instruments and tools, applied correctly!

Vaccination, rapid tests, self-tests correctly applied and interpreted, clarity about the vaccination rate – and another look into the crystal ball for summer/fall 2021.

Started in February 2020, the SAJO blog is providing a thread through the pandemic with up-to-date information and suggestions around SARS-CoV-2.

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Dear readers,

First, a personal word by Sabine: Last night I watched a concert by Joe Cocker, in the Waldbühne, Berlin on #wirbleibenoffen. Music is mesmerizing. Joe Cocker was accompanied by excellent musicians. It made me happy, it elated me.

The concert was recorded in 1997, now a fast forward to the year 2021.

Vaccination rates in Germany are climbing, a fact we welcome. A number of questions around vaccines keep reaching us, so we want to address some of them.

Am I protected and safe from the virus after a shot?

Please DO NOT feel safe after just one single shot! What does this mean, exactly? You’ll receive a first shot. That’s good. What is happening inside my body, afterwards? The immune system takes 2-3 weeks of time to mount a defense. The vaccine protection, mediated by antibodies and T cells, is having an effect on the major variants currently circulating in Germany.

Keep in mind: Full protection is only being reached two weeks AFTER the second shot. The second shot, as well as further follow-up boosts, are necessary to keep up the protective effect. They may have to be adjusted for new variants.

Vaccine mediated protection is reaching 60 – 95 % of vaccinees, depending on the vaccine. This means, that 60 – 95 % of vaccinees are protected from severe disease, and deadly outcomes, depending on the individual and the infecting virus variant.

This also means that 5 – 40 % of vaccinees are NOT or only weakly protected.

Protection will wane with time – again depending on the individual. That means, after a certain time there will be no more full protection, depending on the vaccine.

If vaccinees may be infected again is depending on the individual and his/her behavior(!). With SARS-CoV-2 science cannot really exclude the possibility of infection. Even spread cannot be excluded. However, we may speculate that with a lower amount of virus inside the body, less virus may be spread. The same is true for people who had lived through a previous infection. With time, immune responses will decline. This is a crucial point.

Within the population, people will meet, who are a) building up protection after a first shot, b) protected, c) having a waning immune response, d) not vaccinated, and e) vaccinated but belonging to the 5 – 40 %, who are not fully protected from severe COVID-19.

The current discussion about privileges for vaccinees is ignoring the latter group.

The danger with SARS-CoV-2 is the fact, that people may be reinfected after a first bout of disease. This second one may be less severe or more severe, the game is open. Constant high infection rates are leading to the emergence of new mutations, further exacerbating this problem.

For these reasons, together with the low number of achieved vaccinations we are advising against the planned liftings of measures. Believe us, we would think otherwise if the situation and the facts were different, since personally it gets on our nerves. Especially annoying are these foolish discussions in politics and media.

Does the mRNA vaccine change our genes?

This question keeps coming up. The short answer is: NO! mRNA is a labile molecule that is being degraded within a cell after a short while. It is only providing a quick information to the cell on how to produce certain molecules. After doing its job, it is being chopped up.

To repeat yet again, the vaccine IS NOT integrating into your genome. Period.

Rapid tests – correctly interpreted, and what to do afterwards?

Often, we are being quizzed about rapid tests. It is important to correctly take the swab, and to take it BEFORE cleaning your mouth.

Should the result be negative, it means that you might possibly not be contagious that very day.

A drawback of these tests is their low sensitivity: Only around 60 – 70 % of highly infectious persons will be identified. This means, 30 – 40 % of tests are negative, although they are infectious. Thus: Please keep wearing N95 masks for your own and others’ protection, and keep a distance, even outdoors.

Self-tests are not officially accepted, since they are not accredited, and thus prone to forging. A correct use is imperative. Self-tests merely give a hint for orientation, since they only identify a fraction of contagious persons, too.

Therefore, we are advising to test in the morning, before leaving your home. Minors should do the test under supervision, either at home or at the childcare center, school, educational institution.

This is important for both kinds of tests: In case of a positive result, be aware you are highly contagious – independent of symptoms. It means you and your complete household need to quarantine at home immediately, as well as all your contacts of the previous 7-10 days.

Call your family physician to get more information and follow their instructions.

Should you, independently of any test result, have flu-like symptoms, with the current situation this is a sign of COVID-19. Don’t go to work, don’t leave the house. Contact your family physician and get a test immediately to find out.

We do not understand the high prices of rapid and self-tests, starting at € 5 per test – for an article produced at Cents. Plus, results are valid for 12 hours only. Politics needs to work against this extortion.

A more sensitive method is the PCR test, performed by specialists and laboratories. This test has a 99.9 % reliability, it detects minuscule amounts of virus, but the analysis is taking several hours.

Some exemplary companies are testing their employees via PCR twice a week.

In some businesses we know, who are testing their personnel by PCR, numbers of infection are reaching 6 % of staff. This number is far too high. The company management MUST react regarding behavior and using the option of home-office. It is simple. We are pointing to our previous blog post. An important point would be an air exchange several times per hour indoors. Wearing of N95 masks with more than one person present is a MUST.

And do not forget your contractors, delivery personnel, part time employees, who may have access to your premises, such as cleaning personnel. Each place where people meet, is a place for viral spread.

To bring up an important point once again: Negative test results are valid ONLY FOR ONE DAY, and even then, with certain limits. Older tests (more than 12 hours) are worthless.

A word to the experiment “Testing away the virus” in Tübingen, Germany: The idea was o.k. a couple of months ago, until it became clear that the low sensitivity of rapid tests rendered them useless for such an experiment.

The Tübingen model was NO success, contrary to the mayor’s boasting with his misinterpretation of the results. Again, our hint: Do not fall for influential people without proper expertise.

Tests are a measuring tool to identify infectious persons, who then should act accordingly, staying at home. Responsible behavior means: Not to leave home, NOT to go to work, NOT to use public transportation, NOT to have physical contacts. Chains of infection may be broken only if a positive test result is there early, and consequences are taken.

Protective measures and a change of behavior are a MUST for everybody. The Tübingen experiment failed because the tool of testing was used and interpreted in a wrong way. Infection numbers are paralleling the surrounding region, increasing steadily. This is no success but a politically motivated misinterpretation of results. Unfortunately, there is a lack of reflection or magnanimity.

How about the increasing vaccination rate, and when will we see an effect?

The vaccines have reached 20 % of the population once. 8 % of the people have received two shots. A good vaccine is one important tool to fight the pandemic. However, with this pandemic, this is not enough. A vaccination rate of at least 80 % is necessary, more if possible. Everyone needs full protection.

As we had described earlier, a moderate pressure, such as an incomplete vaccine protection, is exhibiting a fatal selection pressure upon the virus. Together with existing high infection rates and a lacking acceptance of the people, the virus is provided space to expand and change, with new mutants. The outcome might be bad.

A current article by our colleague John Mellors in “Science” is making this point as well. The virus has got some inconvenient characteristics that enable escape mutants. Here is the link for those of you who are interested:

For these reasons we are advising not to lift the measures in summer 2021. We would repeat the mistakes made in 2020.

Numbers of infection NEED to go down dramatically. This is the only chance to avoid the ugly face of this pandemic in the fall.

The government body “Roland-Koch-Institute” as our minister for health named it recently is publishing lower infection rates and R values. Its reporting is becoming contradictory and non-transparent. We do not know if the late reportings by too many local health authorities are being incorporated in the current calculations. A vaccination rate of 20 % with only one shot cannot have an impact on new infections.

Is there a way back to pre-pandemic level “normalcy” for vaccinated and recovered people – while a pandemic is raging?

Discussions about special treatment of vaccinees are out of place at this moment. It is too early for that. The individual level of protection by vaccines needs to be high, at 80 % for the population. New infection numbers need to be low. Even 20,000 weekly new infections would be too many. Momentarily we are counting more than 100,000 per week.

That is when it makes sense to speak about lifting measures, otherwise we shall see the true face of the pandemic in the fall – mark our words.

There is no choice: We need to apply all the means we have to fight this virus, to reduce infection numbers. This is THE WAY out of this pandemic. May we enjoy a better 2022.

An efficient control of a pandemic is not feasible with populists wanting to get reelected at all costs. In Germany, 2021 is an election year. Our politicians should not take a reelection as an affirmation, for citizens are insecure, holding onto everything for stability.

Hence our appeal to the politicians: In this pandemic you are repeating the mistakes that had been done in all previous pandemics. Merchants, today called economists, used to exert influence then as much as today. The results were fatal for the populace, costing innumerable lives. These losses are the responsibility of politicians (then all male) and merchants (until today mostly male).

Our politicians, merchants, and lawyers know all too well how to dismantle the means and tools scientists have developed over decades in long working hours and shifts. All the means need to be used in the right way. This also holds true for vaccines and vaccination strategies. Thus, now is not the time to talk about a feeling of wellness for the vaccinated who want to get back to the “old” life.

A personal word to the abuses, intimidations, up to death threats against excellent colleagues. It is a disgrace that individuals and their families have to endure this. The government has the duty to protect. This expert elite is attacked? Please, take a look back: Before WWII, Germany lost most of the best scientists it had, they left for good and emigrated to the US. Would you like to see this again? Those who may help protect the population with their expertise, which is being ignored? You can’t help it, the virus is here, you can’t test it away, or sue it, or ignore it. The ugly face will strike with a delay. You’ve got an alternative: Your best scientists, who know better, and are willing to share their know-how.

It is time for our society to modernize and keep up with the times.

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!

This is post No. 174. To our delight our blog is receiving a lot of acceptance, we love to share our know-how and experience. 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.

(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.)

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