Interview with Virologist Christian Drosten “I Am Quite Apprehensive about What Might Otherwise Happen in Spring and Summer”

0
54
Prof. Dr. Christian Drosten, Leitung Stabsstelle Global Health und Direktor des Institut fürs Virologie, auf dem Gelaende der Berliner Charite auf seinem Fahrrad bzw. in einem Bueroraum innerhalb der Virologie.

In an interview with Christian Drosten, the German virologist looks back on the mistakes he has made in the coronavirus pandemic – and ahead to the dangers that the pandemic still has in store for us.

Interview Conducted By Rafaela von Bredow und Veronika Hackenbroch

DER SPIEGEL: Professor Drosten, the pandemic has entered a decisive phase. The beginning of the vaccination campaign has meant light at the end of the tunnel, but now, more contagious virus variants have appeared. How dangerous is the situation in Germany at the moment?

Drosten: I am, of course, closely monitoring the situation. Politicians are also acutely aware that we have to be careful. Early on, I admit that I had my doubts as to whether B.1.1.7, the new variant from Britain, was as much more contagious as people were claiming. But now, there is a new study from Oxford, really solid data, showing that this mutation is up to 35 percent more contagious than the wild-type virus. It is rather astonishing that the virus has boosted its infectiousness to that degree. That is, unfortunately, more dangerous than if it had become more deadly – because every new case will infect more people, and each of them will infect more people, such that the number of cases will grow exponentially.

DER SPIEGEL: On Monday evening, you were part of the group of experts advising Chancellor Angela Merkel and the governors of Germany’s 16 states. What recommendations did you make?

Drosten: Right now, I am most concerned about the British variant, primarily because of our geographical proximity to the UK. According to the facts we currently have, B.1.1.7 has just started spreading in Germany. I think we have the singular opportunity to prevent, or at least significantly slow, the advance of this variant. With B.1.1.7, there could be a kind of threshold effect. If we are able to keep the new variant below a critical benchmark, we would at least have hope that it wouldn’t spread as quickly here.

DER SPIEGEL: Are the measures decreed on Tuesday sufficient?

Drosten: In the negotiations, I think there was an effort made to find the gaps, the places where not enough has thus far been undertaken to stop the spread. It’s clear that it was a struggle and that the results are a compromise. Some areas appear particularly important to me. Schools and daycare centers, for one, particularly the classes in secondary schools. England has closed such schools, with the exception of children of critical workers, and I think that is also where the most reliable data is to be found. For me, this is unequivocal, and Germany should use it as an orientation.

DER SPIEGEL: What about the measures pertaining to working from home?

Drosten: More could certainly have been done on that issue. It would have been good to take inspiration from the Irish experience in the autumn. Ireland introduced strict measures regarding working from home, and it was apparently quite effective. Doing so automatically reduces public transport occupancy. There is also a third aspect where improvements are necessary, something the British are doing: Targeted contact and support for the socially disadvantaged and groups that are difficult to reach in the pandemic. Here, the virus frequently spreads explosively, because many people live in close quarters and have jobs that don’t allow them to work from home. Many perhaps don’t fully understand the problem presented by confined spaces. I think there is still a lot to do here.

DER SPIEGEL: You’ve come up with an image to illustrate our current situation in the pandemic: We are in a rickety truck that is driving down a steep mountainside …

Drosten: … and we don’t know what curves are coming up and whether the road is suddenly about to get steeper. We also don’t know how far we still have to go, but we do know that we absolutely have to avoid missing a corner. In a situation like this, closing our eyes doesn’t help. We have to keep going and do one thing in particular: Hit the brakes, even if they might be rusty.

DER SPIEGEL: What do you mean by that?

Drosten: That means, we have to lower the reproduction number R.

DER SPIEGEL: The value that tells us the average number of people an infected person passes the virus to.

Drosten: Precisely. Currently, that number is at 0.9. It is great that we have finally managed to push it back down below 1, so that the number of cases can begin to drop. But 0.9 isn’t enough if we want to quickly loosen the brakes. With an R of 0.9, it takes about a month to reduce the number of infections by half. That is too long. We should try, through an intensification of the shutdown, to get the number down to 0.7. Then, the case numbers will drop by half in just a week, and we can get to a point where we can stop the spread of B.1.1.7 or at least give ourselves a head start.

DER SPIEGEL: Do you think that the so-called Zero-COVID strategy, the goal of sinking the number of new infections to zero, is the right way forward?

Drosten: I do think it would be possible with a significant effort. The virus, of course, would continue to flare up, just as we have seen in China and Australia. But it would absolutely be worthwhile to at least identify zero new infections as a target. Primarily because I am quite apprehensive about what might otherwise happen in the spring and summer.

DER SPIEGEL: What do you mean?

Drosten: Once the elderly and maybe part of the risk groups have been vaccinated, there will be immense economic, social, political and perhaps also legal pressure to end the corona measures. And then, huge numbers of people will become infected within just a short amount of time, more than we can even imagine at the moment. We won’t have 20,000 or 30,000 new cases a day, but up to 100,000 in a worst-case scenario. It will, of course, be primarily younger people who are less likely than older people to have severe symptoms, but when a huge number of younger people get infected, then the intensive care units will fill up anyway and a lot of people will die. Just that it will be younger people. We can cushion this terrible scenario somewhat by pushing the numbers way down now.

DER SPIEGEL: Can we be confident that case numbers will begin to drop in spring as temperatures rise?

Drosten: I don’t think so. The fact that we had such a relaxed summer in 2020 likely had to do with the fact that our case numbers remained below a critical threshold in the spring. But that’s not the case any longer. I am afraid that it will be more like in Spain, where case numbers climbed rapidly again after the lockdown was lifted, even though it was quite hot. In South Africa, too, where it is currently summer, case numbers are at a high level. (Sinks into thought, saying nothing) I’m sorry, unfortunately I’m extremely tired.

DER SPIEGEL: Because you were advising politicians deep into the night?

Drosten: (laughs) No. Because I worked until 1 a.m. and then woke up this morning at 5:30.

DER SPIEGEL: How well are you able to juggle your work with family life?

Drosten: I don’t really want to talk about my private life. But I do think that it’s a problem many families are facing at the moment. The pandemic has found a sore spot. In countries like Germany, where people generally aren’t living together with grandma and grandpa, many families find themselves in an extremely difficult situation. I hope that we can learn from this and find new solutions.

DER SPIEGEL: Do you still have time for your real work, as a virologist?

Drosten: Yes, of course. We are currently taking a closer look at the British variant. We hope to have initial results in a few weeks.

DER SPIEGEL: Which of the new mutants do you believe is the most dangerous?

Drosten: In a population that still isn’t immune, like here in Germany, the variant from Britain will likely find success, because it is better at spreading, it is more contagious. The South African and Brazilian variants may be able to infect people who have already had the disease, but that likely doesn’t give them an advantage in a population where immunity isn’t yet widespread. Which means that the virus will be distributed here and there over the course of the next year, and new variants will surely appear.

DER SPIEGEL: What does that mean for the vaccines?

Drosten: One of the mutations in the Brazilian and South African variants has already demonstrated a serious immune escape …

DER SPIEGEL: … which helps the virus evade our immune defenses. Does that mean that the vaccines will be ineffective?

Drosten: Antibodies are just one component of immune protection, another is T-cell immunity. That protects much more strongly against a serious progression of the illness. If the virus mutates, it doesn’t have an effect on T-cell immunity. As such, I don’t think that we have to fear that our vaccines will be ineffective.

DER SPIEGEL: When you formulate such assessments, people across Germany are listening, and it often determines public opinion. How well are you able to live with that responsibility?

Drosten: It doesn’t rob me of sleep. From the very beginning, I hoped that this public role would be shared among several people. And luckily, that is happening.

DER SPIEGEL: Last year, experts who have argued time and again against scientifically proven measures – e.g. Jonas Schmidt-Chanasit and Hendrik Streeck – likely did more damage than corona-truthers. Protecting high-risk groups must have priority, you frequently heard from their group. Yet it has long-since been clear that doing so is impossible when case numbers are high. At what point do you lose your patience?

Drosten: Are you trying to get me to criticize colleagues by name? I don’t think much of personal attacks.

DER SPIEGEL: We are more interested in a fundamental point. Many such experts awaken the impression that only opinions are important in science, and not evidence. That undermines the credibility of researchers who take a more serious approach. How do you deal with that?

Drosten: Like most scientists, I try to convince people with facts. Imagine, for a moment, that a completely new dataset emerges that is so compelling that it knocks you off your feet and you think: Finally, everything is clear! I’ll summarize it and explain it in an interview or share it via Twitter. By doing that, I can explain the facts or clear things up.

DER SPIEGEL: And that’s how you hope to explain to us how serious science works?

Drosten: It could be that this strategy is a bit short-sighted, or perhaps naïve …

DER SPIEGEL: … and perhaps simply won’t be understood.

Drosten: Maybe that as well. Perhaps, though, it is more your job as journalists to make it clear what makes one study more credible than another?

DER SPIEGEL: By not contradicting people who say ridiculous things publicly, you tolerate a situation whereby people believe in false prophets. It’s particularly problematic with corona-truthers, who claim that mortality isn’t much higher than it is with influenza.

Drosten: Let me be extremely clear about that: According to what I have heard, the infection mortality rate in Germany – meaning the percent of SARS-CoV-2 infections that result in death in Germany – is likely over 1.1 percent. That is more than 10 times higher than the flu. But I know what you mean, of course. Though studies that are out of date, that are no longer accurate, don’t bother me so much. That’s just part of science. What bothers me more are arguments made without evidence, without substance, with unfair analogical reasoning. All those things that are essentially akin to suppressing scientific insights. It results in a false balance, with people getting the impression that such arguments are also science.

DER SPIEGEL: Politicians also get sucked in by such assertions.

Drosten: Of course. How is a politician supposed to know who the real experts are? Since fall, when some of these experts sounded the all-clear, I have had the feeling that we have been subject to a false balance. My assessments are now almost always contrasted with opposing views that are not rooted in fact. But I simply don’t have the time to fight on this front. I already have a fulltime job as the leader of an institution, where I carry responsibility for research, for patient care and for public health.

DER SPIEGEL: Is the battle for interpretive authority in the pandemic becoming more aggressive?

Drosten: There are certainly some attacks that on top are driven by testosterone. You simply have to ignore them.

DER SPIEGEL: Why?

Drosten: People who attack others personally are, depending on their style, like drivers who sit in the safety of their cars and scream at other drivers – something they would never do as pedestrians on the sidewalk. Or like a person who secretly lets the air out of someone’s bicycle tire. But I don’t want either of those things. I can’t be like that; I don’t want to behave like that.

DER SPIEGEL: Most recently, the virologist Melanie Brinkmann was attacked by the tabloid Bild because she is a proponent of the Zero-COVID strategy. You have also had an encounter with Bild. What advice would you give her?

Drosten: To pull back. It’s the only thing you can do. As scientists, we are defenseless, we can’t simply ignore such attacks or stand up to them. It’s not just a question of thick skin or practice, but also of protective structures.

DER SPIEGEL: When you look back on this year of pandemic, what mistakes have you made?

Drosten: Certainly, when it comes to communication. For example, trying to defend myself on Twitter against attacks. That never works. In general, I made the mistake of spending too much time reading Twitter. Doing so just drives you crazy. And then, it was naïve of me to just announce in brief on Twitter the results of our study on viral load in children. Many people saw that as a provocation.

“It was naïve of me to just announce in brief on Twitter the results of our study on viral load in children. ”

DER SPIEGEL: As a consequence of the study, you warned against reopening schools and daycare centers.

Drosten: I thought it was a piece of information that everybody needed to see: Let’s redouble our efforts so we can publish as quickly as possible. It wasn’t clear to me at the time that it could seem like a provocation – particularly in the heated atmosphere of the time.

DER SPIEGEL: The issue of school closures was the subject of hours of debate on Tuesday during the meeting between Merkel and the state governors. Why has it been so difficult for scientists to convince people on this issue?

Drosten: To be honest, even without our study on viral loads in children, I would not have considered it likely that children would be spared by SARS-CoV-2. From a purely biological perspective, the mucous membrane doesn’t change all that much during puberty. Which means that children can also get infected – and be contagious. That so many doubts about that fact have arisen was always, and still is, confusing to me.

DER SPIEGEL: Was Germany paralyzed as a result and not prepared with clever ideas for keeping schools open throughout the winter?

Drosten: I thought, yeah, people will discuss it and then find practical solutions – like, for example, removing windowpanes and replacing them with a piece of cardboard outfitted with a fan. But then, the infectiousness of children was denied for so long, and nothing was done, no decisions were made for so many months through the summer. I found that very, very astonishing.

DER SPIEGEL: That’s all the mistakes you made last year?

Drosten: (laughs) I don’t think I was fundamentally wrong with my scientific assessments of the pandemic.

DER SPIEGEL: You did make one bad mistake in your podcast on Tuesday.

Drosten: Uh oh. What?

DER SPIEGEL: In answering a question, you mentioned a number. The number, you said, was the same one as from the science fiction classic “The Hitchhiker’s Guide to the Galaxy”: 21. Really, 21?

Drosten: Wait a sec. I’ve read the book! The 21 in the podcast was a spontaneous joke. I knew it was half of the real number!

DER SPIEGEL: Precisely. In the book, 42 is the answer to “the ultimate question of life, the universe and everything.” We’re quite relieved. In your interview with DER SPIEGEL in May, after all, it became clear that you were familiar with neither Obi-Wan Kenobi nor Gandalf. SPIEGEL readers and Twitter followers offered to send you copies of “The Lord of the Rings” and “Star Wars.” Have you since read them, or watched the movies?

Drosten: (laughs) I haven’t actually found the time to read “The Lord of the Rings” this year. But I received them. They’re on my shelf!

DER SPIEGEL: You can maybe plan on reading them when the pandemic is over. When will that be?

Drosten: I think that at some point in the middle of fall, the effects of vaccinations will begin to become apparent. Population-wide, not just in the sense that risk groups are protected. So that far fewer people will be getting infected. But for that to happen, nothing completely unforeseeable can happen.

DER SPIEGEL: Are you then going to write a book, as some of your colleagues have done?

Drosten: I did think about writing an informational book, kind of like my podcast. But in the course of discussions about it, I realized that there was a greater interest in me, personally. I then said that is something that I really don’t want. I might write my memoirs when I retire, but not right now.

DER SPIEGEL: You have better things to do?

Drosten: Precisely.

DER SPIEGEL: Professor Drosten, we thank you for this interview.

Der Spiegel

LEAVE A REPLY

Please enter your comment!
Please enter your name here