Interview Bonn According to Bonn virology professor Hendrick Streeck, a curfew alone does little good. On the contrary, he agrees with aerosol researchers that the risk of infection is much greater indoors. Hendrik Streek spoke to GA’s Andreas Baumann and Lisa Inhoffen.
The federal government wants to introduce a nationwide lockdown with a night-time curfew – will this stem the third wave?
Hendrik Streeck: Curfews are probably not enough to reduce infection rates. According to calculations by Professor Kai Nagel from the Technical University Berlin, a curfew between 10 p.m. and 5 a.m. could generate around a 7.5 per cent reduction in mobility. However, this is not the same as reducing the occurrence of infection. Of course, if people have fewer opportunities to meet, this reduces the likelihood of infection. However, I am concerned when I read the reports about the occurrence of infections in socially weaker regions. Where many people live in close confines, for example in high-rise buildings, residents will increasingly congregate inside the buildings during curfews. We need to create spaces for them where they can meet more safely than in their homes.
What should that look like?
Streeck: This can be envisaged in many areas. The aerosol researchers have indeed made an important push with their open letter to Chancellor Merkel, pointing out the paradox that the measures to reduce us to the private sphere are the opposite of what they recommend, namely allowing people to meet again outside at a distance and in compliance with corona regulations. This is probably much more effective in reducing the occurrence of infection than when we have to remain indoors together.
What consequences must policy-makers draw from the realisation that the socially disadvantaged are particularly affected by corona?
Streeck: Our society does too little to improve the situation for socially vulnerable people. They are not only more susceptible to infection, but also to a more serious course of illness due to more frequently undetected and untreated pre-existing conditions such as diabetes or heart disease. If we are saying that the majority of infections occur in the private sphere, we must finally start to differentiate. This means if we find that the occurrence of infection is particularly high in neighbourhoods with a high proportion of socially disadvantaged people, we have to take targeted countermeasures there. But that does not mean confining people even more. Many families in such neighbourhoods live in very confined spaces.
What pandemic containment measures do you think make sense?
Streeck: We did something very sensible at the beginning of the pandemic - we cancelled major events. These were the big pandemic drivers. So I consider the AHA rule and ventilation to be useful. I also think it makes sense to install filter systems in closed rooms where people have to be there for longer periods of time. In principle, it is true that fewer contacts equal fewer infections. But I cannot fully answer that question for you because we haven’t learned to understand which type of contact leads to more infections so we can’t differentiate yet. Therefore, we are always left with the hammer method and I find it regrettable that we have not learned and do not want to learn to be more precise.
First the schools in NRW were supposed to reopen on Monday and switch to alternating classes, but now they are staying closed. How do you rate this?
Streeck: The issue of schools must also be seen in a more differentiated way. The question is always asked whether children are drivers or not drivers of the pandemic. We know that they contribute less to the infectious process up to a certain age. On the other hand, however, children can become infected and pass on the virus. That’s why I say, if there is a very high occurrence of infection, schools must also remain closed. With a low rate of infection, the situation is different.
In simple words: With the current rising, high incidence rate, do you advocate closing schools?
Streeck: I cannot give you that answer. Because here, too, one has to differentiate - which schools are involved, which school years are affected, and how is the occurrence of infection developing in this area?
Some explain the rising incidence rate mainly by the increased number of rapid tests. Do you too?
Streeck: It is logical that the introduction of rapid tests has had an effect. The week they were introduced, there was an unnatural jump. But there are many other reasons for the rise in the incidence rate. Otherwise we would not have an increased number of corona patients in intensive care. Fortunately, nationwide, we have no longer had such sharply rising numbers in the last few days.
But the university hospital in Cologne has now warned that they are on the verge of triage. Other doctors are obviously more sceptical about the situation than you...
Streeck: I am talking about the situation in the whole of Germany. And it is correct that the situation in Cologne can look very different from that in Schleswig-Holstein, for example.
Nevertheless, intensive care beds are in short supply in Germany. How concerned are you?
Streeck: Of course, we have to take every warning from the intensive care workers seriously. However, I wonder if we don't have a structural problem, even though our health system is one of the best in the world. This was already the problem last year - it is not so much about the capacity of the beds per se, but about qualified staff, who are simply lacking in too many places. However, we have been aware of this shortage for years and thus well before the outbreak of the pandemic. This is where we finally have to act. In 2020 I already proposed setting up a stress test - i.e. a computer simulation - in order to use models to understand more quickly when and, above all, why we reach capacity limits more quickly in some regions. The federal government must now finally address this problem instead of just noting it and making warnings about it.
The British variant of the virus has also become more prevalent in Bonn. Is this the reason why more younger patients are now requiring treatment?
Streeck: It is firstly important to note that the new variant is more contagious on the same scale for all age groups. There are several reasons why younger people are more likely to be infected, but it is not variant-specific.
The South African variant has also arrived in Bonn. How dangerous do you think this variant is, and why does the virus mutate so much in the first place?
Streeck: The problem at the moment is that we have an enormous number of infections worldwide. So the global viral load is high. The more viruses there are, the more likely mutations are to occur. To put it simply: The virus selects in order for it to be transmitted more easily and to remain for longer in humans. One hypothesis is that at some point, the virus reaches an optimum and this then remains constant. Concerning the South African variant - all the measures we have taken so far also work well against this variant. Of course, a vaccine may eventually become less effective. But I do not think that it will fail completely.
Is Frau Merkel’s statement correct that the virus mutations are more deadly than the original virus?
Streeck: This is a good example of the process that science is constantly going through. There have been three scientific publications on this so far. The first one said the mutations were more deadly. The latest publication now available says the opposite. We now assume that the mutations are not more deadly. Three weeks ago, we saw it differently.
Do you think the pandemic will be over when enough people have been vaccinated?
Streeck: The virus will not be eradicated worldwide. Rather the question must be whether we will then still have a pandemic situation on a national scale. That, I believe, will no longer be the case. With more people vaccinated and through the summer we will hopefully see a decrease in the number of cases. Then the lockdown measures should also be gradually lifted.
Will the vaccine be the same as for the flu, in that it has to be constantly adjusted?
Streeck: The emergence of influenza variants is not comparable to SARS-CoV2. Here, entire gene segments can be taken over indiscriminately from other influenza viruses. This is not the case with coronavirus. How often we need to be vaccinated depends not least on how long the protection from the vaccine lasts.
You published a book which was made into a documentary by the ZDF broadcaster and there was supposed to be a weekly podcast, which you stopped after a short time. You invest a lot of time in your media presence - does your scientific work suffer as a result?
Streeck: In 2020, I was able to publish more scientific papers than ever before - this year, there will probably be even more. I had fantastic support with ‘Hotspot’ due to the collaboration of Margret Trebbe-Plath and the Piper publishing house, but it is also true that I gave up my free time. We do an extremely large amount of research at the university hospital in Bonn and have already published four papers this year and have a significant number in the pipeline. For example, we looked at the circumstances under which the virus can get into the blood from the lungs. And we have seen that this only happens with very seriously ill people who are in intensive care. In the majority of people, and we have examined many, we could not find the virus in the blood. These are findings of considerable relevance for blood transfusion because people who donate blood would otherwise have to be tested for corona.
You are accused of often being wrong with your forecasts. What is your position on this criticism?
Streeck: I have no problem with criticism, and if things have developed differently than predicted, then I do not need any reproaches to see it that way. What is not at all necessary, however, are allusions, accusations and insinuations that pursue a specific purpose beyond what is actually at stake. There are not many, but particularly loud and overly aggressive journalists who present themselves as accusers and judges in equal measure, because they only consider a certain attitude to be good. In recent months, it has been increasingly lost by some people that it is part of science to give different approaches, opinions and recommendations without going for each other’s throats or vilifying each other.
(Original text: Andreas Baumann & Lisa Inhoffen, Translation: Caroline Kusch)