Covid-19: the fourth wave in Germany, a warning for the rest of Europe?

Germany has had a series of sad records on the health front in recent days. The country has just recorded, Wednesday, November 10, 39,676 new cases of contamination in 24 hours. A level never reached in nearly two years of health crisis, even though nearly 67% of the adult population is vaccinated against the Sars-Cov-2 virus.

The seven-day incidence rate, meanwhile, keeps reaching new heights. After having passed the milestone, Monday, November 8, of 200 new cases per 100,000 inhabitants – which was the previous record – this index very followed in Germany continued to grow to now stand at 232.1.

Unvaccinated and vaccinated from the first hour

The situation is also worsening in the hospital. If the number of admissions of patients with severe forms of Covid-19 is not as high as a year ago, thanks to the protective effect of vaccines, “there is a clear increase”, notes Ralf Reintjes, epidemiologist at the University of Applied Sciences in Hamburg, contacted by France 24.

The intensive care units are even “more overwhelmed than a year ago when there were no vaccines”, notes the daily Süddeutsche Zeitung. First, because there are fewer nursing staff due to resignations caused by overwork since the start of the health crisis. Secondly, because more patients with other diseases need to be taken care of. A year ago, containment limited the circulation of other seasonal viruses like the flu.

So many indicators that prompted the German virologist Christian Drosten – as popular in Germany as Dr Anthony Fauci can be in the United States – to sound the alarm. On Tuesday, he deemed the death of 100,000 more people likely if nothing was done to stop the outbreak of the epidemic. “And that’s a conservative estimate”, he added to German radio NDR.

“It is true that with two thirds of the adult population vaccinated, the health situation may seem surprising. But in reality, there is nothing surprising,” says Ralf Reintjes.

A particularly explosive cocktail of factors explains why the fourth wave of Covid-19 in Germany appears to be, in many ways, the worst. The most obvious is “a third of adults who are not yet vaccinated, which represents millions of Germans, some of whom have co-morbidities that make them more likely to develop severe forms of the disease”, notes Till Koch, specialists infectious diseases at the University Hospital of Hamburg, contacted by France 24.

To these unvaccinated are added all those who were part of the first wave of vaccination between the end of 2020 and the beginning of 2021. “For them, the effects of the second dose – administered more than six months ago – begin to fade, and they are less well protected against the virus “, notes Ralf Reintjes. These early vaccines are often elderly people who are among the populations most at risk.

The virus is also no longer the same. The German health situation “confirms that the delta variant is much more contagious than the historic strain of a year ago, even in vaccinated people”, specifies Ralf Reintjes.

The general election effect in Germany

Finally, “we have the impression that we have returned to normal life with individuals who behave as before the pandemic”, notes Till Koch. A real boon for the Sars-Cov-2, which can circulate much more easily than a year ago, when bars and restaurants were closed and the Germans were much more respectful of barrier gestures.

A relaxation which can be explained, as everywhere in Europe, by a certain weariness with regard to all social distancing measures, coupled with “a false impression that thanks to vaccines, we could turn the page on this crisis sanitary “, notes Ralf Reintjes.

But there is also a German specificity which would be due to the “general election effect”, affirms this epidemiologist. During the electoral campaign before the vote on September 26, the “health crisis has taken a bit of a back seat”, he explains. In addition, the politicians preferred to highlight their successes in the fight against the pandemic, which made “that the communication on the health risk was bad, giving the feeling that everything was better”, deplores Ralf Reintjes.

For the experts interviewed by France 24, the main lesson of this fourth wave in Germany is “that we have relied too much on vaccines to the detriment of other measures to fight the virus, such as tests and traffic restrictions”, emphasizes Ralf Reintjes. “Faced with such a variant, nearly 70% of the adult population vaccinated, it is simply too little to stop the epidemic,” adds Till Koch.

Lessons to be learned for other countries

Enough to give a cold sweat to other European countries which, like France, have vaccination coverage rates similar to Germany. “It is clear that we can think that what is happening here is likely to happen on a European scale in the weeks to come”, acknowledges Till Koch.

None of the factors – apart from the electoral calendar – is unique to Germany. The number of cases is already starting to skyrocket in the Nederlands and at Denmark.

It is no coincidence that northern Europe is affected first. “Like all respiratory viruses, Covid-19 is seasonal and countries in the south of the continent such as Spain and Italy are still protected by milder temperatures,” explains Till Koch.

But it is not inevitable either to undergo a new wave of all the records all over the Old Continent. “The advantage is that you can easily learn from what is going on at home,” says Till Koch. It would thus be imperative not to be satisfied with 70% of the vaccinated population, while this rate was still considered a year ago as a holy grail to overcome the epidemic. “It is also essential for the authorities to make people understand that the health crisis is still there and that we must not relax, especially in this winter period,” says Ralf Reintjes.

Finally, more space should also be given to measures other than vaccination. And it is not necessarily a question of returning to economically painful solutions such as curfews or the closure of bars or restaurants. For the two experts interviewed, measures such as large free screening campaigns would make it possible to detect cases of contamination earlier and thus limit the spread of the virus.

It remains to be seen whether the other countries will learn the lessons of Germany in time. In France, we are still quite far from the situation across the Rhine with “only” 7,000 new cases per day. But this is a 23% increase in the number of contaminations compared to last week. Not sure that the announcement made by President Emmanuel Macron concerning a third dose for those over 50 and the decision to make wearing a mask compulsory at school is sufficient.