Many in Germany thought the worst of the pandemic was behind them. But the country is now being slammed by the fourth wave – fueled by millions of people who refuse to be vaccinated and political leaders who have abdicated leadership. The situation, say virologists, is grave.
Nobody really wanted to listen to him in the last few months. He was seen as a killjoy, dragging down the mood. That annoying guy from Berlin’s Charité University Hospital. German politicians also studiously ignored his warnings of a difficult fourth epidemic wave – of a deadly corona autumn. But here we are. Because as it happens, Germany’s best-known virologist, Christian Drosten, in concert with many of his fellow scientists, had been spot on.
Aus: DER SPIEGEL 46/2021
Jeden Tag neue Rekordwerte. Trotz eindringlicher Warnungen aus der Wissenschaft hat die Politik das Land nicht auf den Coronaherbst vorbereitet. Dieses Versäumnis, gepaart mit der Renitenz trotziger Impfverweigerer, könnte nun zur Katastrophe führen.
Countries with high vaccination rates like Spain and Portugal, says Drosten now, “could definitively leave the pandemic behind them” in spring. But in Germany, because of the many people who still refuse to be vaccinated and due to the sluggish booster campaign, is “still miles away” from that. “As soon as Delta strikes with full force, the hospitals will quickly be overwhelmed,” Drosten warns.
And Delta is currently hitting Germany hard. On Thursday, the Robert Koch Institute (RKI), Germany’s center for disease control, reported more than 50,000 new infections. A record. The seven-day incidence rate climbed to 249 on Thursday, also a record. The RKI also reported 235 deaths from the virus on Thursday alone.
The hospitals are getting fuller by the day, and 2,800 COVID-19 patients are in intensive care. In response, Charité has cancelled all non-emergency surgeries and many other clinics in the country have done the same. If the trend continues, many of them could soon be overwhelmed.
A federation of imbeciles has ensured that Germany is being hit extremely hard by the fourth wave – much worse than many other European countries.
Irrational political leaders chose not to heed the warnings of scientists. They refused – once again – to prepare for the coming autumn and they now have no plan for what promises to be the most dangerous phase of the pandemic yet.
A Pandemic of the Feebleminded
Meanwhile, a large population of the feebleminded have continued to ignore the dangers presented by the virus and refuse to be vaccinated. Indeed, the untenable situation in Germany’s intensive care units is primarily due to this group. In its most recent weekly report, the RKI notes that 87 percent of adults under 60 receiving intensive care due to COVID-19 have not been vaccinated.
“The winter will be a societal and medical challenge for Germany, resulting from a lack of preparation, clear rules and rigor,” said Gerald Haug, president of the German National Academy of Sciences Leopoldina. The unusually stern tone of his message is justified. Almost no preventative measures were taken, the rules now in place aren’t particularly rigorous, and they are hardly enforced.
The fact that Germany is stumbling into the fall virtually unprepared is one problem. The fact that the country has essentially been without leadership since the September general election is another. The leadership shown – or better, not shown – by the country’s political representatives in recent months borders on malpractice. Hardly anyone is doing what they should be doing in the face of a crisis like this. Angela Merkel is no longer offering guidance. Her likely successor, Olaf Scholz, isn’t yet in office. And even worse, the next coalition will in all likelihood include the Free Democrats (FDP), a party which, when it comes to measures to control the coronavirus, is far more focused on what they don’t want than on what is necessary.
The result is that Germany’s federal politicians are pushing off responsibility onto the states. And they are again doing what they always do: Each state comes up with its own strategy. No coordination. Collective negligence.
The consequences are serious. Whereas more than half the population of Israel has received a third dose of vaccine, the rate in Germany is just 4 percent. Despite the fact that it has been known for some time that protection from the initial doses begins to wane after a few months.
Back in summer, immunologists and virologists made it clear to the German government that all elderly people in the country and those with compromised immune systems needed to receive a booster, which can increase protection from the virus by up to 20 times. The Health Ministry, under the leadership of Jens Spahn, calculated that up to 11 million people could be reached by the end of October. It is now November, and just over 3 million have received their booster shots. Just how outgoing Chancellery Chief of Staff Helge Braun intends to achieve his self-proclaimed target of 20 million boosters by the end of the year remains his secret. Preparations for the campaign have suffered for weeks from chaotic agreements and contradictory statements.
And it was Health Minister Spahn himself who was the source of much of the confusion. After he – in concert with the RKI – initially recommended booster shots after six months for the elderly, those with weak immune systems and health-care personnel, he suddenly shifted his approach two weeks ago. He did so in response to a discussion with his Israeli counterpart, who has been preaching booster shots for some time. There are now indications that boosters don’t just help at-risk patients, but can also result in a lower virus transmission rate, thus breaking new chains of infection.
So, Spahn also suddenly recommended that everyone get their booster shot.
The consequence has been massive confusion in medical practices across the country. Primary care physicians say their phone lines were suddenly jammed and people mobbed their offices – right at the beginning of the cold and flu season. Last Tuesday, the outraged doctors took an unusual step. In comments to journalists in Berlin, Andreas Gassen, head of the National Association of Statutory Health Insurance Physicians, said that comments from political leaders introduced “chaos” into German medical practices. It was clear that he was talking about Spahn.
On Thursday, Gassen and Spahn sought to lower the temperature on their conflict and agreed on a compromise over the phone. They sent a joint letter to doctors in the country asking them to “continue doing all you can to support the vaccination campaign.” Essentially, the message is: Hang in there.
Foresight in Short Supply
The problem, though, is that has become more difficult to organize mass vaccinations. In late June, Spahn and the state health ministers decided to phase out large vaccination centers starting on Sept. 30. In late summer, fewer and fewer people were showing up for their jabs and operating costs were far higher – up to tenfold – than simply having vaccines delivered by primary care physicians. It seemed like the logical next step to clear out of the sports arenas and cafeterias that had been utilized for the vaccination effort.
Many states, like Saxony-Anhalt and Bavaria, for example, have re-focused their efforts on mobile teams that are better suited to reaching care homes, or smaller “vaccination stations,” as in Bremen. Because demand is now rapidly climbing again, such solutions are no longer sufficient. In Saxony, for example, the roughly 30 mobile teams have reached their limit, as the German Red Cross has complained. Instead of the planned 3,000 vaccinations on Saturday, 4,500 were carried out.
Demand is rising in Baden-Württemberg and Lower Saxony as well, and both states have ramped up their vaccination teams in response. “The closure of the vaccination centers now appears to have been a mistake,” says Karl Lauterbach, a member of parliament with the Social Democrats (SPD) who is also a trained virologist and the party’s point person on pandemic response. But, he says, when the health ministers decided to close the centers, it wasn’t yet clear that everybody would need a booster, and not just the elderly.
Be that as it may, foresight has been in short supply in Germany since the very beginning of the pandemic, with the country rarely being prepared for what the future might bring. Instead, the country’s political leaders have tended to hectically respond to developments as they happen.
Confusion stemming from Germany’s federal structure was also apparent when it came to how the elderly would be informed that they required a booster shot. Berlin sent out invitations, while seniors in North Rhine-Westphalia received a letter from Health Minister Karl-Josef Laumann. Germany’s federal government wishes all states would follow those examples.
It was also a mistake for the government to cease its funding of rapid COVID antigen tests – a decision made in the erroneous belief that doing so could motivate anti-vaxxers to get their jabs. The combination of vaccination and regular testing could have made Germany a halfway safe place this fall. Could have.
The parties currently involved in negotiating Germany’s next governing coalition have now agreed to reintroduce free testing, with the ordinance potentially coming into effect as early as next week. Meanwhile, though, many of the small test centers have disappeared because without federal funding, they could no longer operate.
Indeed, there are myriad indications that Germany is facing fundamental structural issues. After waiting for half an eternity, the federal government in July finally launched a new funding program to help schools and daycare centers purchase portable air filtration units. But of the 200 million euros made available, not a single cent has been paid out. Why not? It took an entire month for the federal government and the states to agree on how the program should be administered.
Restrictions Lifted Prematurely
Plus, many coronavirus measures were prematurely lifted. In early October, Spahn said “from today’s perspective and with the vaccination levels we have, no additional measures are necessary” beyond those already in place. Really?
The governments in many states became lackadaisical. Political leaders in Bavaria, Baden-Württemberg and Saarland lifted mask requirements for schoolchildren, while Berlin and Brandenburg did the same for kids in the sixth grade and below. Since the beginning of November, pupils in North Rhine-Westphalia also no longer have to wear masks in the classroom.
The state also allows those who have recovered from an infection, been vaccinated or have recently tested negative to go to nightclubs, with no social distancing requirements. Schleswig-Holstein eliminated mask-wearing requirements and maximum size rules for large events. Meanwhile, case numbers continued to climb. Only a few states, like the city-states of Hamburg and Berlin, were much more cautious and even back then began insisting on the introduction of the so-called “2G rule,” which means that only those who have recently recovered from the coronavirus or been vaccinated may enter closed public spaces. Even back then, it was clear that the new feeling of freedom was a delusion.
“It is insane what we were talking about just a few weeks ago.”
At least one German parliamentarian realized as much and never tired of pointing it out. But many didn’t want to hear it, because Cassandras like Karl Lauterbach can become extremely tiresome over time. “And now,” says Lauterbach, “you have to say: It is insane what we were talking about just a few weeks ago. For example, a so-called Freedom Day, on which all coronavirus measures would end.”
The biggest failure of Germany’s political leaders, though, is their approach to the almost 15 million people in the country who are either opposed to vaccinations or at least skeptical of them. Germany’s vaccination rate is far lower than it is in Spain, Portugal and Denmark, to name just a few examples. Apparently, nobody understood that it would require an immense effort to reach the doubters, no matter how crude the methods.
Nobody disputes the fact that it is difficult to sway the recalcitrant. Their motives are simply too varied. But there are patterns.
The Degrees of Vaccine Skepticism
Not all anti-vaxxers are as radical as the two doctors from the town of Lüchow in Lower Saxony, one an orthopedic specialist and the other a family doctor. They both recently hung signs on the doors of their practices reading: “Only for the unvaccinated.” One of the doctors claims that the German vaccination campaign is the “largest experiment on people in the history of medicine.” He organized a meeting of so-called “Querdenker” – a movement in Germany that is essentially a collection of anti-vaxxers, conspiracy theory aficionados and right-wing crackpots – in a barn. He told a local newspaper that he hoped his sign would “make people think” and that he wanted to “show the vaccinated what it’s like to be excluded.”
Anti-vaxxer tendencies have a long history in Germany. When Emperor Wilhelm I introduced a vaccine requirement in 1874 against smallpox, an organized resistance to the decree quickly popped up and even published its own newspaper called “Der Impfgegner,” – The Anti-Vaxxer. It printed caricatures depicting the vaccinated with cow ears, since the vaccine was made using the cowpox virus. Today, people say that Bill Gates has planted microchips in the vaccine to control humanity. But that degree of whack-jobbery applies to only a relatively small group.
Psychologist Cornelia Betsch leads the Cosmo survey at the University of Erfurt, which explores the reasons people are opposed to vaccination. She believes that people like the doctors in Lüchow make up 2 to 5 percent of the population at most – and says that they are essentially unreachable.
Many others, by contrast, say they are essentially open to vaccinations, but are just wary of the coronavirus vaccine. They tend to be concerned about the relatively new mRNA vaccine technology used by BioNTech and Moderna. And there is a fair amount of inaccurate information out there about these vaccines, such as the claim that they can make women infertile.
“My husband and I would like to have children,” says, for example, Jasmin D., who works in a daycare center in Hamburg. “I don’t think there has been enough research into the effects the vaccine could have on fertility and on the health of embryos, which is why I’m being careful.” Otherwise, she has received all her vaccines except for the flu jab. “I’m not an anti-vaxxer,” she insists.
Lisa-Marie T. from Munich expresses similar concerns. “As a young woman, I wonder if the vaccine could have an influence on fertility. Friends of mine experienced serious menstruation complications that they had never had before.”
The 23-year-old says she is aware that people in her age group can also experience serious symptoms from COVID-19. “But my concerns about the vaccine are greater than my fear of the disease,” she says. Joshua Kimmich, a professional soccer player who plays for Bayern Munich and the German national team, also says he intends to wait for an inactivated vaccine – those that use dead, or inactivated pathogens in their production. That tried-and-tested technology has been the basis of vaccines for several decades.
The rumor about the vaccine’s possible negative effects on fertility entered the public debate early on and has unsettled many. Yet the study performed as part of the vaccine authorization proceedings unintentionally proved the rumor’s speciousness. Even though all test subjects were requested to use contraceptives, 23 women got pregnant during the study: 12 of those who had received the vaccine, and 11 who had been given a placebo.
The worst thing about the misleading information regarding fertility is the fact that pregnant women are at far greater danger from COVID-19, regardless of preexisting conditions. As such, those wanting to have children are especially advised to get vaccinated.
The Unvaccinated Tend to Vote for the AfD
A striking number of anti-vaxxers are supporters of both alternative medicine and alternative politics. Studies have shown, for example, that people who believe in homeopathy are more likely to reject vaccines.
They and the anthroposophists are joined by many people who are members of or tend to support the right-wing radical Alternative for Germany (AfD) party. According to a survey by the pollster Forsa, 50 percent of unvaccinated voters in Germany cast their ballots for the AfD in September’s federal election, with another 15 percent voting for Die Basis, a party that serves as the political arm of the “Querdenker” movement, which has protested the measures taken by the government to contain the coronavirus’ spread.
In the Cosmo study, 18 percent of respondents said that refusing to get vaccinated was a way of expressing their political dissatisfaction. “There’s a fairly stable milieu that works itself up against the state and its institutions at every available opportunity, reinforced by the echo chambers in the social networks,” says Raj Kollmorgen, a professor of sociology at the University of Applied Sciences Zittau/Görlitz.
This phenomenon is particularly apparent in rural areas that were once part of East Germany, he says, where the population tends to be older. Younger people, who are usually better informed, he adds, moved to the cities. “There’s a lot of pressure to conform,” Kollmorgen says, adding that those open to vaccination would quickly encounter that pressure in the form of stigmatization.
That might seem to apply to Muslims, too, who are often accused of refusing to get vaccinated for religious reasons. But that claim isn’t backed by studies or polls.
The problem has more to do with difficult access to the healthcare systems, says Shao Xi Lu of the Berlin Health Collective, an organization that seeks to bring quality healthcare to underserved communities. “For example, the invitations to get vaccinated were written and sent in official German language,” she says. “When people don’t have a good understanding of German, they can also have more difficulty getting an appointment to get vaccinated.”
Several representatives of Muslim communities stress that they promote vaccination. They say the majority are open to vaccination because Islam is also about protecting the health of others. In a several cases, Muslim communities organized vaccination centers and vaccination buses on their own initiative.
Ultimately, the key question for Muslims or Christians is how great the benefit of vaccination will be versus how big the side effects will be.
Can Growing Pressure Get Us Out of the Worst?
Policymakers should have done more to counter fears and misconceptions. Now, it appears that strong pressure alone could bring an end to the emergency situation. Calls for compulsory vaccination for occupational groups with special responsibilities are growing louder. This week, the German National Academy of Sciences Leopoldina called for obligatory vaccinations for nursing staff. It’s a view that doctors’ associations and some nursing home operators have already held for some time now. In one home in the municipality of Schorfheide in the eastern state of Brandenburg, 16 senior citizens recently died during a COVID-19 outbreak.
But the greatest pressure on the unvaccinated is likely to come from the “2G” model being adopted in many places across Germany. There are signs that the 2G model really is a driver for people getting vaccinated. After Austria made 2G national law on Monday, long lines immediately formed in front of many vaccination centers.
In Germany, the federal and state governments debated back in August whether such a rule should be introduced nationwide. In the end, they decided against it, and many opportunities were missed to mitigate, if not break, the fourth wave. Merkel’s government had already discontinued its active corona policymaking during the election campaign, so it came as no surprise when some cabinet members received a message from the Chancellery on Wednesday that the special “corona cabinet” panel would not be meeting on Monday. No reason was provided.
Merkel Checks Out and Future Chancellor Is Absent
The round table in which the chancellor discusses the pandemic situation and measures with ministers, hasn’t met for weeks. One minister says he finds it odd to simply skip out one of the most important decisionmaking meetings given that the numbers of newly infected people are at an all-time high.
It may be because the chancellor and her cabinet received their certificates of dismissal from the German president around two and a half weeks ago. Essentially, the Merkel cabinet is now a caretaker government that doesn’t make any far-reaching decisions and no longer passes any bills.
Still, the rules don’t envision a caretaker government completely removing itself from day-to-day business. Merkel, though, appears to have switched into a complete hands-off mode in her final weeks in office. She even cancelled her weekly cabinet meeting on Wednesday. The chancellor instead preferred to host a dinner for the leaders of Portugal and Latvia.
Merkel did use the occasion as an opportunity to call for a “nationwide show of strength,” a timely gathering of state governors, rapid booster vaccinations, and an increase in 2G rules in Germany. It sounded almost as though she hadn’t had the opportunity in recent months to push for such things.
The result is that there is no wide-ranging vaccination campaign, no proactive strategy for boosters, and no ideas for better protecting children. The chancellor, who played the role of vocal worrywart through much of the pandemic, has remained largely silent. And Germans are now having to pay for that ignorance.
Does Future Government Lack Fortitude?
Unfortunately, Germany’s likely future government coalition also doesn’t seem to have grasped the gravity of the situation. Or they can’t agree on measures because the FDP, in particular, rejects them and no one wants to risk the new coalition collapsing before it gets into office.
So far, the most conspicuous thing about the SPD, the Greens and the FDP has been their lack of action. Olaf Scholz, who will become the next chancellor if a coalition agreement is reached, has been almost invisible. Even people from within the parties in his likely future government are noticing. At the Green Party’s parliamentary group meeting on Monday, faction leader Katrin Göring-Eckardt repeatedly criticized that Scholz was doing “nothing.”
This week, the SPD, the Greens and the FDP presented legislation that virologists and doctors criticized for lacking practical relevance and being half-hearted. There are to be no curfews, contact restrictions or blanket school closures. Nor will there be blanket 2G rules for areas of public life. And there is no mention anywhere of compulsory vaccination for healthcare workers and care home staff.
It seems as if the FDP has had a strong role in shaping the next government’s coronavirus policy, a party that had long been suspected of not taking the virus seriously enough.
In parliament this week, conservative CDU politician Jan-Marco Luczak accused the Greens and the SPD of being “obviously afraid of the FDP.” Luczak said the parties in the next government don’t have sufficient fortitude to take responsibility. He then turned to face Lauterbach. “You’re the SPD’s public face in fighting the coronavirus, but you obviously have zero clout in your own party group,” he said.
In fact, Lauterbach has long been fighting for 2G rules nationally. But because the FDP strictly rejects the rules and appears to have a soft spot for the unvaccinated, it successfully vetoed those calls. Commenting recently on the plans of his party’s prospective government coalition partners, Marco Buschmann, a senior official in the FDP’s parliamentary group, said that “unconstitutional curfews would henceforth no longer be possible.”
But even the business-friendly FDP are beginning to come around to the fact that, as a prospective governing party, you have to weigh your words more carefully than when you’re in the opposition. Earlier this week, FDP Secretary General Volker Wissing’s staff circulated a tweet that caused particular outrage, especially in the health sector. “Our health care system is stable, health care for the people is secure, and the ‘epidemic emergency of national scope’ can be lifted.”
Wissing had the tweet deleted shortly after it went out.
The latest wave in the pandemic is being taken somewhat more seriously by Germany’s military, the Bundeswehr, than by politicians. The armed forces are a bit like canaries in the coal mine when it comes to new waves of the coronavirus. As happened in 2020 and the spring of 2021, the number of requests for administrative assistance it receives from authorities across Germany has increased. Right now, most are coming from Thuringia, Saxony and Bavaria. As early as next week, however, requests for civilian assistance from the military are expected from all over the country, asking for soldiers to be deployed to assist in vaccination centers, health offices, hospitals and mobile testing teams.
In his daily brief, the commander of the Bundeswehr’s Joint Support Service warned his units to prepare for a “difficult winter.” The modeling experts on his crisis team believe they have solid predictions for what lies ahead for Germany and the troops. According to their calculations, the fourth wave will hit Germany with full force pretty much right at Christmas, with a slight easing expected at the beginning of February at the earliest.
To avert that scenario, the German states would also have to better coordinate with each other. As in the worst of times during the pandemic, there is currently a dizzying array of rules in different states. Bavaria has already implemented the 2G requirement. Hesse is considering expanding 2G rules to other areas of public life. Mecklenburg-Western Pomerania implements stricter rules based on local infection numbers. Meanwhile, Baden-Württemberg and Brandenburg are strengthening measures against unvaccinated people. Even those responsible for these rules are sometimes having difficulty keeping track of everything.
A Push for 2G Rules Nationwide
Bavaria Governor Markus Söder, whose state is struggling with one of the worst coronavirus infection rates, has been pushing for stronger coordination for days now. “The coronavirus is a national problem,” he warns. “We’ve seen this happen a number of times, unfortunately: The crisis originates in hot spots and then spreads across the entire country.”
According to Söder, it’s quite obvious what needs to be discussed and regulated: “We need uniform 2G rules for all states. And we need to talk about how we allocate capacity in intensive care units among states in an emergency.” He also wants to discuss compulsory vaccination for certain professions.
The Bavarian governor, once a contender to become his party’s chancellor candidate, hasn’t held back in his massive criticism of the future coalition government. The future government, he says, “needs to offer more than a first-aid kit. It needs emergency plans.” This prompted return salvos from the Social Democrats, who accuse Söder of trying to fob the blame for the rising number of coronavirus infections in Bavaria onto Scholz and his incoming government. It appears right now that the political parties are more concerned about scoring political points than they are about the joint effort to prevent a disaster.
After the eternal wrangling and tactical quarrels between the parties, there are now plans for a meeting of state governors next week, after all. And the decisions that they should be making at that meeting are clear, at least from a scientific point of view.
“We need to slowly and deliberately maneuver our way into the epidemic phase without allowing our health system to be overstretched to the point of collapse along that path and resulting in deaths like those in Britain,” says Christian Drosten. To do that, we have “act as quickly as possible.” In other words: The pandemic won’t be over until immunity in the population is so high that only limited regional outbreaks still occur. At that point, the coronavirus will become endemic.
Drosten has three clear recommendations: Shutdowns, booster shots and closing the gaps in immunization. “From a scientific point of view, contact restrictions are urgently needed in order to push down the incidence, which is really alarmingly high,” he says.
“Every effort must now be made to close the million-fold vaccination gap in the adult population,” says Drosten. After all, new virus variants could emerge at some point “against which we would have to vaccinate completely anew – especially if we aren’t yet in the endemic phase.”
And because it’s a lengthy process, the virologist says, it depends on everyone, just as it did last winter. “Everyone should consider whether you can’t consciously limit your own contacts again for a few weeks,” warns Drosten. “The public’s own voluntary initiative helped get us out of trouble during the previous waves. I hope this will succeed again.”
Once again, it seems it is up to the sensible people to fix everything – because others are either unwilling or incapable.