Faced with declining vaccination rates and persistent skepticism, Germany is now preparing for another autumn of living with COVID-19. Politicians are looking at several measures, including air purifiers for schools, compulsory testing for travelers and a pro-vaccine ad blitz.
People in Berlin’s government district are currently saying a farewell – a slow, quiet farewell, with no statements, no press release, a farewell that can no longer be stopped. And it will have consequences for the months to come, maybe even years. It is a farewell to an illusion.
Last Monday, for example, German Health Minister Jens Spahn of the center-right Christian Democrats (CDU), held a small online meeting of experts – politicians, doctors and other officials. It centered on the autumn, the next steps in the fight against the pandemic, the question of vaccine booster shots. And about the goal politicians have been pursuing since the start of the year: herd immunity.
In other words, about the goal of immunizing so many people against the virus that it loses almost any capacity to threaten us. It would be the end of the pandemic, a triumph over COVID-19. That was the plan, the hope. The illusion.
Representatives from the Robert Koch Institute (RKI), Germany’s center for disease control, spoke up in the meeting: To reach herd immunity, they said, 85 percent of those aged 12 to 59 would need to be vaccinated, as well as 90 percent of all those above the age of 60. They argued that this would be possible by September. This was the official line that the RKI has been pushing for months – but there has been increasing pushback recently, including on Monday.
According to reports from the meeting, several participants made it clear that they no longer believe that goal to be realistic. They believe that the 85 percent won’t be met, by far. Health expert Karl Lauterbach of the center-left Social Democrats (SPD), who also took part in the meeting, agreed.
“I unfortunately can hardly imagine at this point that we will reach herd immunity,” Lauterbach says, adding that the vaccination rate is already decreasing and that cases are going up again. The percentage of people who have been fully vaccinated stands at 47 percent.
Lauterbach has abandoned the illusion. Spahn must also now understand that there will be no herd immunity by the fall. So, what now?
One participant at the video conference reported that alternatives and consequences had been discussed at the meeting. “The models show that even if we reach a vaccination rate of 75 percent and assume that 10 percent can still get infected despite full protection, we won’t be able to manage without contact restrictions,” one person argued.
A return to contact restrictions? Despite well-functioning vaccination distribution? Even though there is enough vaccine available for everyone? Things are not going the way they were meant to.
The story of German pandemic policy is a story of failed dreams and burst illusions. At the very beginning, some hoped things wouldn’t get that bad. Then came the virus. And things did get pretty bad.
In the summer of last year, some leading German politicians gave into the hope that the worst was over. But then came the second wave, and it was worse than the first one.
Since the beginning of the year, when the vaccination campaign kicked into gear, many had hoped things would be finished by the fall, that enough people would be vaccinated or recovered from the disease by then that a return to normalcy would be possible, despite the colder weather once again pushing people indoors.
But that won’t happen. The vaccination rate isn’t high enough. This is indeed a watershed moment, also from a psychological perspective.
Thus far, pandemic policy, with all its restrictions and incursions into daily life had its hopeful moments. There was the assumption that everything would have an end.
All the prohibitions and rules – closed schools and daycare centers, weddings without guests, the wearing of masks outdoors – were only meant to last until the curve with the case numbers was flattened enough again, and then, once there was enough vaccine and enough people had received their jabs, it would all be over. This hope helped an entire country get through the winter.
The End to the Carefree Summer
Not reaching herd immunity means things won’t end now, or probably ever. Germany needs to prepare for a further autumn, and probably also a winter, with the virus. The delta variant is already putting an early end to the carefree summer.
Numerous leaders have said there will not be another lockdown. “Very soon, anyone who wants to get vaccinated will be able to do so,” says Thuringia’s governor, Bodo Ramelow of the Left Party. “We should return to a form of normalcy in the autumn – also recognizing the variants, which are spreading more aggressively.”
It’s like a war that the leadership recognizes cannot be won. We will have to learn to live with the enemy, somehow, and hope that it behaves peacefully.
How will this new normal look? Preparations are currently taking place across the country – some places are doing more, others less.
Oliver Eissing, the principal of the Wolfgang Ernst High School in the town of Büdingen, in the central German state of Hesse, is a pragmatist. At the beginning of the pandemic, when Germany was still talking about whether it made sense to wash one’s hands, he sent his custodian to the nearest supermarket to buy as much liquid soap and paper towels as he could transport.
In March, when Germany was yearning for an end to the second shutdown, Eissing received an offer. A company from the region asked if he wanted to test a new UV-C indoor air purifier. Eissing took up the offer. “In Hanau, our neighboring city, air purifiers were installed on every bus,” he says. He argues that what works for buses can’t be bad for classrooms, right?
Eissing had the first unit, a gray box the size of an 80-liter garbage bin, installed in the teacher’s room.” “We wanted to test how loudly it hums – and if the noise disrupts teaching.” It didn’t – the teachers found the noise tolerable.
Eissing was excited, he wanted to order more units, but the Wetterau district rejected it and pointed to a recommendation of the German Environmental Agency that air purifiers are only necessary in rooms that are hard to ventilate. “Our building has a large façade of windows,” says Eissing. “That was basically the end of the discussion.”
That makes it unlikely Eissing will have any air purifiers in the school this fall. He’ll just have to open the windows and ventilate the rooms – even when it’s stormy and hailing outside.
Germany is often good at managing and bad at creating. This has also been the case during the pandemic. The federal and state governments reacted to new developments, but never developed a mode of strategic planning or foresight. They took a wait-and-see approach, which hit the schools and parents, teachers, children, especially hard.
Sometimes the children stayed at home, sometimes they did hybrid learning, with online lessons and half-full schools, and classrooms were to be frequently ventilated. The week before last, Health Minister Spahn was furious at a cabinet meeting. “If I had procured masks in the same manner that you are discussing ventilation here, we wouldn’t have any to this day,” he told his colleagues. Nevertheless, the cabinet decided to purchase 200 million euros worth ($236 million) of mobile air purifiers – almost one and a half years into the pandemic.
But in some German states, school is already starting up again in early August, by which point the devices are unlikely to have arrived. It’s also unclear how far those 200 million euros will go. Heinz-Peter Meidinger, chairman of the German Teachers’ Association, calculates that it would take 1.5 billion euros to fully equip Germany’s approximately 650,000 classrooms. That target seems about as far away as herd immunity.
Another impediment to herd immunity is that it would require us to vaccinate children, a tricky topic. Not even 2 percent of children and adolescents between the ages of 12 and 18 have been vaccinated – and not just because there hasn’t been enough vaccine up until now.
As has so often been the case during the pandemic, the people in charge have vacillated on the issue. The European Medicines Agency approved the BioNTech/Pfizer vaccine for children above the age of 12. The Standing Commission on Vaccination (STIKO), on the other hand, has only recommended the vaccination for children with pre-existing conditions. Health Minister Spahn, meanwhile, has stated that children and youths should decide for themselves about whether to get vaccinated.
Parents are free to make their own decisions, but even well-intentioned ones are likely to feel uncertain at this point. And, so far, no vaccine has been approved for children under 12, anyway. Now, the pressure on STIKO is growing. Politicians from various parties are demanding it change its recommendation for children 12 and older.
Are schools facing another period of hybrid learning or even more school closures? Spahn seems to fear precisely that. Together with German Education Minister Anja Karliczek (CDU), he wrote to the states’ ministers of health and education last week. “After the summer holidays, our common goal should be bringing the pandemic under control without the further closure of daycares and schools,” the letter states. To do this, it argues, there needs to be “a systematic and sensitive testing plan for children.” But the letter also argues that this plan is missing in the states.
Spahn and Karliczek have been the target of a lot of criticism during the pandemic, and this time they don’t want to be the ones to get the blame, especially after they issued a warning.
But air purifiers, testing plans and vaccinating children will have little effect if adults don’t get vaccinated. There is enough vaccine, and anyone who wants an appointment can get one quickly. But many just don’t want to.
Vaccination euphoria has seemingly given way to vaccine fatigue, and despite all the efforts and appeals, part of the population still doesn’t want to get vaccinated. The key question is how big that segment of the population will be. And how much of it can still be persuaded or pressured to get vaccinated.
Are mandatory vaccinations plausible? So far, that rule has only been applied in states like Tajikistan and Turkmenistan, which generally aren’t big supporters of human rights. The Vatican has also instituted mandatory vaccination for all residents and employees. But where else?
In France, anyone who works in a hospital or a nursing home must be vaccinated by Sept. 15. Greece has imposed similar rules. In Italy, medical personnel with contact to patients have had to get vaccinated since the end of May.
French President Emmanuel Macron once campaigned as an economically liberal politician, but amid the pandemic, he has been increasingly relying on regulations. Starting this week, anyone in France wanting to attend a public event with more than 50 participants will have to show a “pass sanitaire,” or a proof of vaccination, or that they have recovered from the virus or had a negative test. Starting in the fall, the French will also need to pay for their own PCR tests. Beginning in August, the pass will also be necessary to access shopping malls, long-distance trains, restaurants and cafes. That’s not a mandatory vaccination, but it does increase the pressure – and pushes things close to the edge of what is possible in a free society.
And in Germany? Angela Merkel and Jens Spahn reiterated last week that they do not plan to make vaccinations compulsory for those working in daycare centers or schools, for instance. But they, too, want to ratchet up the pressure.
The pandemic is a large-scale experiment in how much solidarity a society can muster. There was solidarity with the elderly and the sick because they needed to be protected more than everyone else. But what about solidarity with those refusing vaccines and placing their own reservations above the health of the general public? On several occasions last week, Spahn suggested how things might go. He did say that in a later stage of the pandemic, testing could stop being free of charge for people who haven’t been vaccinated. Together with other restrictions, this could, as in France, become an indirect driver of people getting vaccinated.
German Interior Minister Horst Seehofer of the Christian Social Union (CSU), the Bavarian sister party of Merkel’s CDU, disagrees. “I don’t believe that people who refuse the vaccine should be forced to pay for the tests themselves in the future,” he told DER SPIEGEL. “Many would then refrain from getting tested. This would lead to us losing the overview of the infection situation, which would be disastrous.”
The opposition views things similarly and is instead calling for more incentives. “We need a large-scale education and advertising campaign for vaccinations, ideally with celebrities from the arts, sports and society in general,” says Michael Theurer, the deputy chairman of the parliamentary group of the pro-business Free Democrats (FDP).
Green Party parliamentary group leader Katrin Göring-Eckhardt is calling for “attractive vaccination opportunities” to be brought “as close to people’s daily lives as possible.” She argues that there is still too little advertising and not enough information about accessible vaccination options, and that not enough is being done to debunk myths about the vaccines. “The vaccination in the pedestrian zone, in front of the supermarket or in front of the university cannot be an exception or a one-off project,” she says. But the federal government is actually promoting vaccination with an ad campaign featuring former “Baywatch” star David Hasselhof.
Young adults are currently a big problem, because their infection numbers are rising particularly strongly. Germany’s health and education ministries are already worried about the universities’ winter semesters. In a letter, both authorities appealed to the heads of the German Rectors’ Conference and the Student Union that students “be informed on the local and regional levels about the importance and significance of vaccinations.”
Putting Vacation over Vaccination
But the problem isn’t just that people are refusing vaccines, it’s that it’s vacation season. As recently as spring, people were worried that they wouldn’t be able to travel without a vaccination. Now everyone can do so – which seemingly led many Germans to prioritize their vacation over their vaccination.
The number of vaccination shots being administered each day has been declining for weeks, and many appointments are not being kept. Recently, the idea of imposing penalties in such cases has been discussed. Those won’t be imposed, for now. Instead, the question is how to deal with those who are returning from vacation.
The issue was discussed last Tuesday by the Berlin COVID-19 crisis team. One possibility is requiring all travelers returning from vacation to carry either a negative test or proof of vaccination with them – no matter which country they are coming from, and whether they are entering Germany by plane, train or on foot.
Things could get uncomfortable for the unvaccinated, while, conversely, vaccination could offer travelers advantages. The crisis team is considering shortening the quarantine period for vaccinated people returning from so-called virus variant regions. At the moment, it is 14 days – with or without vaccination. “I’m strictly against mandatory vaccination,” says Interior Minister Seehofer, “but I’m definitely in favor of linking vaccinations to consequences, for example when it comes to rules for entering the country: no quarantine, no tests for vaccinated people.”
The new normal will be bifurcated and will feel different for those with vaccinations than those without. This will deepen divisions – but the rift would be even deeper if nothing would change for those who had been vaccinated, and everyone had to make allowances for those who refuse the jabs.
But some things will be the same for everyone: new numbers and indicators. At the start of the pandemic, Germany stared obsessively at the absolute numbers and the so-called R value, the number of people, on average, that a person with the coronavirus passes the infection on to. By the time most people understood the latter, the incidence value – the number of new infections per 100,000 inhabitants in the past seven days – became more important. But another value beyond the incidence could attract new scrutiny in the future.
The more people there are who are vaccinated, the higher the incidence value can be without the healthcare system collapsing. Chancellor Merkel said last week that higher incidence levels could be permitted in the future. In the United Kingdom, the incidence is well over 300, but things are opening up nevertheless.
The Health Ministry doesn’t want to go that far, but officials there are also looking at a different value now: the hospitalization rate. Since last Tuesday, German hospitals have thus been collecting more data on their patients with COVID-19.
It’s a long, arduous road. The country is gradually learning to live with the pandemic, but it is struggling, partly because not all consequences are foreseeable. The new normal is only gradually becoming clear.
Long COVID Worries
Heyo Kroemer, for instance, the head of Berlin’s Charité University Hospital, recently had an encounter related to long COVID – when people who suffer from symptoms long after they were infected, like fatigue, shortness of breath, insomnia – that worried him.
“In a meeting with our deputy clinic directors last week, I was told that there is extreme demand from patients suffering from long COVID,” Kroemer says. His team believes that up to 10 percent of those infected with the coronavirus are affected.
“The severity of the infection and the severity of long COVID do not seem to correlate, based on our findings,” Kroemer says. That means a patient can have had a harmless progression of the disease and still suffer long-term consequences. That’s a scary prospect for a society, and Kroemer expects that long COVID will keep the healthcare system busy for some time to come. He expects university hospitals to set up central contact points for it.
What does that mean? Namely, that even if it’s all over one day, things still won’t be over.