There is a way out of this mess.
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Our recommendations are based upon scientific results and know how, exclusively.
Our politicians who are leading us through this pandemic are not to be envied momentarily. While some politicians are trying to have sham fights without any constructive ideas, thus paralyzing parliament, the virus is spreading happily. We understand our chancellor who does no longer want to go through senseless questions, stealing time. The regular discourse with the 16 governors is strenuous enough. It reminds of sandpit games. The virus is running amok while Germany is buried under a lead coating and populist politics.
In the beginning of the pandemic, it was alright to react on short notice, meaning biweekly meetings to adjust measures to new scientific and medical insights.
Over the past year however, science found out a lot about SARS-CoV-2. The governors should try and make use of the new findings for efficient and understandable protective measures, but this does not work. Instead, lobbyism is carrying the day. Implementations may be rated a D at best when it comes to vaccinations and tests. And the everchanging catalogue of measures is just disastrous. Politics is acting erratically.
(Note: We are no members of political parties, religious congregations, or societies. We value independence, sovereignty, and freedom. With our blog we are providing purely scientific advice, without conflict of interest, altruistic. We are not being paid for it.)
A long-term strategy is overdue. To check peoples’ sensitivities every other week, looking for short-term solutions for a viral onslaught, is wearing people down.
Thus, it is time now to pull the emergency break. Exponential increase is seen globally, independent of single countries with good vaccination quotas. As mentioned already, a vaccine campaign alone will not free us from this pandemic. The reasons we had discussed on several occasion.
Week 10 had a 20 % increase of new infections compared to the previous one, week 11 showed another 30 % increase, and week 12 again resulted in 25 % more infections. This is called exponential growth. Should you still have trouble with this concept, please see one of our first blogs that illustrates clearly what exponential growth means (https://www.sajo-innovation.de/blog/r0-and-the-meaning-of-logarithm-in-music/). Critical care doctors are raising the alarm, ICUs are filling up again. This time with younger patients. What more signals do our politicians need to act?
We are advising a four-week shutdown, in an early agreement with the economy, as an EMERGENCY BREAK. A country-wide, complete shutdown with curfews, to reduce infection numbers. Once low rates of infections are reached, a long-term strategy will be implemented.
The German government had envisioned a “wave-breaker” over Easter. The idea itself was a good one, but the implementation was on short notice and the five-day period was too little. To reboot this idea, the government should arrange – together with the economy – a date as early as possible at which the whole country will go into a complete shutdown for four (4 !) weeks. This would give a chance to reach a “wave-breaker”.
Why four weeks? An infected person is contagious for up to 14 days. Should this person infect another at the end of this time slot, the infection chain is extended for another 14 days. Hence, four weeks will provide extra safety, which is needed.
How will this shutdown look like?
We want to point to our recent 18-bullet-plan: https://www.sajo-innovation.de/blog/strategy-2021-to-defeat-sars-cov-2/
Furthermore, the following additional measures are necessary:
All businesses are closed, schools and universities return to online courses, public transportation will be stopped.
Just the essential businesses are allowed to open (grocery stores, pharmacies, physiotherapy etc.), as well as vaccine centers.
We hate curfews, but we are aware that too many people are ignoring basic measures, thus endangering others. Should this not change, areas of high population density might necessarily impose such curfews.
If you think these measures are undemocratic or even dictatorial, you should ask yourself, if this had not been avoidable, if everyone had just pulled themselves together last year, self-determined and democratic! In Germany, this seems impossible in a voluntary way.
It is time that reason is getting the upper hand. The shutdown will take away the hilt from the greedy, stupid, and ignorant people.
The shutdown will give the federal and state governments the time slot to finally agree upon a long-term strategy, to be implemented after the shutdown.
A long-term strategy would include a slow re-opening with a change in behavior by the people. Numbers of infection are increasing because people do not heed the measures. The four weeks at home may be used for education campaigns, dealing with the proper behavior, and the implementation of fines for violations. A violation of meaningful measures is putting too many people in danger.
Such campaigns for infection safety might be similar to the all too well-known election campaigns, giving a good feeling to vote for the one candidate. … – I am feeling fine, so I will act accordingly – …. These spots would make more sense in pandemic education than in elections. But you may well do both. After all, the current situation is putting politicians against two duties: Politics and the fight against a pandemic. This is more difficult than before in political offices.
After four weeks, re-openings may start step-by-step under strict conditions: Vaccination, tests, (analog or digital) contact tracing, two weeks quarantine, 6 feet distance, N95 masks; this is all it needs to eliminate this virus, it just needs the will to do it. Other countries have successfully done this. Sometimes, it is worth to take a look across the borders.
Until a large fraction of the population will have been vaccinated, distancing and face masks remain the best protection. Thus, in public spaces, a mandatory N95 mask is necessary, surgical masks are not enough.
In times of a highly contagious pandemic, which is changing constantly, travel is impossible. Reasonable people are staying at home. We would understand a travel ban, such as the one the UK had imposed recently. How do you explain hundreds of passengers cramped into a plane, while theaters, movies, and opera houses had to close?
Rapid tests and self-tests need to be implemented nationwide.
Tests at home make sense in the morning before oral hygiene. Even with a negative rapid test, protective measures need to be applied, since depending on the test vendor, up to 30 % of positive individuals will be missed, showing a false-negative result. Positive rapid tests are identifying highly contagious individuals. This is the only crude result such tests are providing.
With a positive test, the complete household needs to go into quarantine. A quarantine means 14 days withdrawal into your home, without any exceptions. For further assistance this should be communicated with the local health authorities and the family physician. After seven days, the quarantine may be lifted, if all members test negative by PCR. This is the only way to stop the viral spread.
It is high time that the economy is not just being supported while asking for even more, but to take responsibility and protect their employees. To demand this should be the duty of unions and workers’ councils, who boast their activity for employees’ wellbeing. However, this seems to only include the fight for fewer working hours and higher wages. We do not see any commitment regarding protective measures against infections at the workplace. Each business needs to test all employees once a day. Positive results need to be communicated to the authorities immediately. Should there be a significant number of positive tests, it is indicating that this business is lacking hygienic measures, and thus turned into a hotspot. In consequence, this business will be closed, all employees undergo quarantine, until all people involved are negative with a PCR test.
Schools: In Asia, students are sitting at a distance in the classrooms, while in Germany they are cramped together. Even in meeting rooms people are sitting closely together for meetings. It is unbelievable that after a pandemic year, people are still behaving recklessly. These are the reasons for increasing infection numbers.
A recent meta-study in “Science” gave some hints as to the main drivers of the pandemic. Researchers at the Oxford University had analyzed data from 42 countries regarding government-imposed measures and their effects upon infection numbers. Two measures are sticking out: The ban of gatherings of more than 10 people, and the closures of schools and universities had the biggest impact on the pandemic course. (https://science.sciencemag.org/content/371/6531/eabd9338)
Regarding the current openings of restaurant patios, we have to say: Since people are coming into close contact without face masks, we are critical of it. The risk is smaller outdoors, but this is dependent on several factors, such as air flow or the level of exposure to other people’s aerosols. It depends on the density of tables, the density of people at tables, as well as peoples’ behavior (speaking, shouting, spitting…), their discipline when getting up. A windy day will minimize risks. Large areas or thinly occupied terraces are preferable. We also see a problem with waiters meandering from table to table, coming too close, while wearing no N95 mask. Kitchen personnel needs to don N95 masks as well, anything else is mere sham.
The vaccine alone will not lead us out of this pandemic, as may be seen with first numbers from other countries. A change in behavior of the people is necessary, as well as the development of antiviral drugs for acute treatment. Otherwise, we will not overcome the pandemic.
The pandemic wheel keeps on turning. It is about time for the economy to show a commitment against the pandemic. This coronavirus is amassing mutations at a faster than anticipated pace. This is giving us scientists the creeps.
Remember: The race against this virus is in full swing. We are in the midst of it!
We are again pointing to our post dealing with the strategy for 2021 to defeat the virus.
Yours, Sabine and Jörg
SAJO is consulting all around infectious diseases. We are applying our know-how, that we have acquired in more than 20 years. We do what we can to fight this pandemic.
SAJO – for a healthy world and better future!
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A heartfelt thanks to Oliver Hoogvliet for the awesome cartoons, ollihoo (https://hoogvliet.de).
This is post No. 164. To our delight our blog is receiving a lot of acceptance, we love to share our know-how. Single posts and contents are being adopted by others, also in media. We have learned how to correctly make a citation; this we would wish from others in return as well. Please feel free to share the link – it is an informative tool to fight this pandemic.
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