COVID-19: a view from Germany

A contribution by Bert Tjeenk Willink, MD 

I am a Dutch physician, living near Frankfurt, Germany, with a German ex-wife living in Milano, Italy. She has four children from an earlier marriage. I have been diagnosed with Morbus Waldenström some years ago, so I guess my immune system could be in a better shape. Some two weeks ago, when Germany was large free of Covid 19 and Milano was hitting a stage of panic, I advised my ex to pack up the children and leave for Munich, where her family lives. The idea wasn’t to prevent infection but to do something to slow down the spreading of it. Moreover, at that moment towns in northern Italy were being locked down in Milano the supermarkets were empty because of hamstring and two trains from Italy were stopped at the Italian border. They followed my advice. Meanwhile, the situation of course has not returned to normal, but the atmosphere of blatant panic seems to have subsided a bit and they have returned. For my part, I go about my business more or less as normal, though we have canceled a meeting I had to attend in Singapore.

In Germany, the authorities I think are following a rational approach. People are being advised to take certain preventive measures like hand washing and disinfection. Many people avoid physical contact (e.g. hand shaking and kissing) and a number of large events (congresses, shows and sports events) have been canceled or postponed. Infected people, proven and/or suspected, are being quarantined. This, on a voluntary basis, even applied to a village where there had been a large carnival party after which a number of people were proven to be infected. Meanwhile, most of the inhabitants have been ‘released’ from quarantine. There is little mastering ongoing, though products like hand disinfectants are in short supply. I do not sense panic in Germany. If anything, I think people might take it too lightly.

As mentioned before, the idea is not so much to prevent the epidemic, but to reduce the speed (and maybe the peak) of penetration. Meanwhile, there is some evidence from studies and experts that preventing is a lost cause. Somewhat reliable data regarding R0 and other parameters regarding the infectiousness, mortality rate etc. are appearing. This epidemic is serious. Over and above the sickness and potential mortality, our entire healthcare system is at risk. If we are not able to slow it down, our system will just not be able to cope with the epidemic. The authorities are doing their best to prepare the system. Nevertheless, there is a shortage of tests and if we would have an unbridled explosion of infections, options for hospitalization, quarantine, and sufficient trained medical staff would truly become a major issue. Any actions to slow down the spread are highly appropriate.

Ultimately, I believe that our economy is at an even higher risk. This meanwhile is a widely shared opinion. Not so much as a result of the huge drop in stock values around the world, but to a large extent based on the exposure of supply lines. From the pharmaceutical industry to car makers and everything in between, we have made ourselves increasingly dependent on product supply from China. Obviously not a pretty situation given the current situation there. So the impact will be much more widespread than by affecting our healthcare system. Truly worrisome indeed.

People need to take it seriously. Slowing down the spreading is critical. Though research efforts are ongoing, the chances of timely finding a truly effective therapy, let alone a vaccine, are very limited indeed. So this is real life it is there. No reason to panic, but do take it seriously.

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