Rural Coronavirus Hotspots The German Towns on the Front Lines of COVID-19

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07.05.2020, Thüringen, Greiz: "Bleiben Sie gesund! Ihr Bürgermeister Alexander Schulze" steht auf einem Plakat in der Altstadt von Greiz. Der Kreis Greiz in Thüringen bleibt bundesweiter Brennpunkt neuer Corona-Nachweise. Der Ostthüringer Landkreis ist unter allen Kreisen und kreisfreien Städten der einzige bundesweit, wo der kritische Wert von 50 Neuinfektionen auf 100.000 Einwohner überschritten wurde. Foto: Hendrik Schmidt/dpa-Zentralbild/ZB +++ dpa-Bildfunk +++

German Chancellor Angela Merkel and the country’s state governors have decided that if a municipality becomes a coronavirus hotspot, authorities there must intervene. But local leaders have other plans.

Greiz advertises itself as the “pearl of the Vogtland,” a scenic region abutting the Czech border in eastern Germany. These days, however, it wishes it were less well known.

The outbreak in the district, located in the eastern German state of Thuringia, supposedly started with a festive family celebration on February 29. Two weeks later, the district’s health authority registered its first COVID-19 patients. The first casualty came on March 22, an 82-year-old who died at home from pneumonia. Two days later, a post-mortem examination revealed that she had had the virus. It marked the deadly virus’ arrival in this rural part of the country.

Now, 44 people have died in the Greiz region and 585 people have been confirmed as infected. In a special report, Germany’s Interior Ministry found that no fewer than eight care homes in the district are “especially affected.” Two hospitals and a manufacturer of rubber goods were also classified as hotspots. In May, the district had up to 88 new infections per 100,000 inhabitants per week — at that point, the highest figure for that metric in the country.

As a result, Greiz has drawn the attention of political leaders. The region is one of several German hotspots, alongside Coesfeld in the western state of North Rhine-Westphalia, Steinburg in the northern state of Schleswig-Holstein, Rosenheim and Traunstein in Bavaria and Sonneberg in Thuringia. An “emergency mechanism” is supposed to be implemented in districts in which there are 50 new infections per 100,000 inhabitants within seven days — a measure meant to once again limit public life. Germany’s state governors agreed on this approach with German Chancellor Angela Merkel.

But in practice, district administrators and, occasionally, state governors are resisting this approach. Not so much because of pressure from local businesspeople, but rather because they are skeptical about the numbers. Hotspot areas often have a single outbreak source. In Greiz, it is care homes; in Sonneberg, a health center; in Rosenheim, refugee housing; in Steinburg, shared apartments for workers at a slaughterhouse. The authorities have imposed quarantines and other limitations on these facilities.

Knowing that, how much sense does it make to close restaurants and hairdressers in these districts, especially given the growing protests against Germany’s coronavirus lockdown measures? Residents can just drive a few kilometers, after all, and have their hair cut in a different town. At least, that’s how people in Greiz, and how Thuringia Governor Bodo Ramelow, see it.

Different Approaches

Every district is now trying to find its own path out of hotspot status. In the city of Rosenheim, the residents of two homes for asylum seekers were told to remain inside. Only those who repeatedly tested negative or who had antibodies in their blood were given a colorful armband and allowed to leave. “The solution is being well accepted in the homes,” says Rosenheim’s municipal spokesperson and head of economic affairs, Thomas Bugl. He added, “public life has widely normalized.”

Lately, the rate in Rosenheim has been fluctuating around the all-important limit of 50 cases per 100,000 inhabitants per week. Without the infected residents of the refugee home, that number would be a third lower. “For those of us on the frontlines, the crucial question is whether or not we can more or less take a local hotspot out of commission to break the chain of infection,” Bugl says. In his view, this has now been accomplished in Rosenheim.

A district’s hotspot status can change quickly. Traunstein in Bavaria was described by the Robert Koch Institute, Germany’s public health authority, in the same breath as Greiz. Now the district has far better numbers. According to Traunstein’s district administrator, Siegfried Walch, quick local decision-making is crucial. “Waiting for instruction from Berlin,” he says, “can take days.”

Walch is convinced that his local authorities are taking decisive actions. “We can stop the events that lead to infections in a targeted manner.” The district administrator argues that additional coronavirus figures should be taken into account, including the number of people who have recovered, the number of tests implemented and hospitals’ occupancy rate. “If one region would have to go into lockdown while others are allowed to remain open, that would be fatal,” says Walch. But he says his district authority has taken special measures.

Unlike the rest of Bavaria, senior citizen and care homes in Traunstein remained closed on Mother’s Day. After outbreaks in two homes for asylum seekers, the district carried out a series of tests and housed infected and non-infected residents separately.

Compromise Solution?

Leaders in Traunstein have almost four months of experience with the virus. The first infections appeared in late January. In March, returning skiers drove up the number of new infections. The health department tripled its staff dedicated to contact tracing, and medical students and civil servants are investigating chains of infection. The citizens’ hotline alone is now staffed by 20 people.

In the Zollernalbkreis district in the state of Baden-Württemberg, the situation is also seemingly under control. There were just under 50 new infections in the district recently. District administrator Günther-Martin Pauli says he is not planning any new closures. He argues that his district is high up in the statistical rankings because it has been affected for such a long time. “We are testing more than other districts, which is why we also have noticeably more results.” He says there is no one particular source of infection, and that the supply situation in the local hospital isn’t particularly dramatic. Pauli calls for “proportionate action.”

But what does that mean? Katrin Göring-Eckardt, the head of the Green Party’s parliamentary group, argues that what’s missing is “consistent, binding rules on how to monitor developments.” The Greens are calling for five corona warning levels to be implemented in order to be better able to classify regional outbreaks.

“We need to make it transparent to people why some places have noticeably higher infection numbers — for instance, because there is a care home there,” argues Gudrun Heute-Bluhm, managing director of Baden-Württemberg’s Association of Cities and Towns. “The numbers themselves always need clarification. This is the only way to increase people’s awareness.”

In Thuringia, which has two hotpots — Greiz and Sonneberg — authorities are attempting a compromise solution. Regional concepts for protecting people are to be implemented in the locations most seriously affected by the problem: hospitals and care homes.

The state government is trying to find a joint way forward together with the districts, but is also showing off the forms of punishment at its disposal: Sources in the state’s Social Ministry say they reserve the right to intervene, and on Thursday, the ministry imposed small restrictions on restaurants.

Now all of the approximately 800 employees and residents in the care homes are being tested, as well as those in one hospital. The German armed forces are also helping. In Sonneberg, mass testing for 600 people is being planned. It’s possible that the numbers will be much higher once authorities take a closer look — turning a hotspot into a mega-hotspot.

Der Spiegel

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