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Refugee center in the Cologne exhibition center
Photo:
Christoph Hardt / Future Image / IMAGO
SPIEGEL:
Mr. Rau, as in other major German cities, several thousand refugees from the Ukraine have arrived in Cologne so far, and they are all undergoing an initial health check.
At the same time, the number of corona infections is at its highest.
How do your people in the health department do that?
Harald Rau:
The tasks are growing enormously at the moment, there is no room left anywhere.
We are currently trying to prepare for the Ukraine refugees as quickly as possible and to ensure supplies.
At the same time, the health department is still dealing with the corona cases.
This is shortage management.
SPIEGEL:
Let's start with the refugees: To what extent do they need medical care?
Rau:
All Ukrainians who report to our arrival center at the main train station must first take a corona test.
Those who are positive will be taken to extra accommodation that is appropriately equipped for Covid-19 cases.
So far we have seen that the number of corona cases among those arriving is roughly the same as it is currently in the general population, with around one percent of those arriving having a positive test.
Those who tested negative are taken to emergency accommodation in a prepared exhibition hall.
People are usually there for two to three days and can visit our local doctors if necessary.
SPIEGEL:
Do you also get psychological help there?
Rau:
So far, the system has been geared towards very basic needs.
I have to admit that we still don't have an overview of which of them needs psychological support.
SPIEGEL:
And how many refugees seek medical advice for other reasons?
Rau:
We see that around ten percent seek medical treatment, that is around 20 to 30 people a day.
SPIEGEL:
That sounds like it can be managed.
Rau:
That's it at the moment.
Still.
Almost 5,000 people have arrived in Cologne so far, with around 300 refugees arriving every day.
There will probably be more.
The situation is unpredictable for us because the distribution is not controlled.
Due to the freedom to travel, anyone who wants to can come to Cologne.
We don't know what to expect.
SPIEGEL:
There are concerns that dangerous pathogens or diseases such as tuberculosis could be imported from Ukraine.
Have you already observed this?
Rau:
So far we have not had any cases.
But we have to reckon with it and prepare for it.
In the shelters, people will be tested for tuberculosis in the future.
SPIEGEL:
The vaccination rate in Ukraine is just around 50 percent.
Are you afraid that there could be corona outbreaks in the refugee accommodation?
Rau:
We can't observe it yet, but it's possible.
So that we can prevent such scenarios, we also offer vaccinations to the refugees.
On the other hand, the recovery rate among them is probably quite high.
SPIEGEL:
Apparently, Ukrainians are not very willing to be vaccinated.
How do you intend to change that?
Rau:
Many volunteers accompany people from Ukraine, including some who speak Ukrainian and also promote vaccination.
The vaccination will also take place in a mobile medical practice set up in a regular bus service.
There is a system for video interpreters.
SPIEGEL:
Until recently, the corona crisis was your main task.
Now the pandemic is taking a back seat due to the war.
Where previously there was allegedly no more capacity, some is suddenly being created again, how is that possible?
Rau:
The disease burden of the currently dominant virus variants is lower, but the pandemic is still not over.
As with the pandemic, we are again able to cope with the additional tasks caused by the flight by temporarily hiring many people.
During the pandemic, we hired over 2,000 people, and that might happen again now.
SPIEGEL:
Nevertheless, up to 300,000 new infections every day in Germany also mean 300,000 PCR tests, 300,000 calls from health authorities and 300,000 reports to the RKI.
This is also a heavy burden for the healthcare system.
Rau:
This procedure no longer makes sense at the current time of the pandemic.
In the beginning we had to find as many infected people as possible and their contact persons and isolate them as quickly as possible in order to contain the spread.
This strategy has now changed, now the protection of risk groups is important.
We can no longer maintain this careful collection of the number of cases and also the contacting of all infected people and their contact persons, and this is no longer necessary in the current phase of the pandemic.
SPIEGEL:
Do you think there will be no more PCR tests in the future?
Rau:
The PCR tests will still be important for certain people, but we no longer have to PCR test every single infected person.
SPIEGEL:
But experts are already warning of a high number of unreported cases.
Rau:
There certainly are, but that's no longer relevant.
The exact number of cases has long ceased to be a relevant indicator in the pandemic.
We are now looking primarily at the hospitalization rate and mortality, and at these very closely, to decide when more intensive measures are necessary again.
We have to think about whether this comprehensive testing is still worth what it costs.
We are currently paying for expensive PCR tests in order to obtain figures that no longer influence political action and are no longer a basis for individual decisions;
we also get this from the rapid tests.
SPIEGEL:
The omicron wave is rushing through the population almost unchecked.
Is it now the new normal that we all get infected with Corona every now and then?
Rough:
This mood, that the pandemic is now felt to be over and is turning into an endemic, also worries me.
You can see on the street how many are now suddenly dropping the protective measures.
Distance is no longer maintained, masks are no longer worn.
We are also not able to get the vaccination rate up any further.
People have accepted that they get infected and they don't care.
But if many people are infected at the same time, there is another danger besides the disease: the more infections there are, the higher the risk that new mutants will form again.
It is not realistic to stick with a variant like Omicron, which has a low disease burden.
We have to be prepared for another variant that leads to more difficult developments.