An interim balance after six virus months


The world is upside down. At the latest since mid-March, when WHO chief Tedros Adhanom Ghebreyesus officially declared the spread of the corona virus a pandemic. At the end of June 2020, you might think that terms such as hotspot, lockdown, mask requirement, R-value, loosening, superspreading and home office have always been part of everyday life.

The newly learned vocabulary will not disappear for the time being. And who knows. It is in the nature of the pandemic that its course is unpredictable. Germany’s top health authority, the Robert Koch Institute, would say: very dynamic. But no matter how the crisis continues: it is clear that the first half of 2020 will go down in people’s history. Sars-CoV-2 has an enormous impact on all areas of life – and it will remain in the world for the foreseeable future.

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How did it start with Corona again?

I wouldn’t be surprised if it happened that it couldn’t be stopped.

Virologist Christian Drosten in January 2020

At the beginning of December 2019, it was reported for the first time about people who suffered from a novel lung disease called mysterious and puzzling. The pathogen was localized at a wildlife market in Wuhan, China. With regard to the gene sequence of the virus, scientists quickly established similarities to the Sars corona virus, which was already responsible for a pandemic with around 9,000 infected people worldwide in 2002.

Researchers quickly recognized the danger posed by this new pathogen. The virologist Christian Drosten from the Berlin Charité, who specializes in coronaviruses, issued a warning in January towards the editorial network Germany: “As a scientist, I assume a realistic pandemic danger. I wouldn’t be surprised if it happened that it couldn’t be stopped. ”

Christian Drosten should be right. A little later, alongside RKI boss Lothar Wieler, he became known as one of Germany’s prominent pandemic communicators in science. The virus was first detected outside of China in mid-January. It reached Europe by the end of January. In Germany, a first case became known to the Bavarian company Webasto. And in mid-February the virus finally got a name: Sars-CoV-2. The resulting disease, initially characterized by lung involvement, was given the title Covid-19.

With the rapidly increasing number of infections worldwide, the strength of the new pathogen became apparent: its speed at which it is transmitted primarily from person to person via droplets and aerosols. It is simply not a “normal” flu virus – seasonal, regional, soon to be over. That is why politicians all over the world put the brakes on under the catchphrase “Lockdown”. China has shown unprecedentedly that shutting down all public life can stop the exponential growth in case numbers – but only if everyone participates. Quarantine, exit restrictions, travel bans: The drastic measures to flatten the infection curve suddenly reduced civil rights – and also led to protests.

And six months later?

In the meantime, Sars-CoV-2 has arrived in 188 countries – and continues to spread. Containment measures have helped flatten the curve in many countries. Nevertheless: At the end of June, more than ten million people had already suffered a corona infection. More than half a million deaths from Covid-19 have been reported to health authorities around the world. It is estimated that around 5 million people are recovered. The statistics – the interactive map of Johns Hopkins University is particularly popular – should be treated with caution. There are different levels of testing in the various countries, and there are differences when it comes to recording deaths.

The UK, Italy, Spain and Russia are the worst affected countries on the European continent as of the end of June in terms of numbers and deaths. Infection is currently accelerating particularly rapidly in the USA, Brazil and India, the epidemic no longer seems to be under control there, and regional health systems are at the limit.

Is the pandemic over soon or is there a second wave?

Virologists warn against jeopardizing the success of corona virus containment in Germany – and risking a second wave of infection. © Source: GGGraphics / shutterstock

The world has learned that the virus is spreading without vaccine and medication. We are far from what is known as herd immunity. Despite the relaxation in May and June – fewer new infections due to strict measures and easing – the coronavirus pandemic is far from over. The opposite is true, according to the World Health Organization. “The pandemic is accelerating,” WHO chief Tedros Adhanom Ghebreyesus emphasized several times. The world is now in a new and dangerous phase. “Many people understandably are fed up with being at home. Countries understandably want to reopen the economy and society. But the virus is spreading fast, it’s still fatal, and most people can still get infected. ”

In Europe, the summer vacation suddenly works, pubs are open again, churches open their doors for church services. The big question: are we loosening up too hastily? “We are currently unable to predict the dynamics of the outbreak,” said Lothar Wieler, President of the Robert Koch Institute (RKI). Outbreaks have increased since June in countries where the virus was thought to be contained. For example in South Korea’s capital Seoul, in Beijing, China, Iran, in New Zealand. There are currently large local outbreaks in Germany that may indicate that the virus is on the move again. Superspreading hotspots par excellence: services, parties, blocks of flats – and always slaughterhouses. Virologists therefore suspect that the virus is transmitted particularly well in the cold, which is why they are concerned about the colder season.

What is the battle plan in the fight against Corona?

Infectiologist Matthias Stoll from Hannover Medical School summarizes the preliminary formula for an increasing risk of an outbreak as follows: “Lots of people together, for long periods, in closed rooms with little air exchange.” He therefore appeals to the reason of every individual. Anyone can now pray for the one-off of fighting viruses: avoid body contact as far as possible. Keep the golden one and a half to two meter minimum distance wherever possible. Wear a mouth and nose cover as a precaution. Wash your hands regularly. Pay attention to possible symptoms – and if in doubt, prefer to be tested using PCR. With a call in advance to the family doctor, of course.

It is also optimistic that should there be another strong infection in Germany with high demands on the health system, everyone is better prepared. General practitioners and clinics know the virus and protective measures. A mouth protection obligation and large-scale PCR test capacities apply. There is a Corona warning app. Antibody test studies are ongoing to better assess the level of infection in the population. Politicians have decided on an emergency brake: If more than 50 new infections occur within a week in a district, lockdown measures can come into force again. Large events remain prohibited for the time being.

What do we know about the virus?

This is how you can imagine it: the novel corona virus, Sars-CoV-2. © Source: Dirk Waem / BELGA / dpa

In the beginning, experts assumed that the virus usually only caused severe lung disease in older people, and that the infection was mild to unnoticed in an above-average number of cases. In the meantime, the list of risk factors for a severe course of the disease has expanded: high blood pressure, diabetes, weakened immune system, smoking, combinations of these and much more. According to current knowledge, a general definition of a risk group is not possible, says the Robert Koch Institute.

The symptoms are similar. Cough and fever are signs of corona infection. The virologist Hendrik Streeck from the University of Bonn was one of the first to draw attention to another symptom: the loss of smell and taste. Particularly tricky: Those who are infected have the highest infectivity one to two days before the onset of symptoms. How long someone has been infectious can only be estimated so far – data start five to seven days after the onset of symptoms.

It is now also clear that Covid-19 is more than just a lung disease. “Covid-19 can manifest itself in a variety of ways and not only in the lungs, but also in other organ systems,” writes the RKI. A picture of possible long-term consequences is slowly emerging. Some patients who are actually considered to be recovering complain of headaches, fever, exhaustion, shortness of breath for weeks afterwards. Experts currently believe that recovered patients have a low risk of developing Covid-19 a second time. Initial studies have shown that people develop specific antibodies after they have been infected. However, it is still unclear how robustly and permanently an immune status is built up and whether there are differences from person to person.

Are there any drugs for Covid-19 now?

Virologist and vaccine researcher Marylyn Addo from the University Medical Center Hamburg-Eppendorf is optimistic about the coming months. She believes that it will soon be possible to pharmacologically stop the virus. Several drug trials took place on their wards. The active ingredient remdesivir, which was originally developed to fight Ebola viruses and has already received special approval in the USA and Japan, is a great hope.

In one study, the preparation shortened the treatment time of the patients in the hospital by a few days. It is currently unclear whether it will also reduce mortality. The European Medicines Agency EMA has already given the green light for corona therapy in the EU. The anti-inflammatory drug dexamethasone is also hopeful. According to a study by the University of Oxford in the UK, the drug can reduce the death rate of critically ill and artificially ventilated Covid 19 patients by up to a third. The evaluation of independent experts is still pending.

When does a Corona vaccine come?

A man pipettes a blue liquid in a laboratory of the biopharmaceutical company Curevac. © Source: Sebastian Gollnow / dpa

The search for a vaccine is faster than ever. According to the World Health Organization (WHO), one or two vaccines against the coronavirus could be available by the end of the year. The development usually takes around ten to fifteen years. After only half a year there are now at least 130 research projects worldwide. The WHO identified a list (as of June 29) of seventeen more promising vaccine candidates who are already in clinical evaluation. That means they are already being tested on humans.

The absolute record for developing a vaccine was four years, according to vaccine researcher Carlos A. Guzman from the Helmholtz Institute in Braunschweig. Current plans assume that there will be sufficient vaccine doses in the second half of 2021. “This is possible without an example and only through the extraordinary international cooperation and the mobilization of enormous resources,” emphasizes the scientist. It is conceivable that no vaccine against Corona could be developed. But the first positive results and the large number of vaccine developments gave hope.

In Germany, the Mainz-based company Biontech received approval for a clinical study in April, followed in June by the Tuebingen-based company Curevac. The vaccine AZD1222 developed at the University of Oxford in the UK is the most advanced. The federal government said there would be no general vaccination requirement in Germany. “With Covid-19, however, I assume that there will be an overall high willingness to vaccinate,” predicts medical historian Karen Nolte. “There is a concrete threat to this infectious disease worldwide.”

In addition to the willingness of the population, there is also the question of how to organize that all people are vaccinated. “It would be a good logistical effort to provide a vaccine for 80 million people in Germany alone,” says the Heidelberg University researcher, recalling the approach to the Hong Kong flu in 1968. At that time, it was only doctors and nurses , Educators and certain high-risk patients have had their turns.

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