Intended for healthcare professionals


Covid-19: Germany’s doctors call for clear rules to “break chains of infection” as cases soar

BMJ 2021; 375 doi: (Published 12 November 2021) Cite this as: BMJ 2021;375:n2783
  1. Ned Stafford
  1. Hamburg

Politicians and doctors in Germany have called for urgent action to control the spread of covid-19 after a record number of cases were reported on 11 November.

Germany had 50 196 new confirmed covid cases on 11 November,1 up from 39 676 cases on 10 November and 9658 on 1 November, showed figures from the Robert Koch Institute, the federal agency responsible for disease control and prevention.2 A total of 235 covid related deaths were reported on 11 November, up from 23 on 1 November.

Speaking in the Bundestag, Germany’s lower house of parliament, the federal vice chancellor, Olaf Scholz, said that immediate steps must be taken to “winterproof” Germany against what is being described as the nation’s fourth wave of covid-19. Scholz, who is likely to become chancellor when Angela Merkel steps down, announced that the federal government will meet next week with the prime ministers of Germany’s 16 states to discuss new measures to fight the pandemic.

“The virus is still with us and threatens the health of citizens,” Scholz said, adding that efforts must be intensified to convince unvaccinated Germans to become fully vaccinated and encourage those already vaccinated to have the booster shot.

Everything must be done, he said, to ensure “that millions of citizens get a booster—that is the task of the next weeks and months.”

Some 67.3% of all Germans are now fully vaccinated, according to the German health ministry.3

Germany’s 16 states currently have two legal options to try to slow the spread of covid. One is the so-called 3G requirement, with each G standing for the starting letter of the German words for vaccinated, recovered, and tested (geimpft, genesen, getestet). Under the 3G requirement, restaurants, bars, and other non-essential public places, such as hairdressers, cinemas, and fitness studios, can deny entry to anyone who cannot show proof of having been vaccinated, to have recovered from covid, or to have recently tested negative for covid-19. Under the stricter 2G restrictions access is allowed only to people who have been vaccinated or who have recovered.

Scholz said he supported implementing the 3G restrictions across workplaces in Germany and 2G restrictions for non-essential public places. Some areas in Germany have already approved 2G restrictions, including Bavaria, Saxony, and Berlin.

Klaus Reinhardt, president of the German Medical Association, gave interviews to several newspapers earlier this week calling on politicians across the country to take prompt action to control covid-19. “We now need clear rules to break the chains of infection,” he said.

Reinhardt said that he supported 2G restrictions across Germany for non-essential public places and 3G restrictions for workplaces. He said that lockdowns for people who had not been vaccinated might be necessary. “After all, it is currently mainly the unvaccinated people with severe covid conditions who have to be treated in hospitals,” Reinhardt said.4

On 11 November 2739 patients with covid-19 were in intensive care units across Germany, up 52 from the day before, reported the Robert Koch Institute. Covid patients occupied 12.3% of ICU beds.

Christian Drosten, head of the Institute of Virology at the Charité hospital in Berlin, said that Germany was already in an “emergency situation” and that he expected a very difficult winter that would include a new round of “shutdown measures.”

“We must do something immediately,” he said, adding that more people need to be fully vaccinated. “We must close the vaccination gaps.”5

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