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The director of the Robert Koch Institute announced that the fourth wave of the COVID-19 epidemic in Germany began at the end of July. The authorities, led by Chancellor Merkel, are calling for vaccination, but the successive campaigns, aimed primarily at young people, are making less and less impression. Those who were convinced of the effectiveness of the vaccination program reported to the points in the spring. Behind the Oder, the percentage of vaccinated people is clearly higher than in Poland, but up to 70 percent, which is the agreed threshold for achieving population immunity, it is still far away. We talk to Dr. Krzysztof Pujdak, a cardiologist working at the Herford Clinic.
- 56 percent Germans are fully vaccinated against the coronavirus. There is still a large group of undecided people
- What could the fourth wave of an epidemic look like in this country? According to Dr. Pujdaka has no concerns that the health care system may be inefficient
- However, authorities fear a large spike in infections, especially among young and unvaccinated people. There are restrictions that will especially affect Germans who have not decided to vaccinate
- You can find more about the coronavirus on the TvoiLokony home page
Monika Zieleniewska, MedTvoiLokony: Has the message about the fourth wave of the epidemic caused a rise in interest in vaccinations in Germany?
Dr. Krzysztof Pujdak: The fourth wave was announced in the week we had 22 infections per 100. inhabitants, it is clearly less than during the first or second wave. At that time, it was believed that less than 100 cases per 100 people is a win-win situation, because the wave is receding, so as you can see, the concept of a wave can be defined quite flexibly.
So far, I have not noticed any increased interest in vaccines; people who wanted to get vaccinated long ago. Currently, 56% are fully vaccinated. citizens, and at least one dose of the vaccine was taken by 63 percent. society. This is what the data of the Robert Koch Institute from last week say.
Vaccines are plentiful, and you can get vaccinated practically anywhere. However, both vaccination centers and GP practices are empty in August. Thus, almost 40 percent. Germans are skeptical about vaccination, and a certain percentage still hesitates.
is a specialist in internal medicine and cardiology from the Herford Clinic, he graduated from the Medical Academy in Gdańsk. He obtained his doctorate at the University of Leipzig. I am an interventional cardiologist.
What are the arguments of vaccine advocates and opponents do you hear the most often?
Of course, the most common argument in favor of immunization is a return to normal. Unfortunately, so far even those who have been vaccinated long ago do not have the opportunity to do so. The official narrative is that by the unvaccinated. It is repeated like a mantra so that the vaccinated be careful of those who do not vaccinate, because they are spreading the virus.
On the other hand, people against vaccines repeat that, without the results of several years of clinical trials, we cannot say anything about the long-term side effects of vaccines against COVID-19, and there is still no final registration of these preparations, the period of the so-called emergency approval, or conditional approval.
What are the emphasis of vaccine campaigns?
In Germany, the old and proven carrot and stick method is used to promote vaccinations. So, on the one hand, we have nice incentives in the form of facilitating everyday life or traveling. The vaccinated do not have to perform PCR and antigen tests at airports, it is enough to present a covid passport.
In Poland, a vaccine lottery is advertised, and here the authorities are wondering whether fully vaccinated people should not receive foreign language courses, book awards or award diplomas. Most of the campaigns are targeted at young people, and so in McDonald’s, for example, a customer who decides to get vaccinated gets a Big Mac set plus fries.
Can you get vaccinated in McDonald’s?
Yes, you only need to be 18 years old, because younger ones need parental consent. You can also have the vaccine in the motorway parking lot. You don’t need any referral, just stop by. This action is focused primarily on truck drivers. Only an identity document is required, but you don’t even need to be a German citizen. When we come to such a point in the parking lot, we present our ID card, we are entered on the list and we get an injection.
And the stick?
It was announced that from October, unvaccinated people will have to test negative for the presence of coronavirus before entering, for example, the cinema, and even that it will be required to enter an ordinary grocery store for shopping. Wherever there are human communities, the unvaccinated will have to show the test. Worse, the tests will only be valid for four hours. Currently, the tests are still free, ie the state pays for them, and from October 11 they will become paid.
I am curious how it will work in practice. It is possible that grocery shopping will move to the Internet or the queue roller profession will appear in Germany.
- The COVID-19 Real-Time PCR test can be performed at selected drive thru points of the Diagnostics network.
What do patients most often ask when they decide to receive the vaccine?
I don’t have any contact with such people, but I know something from my colleagues. Most have an opinion on vaccination – either for or against it. There are very few still undecided. Those who hesitated and nevertheless vaccinated made their decision under the influence of their relatives who had vaccinated earlier. Of course, such decisions were accompanied by heated discussions. The most discussed topic was the choice of the vaccine.
There are environments where the social pressure to get vaccinated is high, and the unvaccinated people are in the minority there. Those who come for vaccination do not ask about anything, because they have no doubts, they believe in the effectiveness of the preparation. What they read in the consent form is enough for them, the complications are described there.
In Germany, children over the age of 12 are vaccinated. Is there a lot of interest?
As far as I know, weak. It has not been proven beyond a reasonable doubt that children are spreading the virus, and it can be seen that they practically do not get sick. In addition, many cautious skeptics about adult immunization are strongly against childhood immunization.
Is there any mention of possible hybrid learning or online lessons after the holidays?
It is said that a lockdown is possible for the unvaccinated, so there may also be a lockdown for unvaccinated children. Then the latter would learn online. Politicians have different ideas, but everything is subordinated to “encouraging” parents to vaccinate their children. A lot will be explained soon, because in some federal states the new school year is starting in a few days. However, the number of new cases per 100 inhabitants is low, lower even than at the beginning of the summer vacation. Therefore, the case will most likely be resolved in October, because in the fall the number of cases will certainly increase, as it was last year.
What picture of the fourth wave emerges from the official announcements of the Koch Institute and your observations?
The latest bulletin of the Institute was published on August 13, and reports are published once a week. We currently have 30 COVID-19 cases per 100. residents. Compared to last week, 236 hospitalized people have increased. Hospitalization per 100 inhabitants is 0,94, which is almost one person per 100 thousand. is in hospital because of the coronavirus. There are 370 COVID-19 patients in intensive care units, which is 2 percent. all sick. The median age of patients is lower than in spring and amounts to 48 years.
Delta variant dominates?
Yes, 98 percent cases is related to the Delta variant. Fortunately, there are few heavy ones.
The old rule seems to be working, that mutations are working towards increasing the virus’s ability to spread through the population, making it more infectious, but at the same time decreasing its virulence. The goal of the virus is not to kill its host, but to reproduce and infect more and more people. Interestingly, the Delta variant appeared in an unusual season for coronaviruses. They usually attack from fall to spring, but not in summer.
However, the symptoms of the infection did not change. These are common symptoms of a cold or flu. There is still a loss of taste or smell, but it seems to be less common. The course of the disease is usually mild, most patients stay at home.
The Koch Institute said the median age of the positively tested cases is lower than during the last wave, but the mean age of those who died from COVID-19 is still high at 84. 86 percent of them had comorbidities and were over 70 years of age. However, I did not find any data on how many vaccinated people contracted COVID-19.
Are fewer detected cases combined with fewer tests performed?
In winter and spring, there were several hundred thousand tests a week, and now there are many fewer of them. People know COVID-19 has softened and are reluctant to test themselves to avoid possible quarantine for themselves and their family. In addition, tests are no longer compulsory in many places.
But in the fall, as the number of cases increases, will the sanitary regime be stricter?
It is possible. For now, all masks are required to be worn indoors. It is possible that German society will be divided into vaccinated and unvaccinated. This is due to the fact that the citizens here obey the government’s recommendations, so they will not protest. It is very important what the elections will bring, and these are planned for September. Then we will find out what the political will is to maintain a creeping lockdown. The main candidate for the chancellor’s position has similar views on this issue to Angela Merkel.
And is the German health care system preparing for the accelerating fourth wave of the epidemic?
There are no special preparations to be seen, health care is working as always. Let me remind you that since the beginning of the coronavirus pandemic, the German health service has not been close to a collapse for a single day and has been working normally all the time, except for the first weeks of March 2020. I do not expect any difficulties if something completely unexpected does not happen.
As a curiosity, the government offered hospitals extra money to organize beds for covid patients. In practice, it looked like that if in the intensive care unit the designated threshold for bed occupancy with covid patients (over 80% of places) was exceeded, the hospital was subsidized. It was a lot of money, so pathologies were formed, many hospitals manipulated the beds. Their number was reduced only to exceed this threshold. The procedure was disclosed by the Federal Audit Office.
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