/archives/mass-testing-high-science-good-behaviour-low-covid-19-deaths-in-germany/"]Full report on MedicalBrief webinar with Streeck[/link]