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Regular exchange: Karl Lauterbach and Angela Merkel
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CLEMENS BILAN / EPA-EFE / Shutterstock
Is Germany facing a third wave of corona infections?
Karl Lauterbach is convinced of it.
The SPD health politician has now developed a strategy that should simultaneously reduce the number of infections and enable opening steps.
That is exactly the dilemma that the federal and state governments will face at the Prime Minister's Conference on Wednesday.
"It is very clear that the exponential growth, especially of the mutation B.1.1.7, proceeds as in the textbook," Lauterbach told SPIEGEL.
An extension of the current shutdown alone would therefore be of little use.
"That would mean that we wait like the rabbit in front of the queue until we have significantly higher numbers of cases."
In addition, movement data showed that the population is less and less adhering to the shutdown rules.
"We would only reproduce the mistake from summer and wait until the third wave arrives," warns the SPD politician.
His proposal rests on two pillars: a modified vaccination strategy and a systematic use of rapid tests to enable store openings.
In order to be able to vaccinate more people faster, Lauterbach calls for the second dose to be given only at the end of the permitted range.
So far, the federal states are holding back half of the vaccination doses in order to guarantee a second injection to all vaccinated people.
Together with the researchers Dirk Brockmann (Humboldt University in Berlin), Michael Meyer-Hermann (Helmholtz Center for Infection Research) and Benjamin Maier (University of Erfurt), Lauterbach carried out a simulation calculation for Germany, the result is available to SPIEGEL.
"You can see that this strategy in the third wave - depending on the scenario - would save between 8,000 and 14,000 lives," says Lauterbach.
The researchers argue that the mRNA vaccines from Biontech / Pfizer and Moderna in particular provide good protection against severe and fatal courses around two weeks after the first vaccination.
Given the current shortage of vaccines, more people could be at least partially immunized in a short time if half of the doses were not withheld.
The Standing Vaccination Commission of the Robert Koch Institute (Stiko) is currently still warning that it is uncertain whether postponing »actually prevents more serious illnesses and deaths than a timely second vaccination of high-risk groups, which then leads to almost complete protection against illness leads".
Lauterbach and his colleagues are proving to the contrary with their study, which is to be published on Monday night.
Using stochastic modeling, they calculated how extending the period between the first and second vaccination dose in the first half of 2021 could affect the number of lives saved if the number of cases increased again significantly.
Vaccination protection could suffer a little - but lives would be saved
Six weeks are the maximum period that the manufacturers consider reasonable based on their data.
According to the modeling, such an extension could prevent deaths in the four-digit to low five-digit range.
If you wait a total of twelve weeks with the second dose, which goes well beyond the recommendations of Stiko and the manufacturers, even more deaths could be avoided, according to the study.
Although the authors assume that the vaccination protection after a delayed second dose may be less than if the recommended period is adhered to - it is still so good that many deaths and severe courses could be prevented.
Britain has now given almost 20 million people an initial dose of vaccine using such a strategy, the BBC reports.
The second dose was only given to around 760,000 people.
Lauterbach also renews its appeal to use the AstraZeneca vaccine in people over 65 years of age.
This is "urgently required".
Stiko has not yet recommended this, but recently stated that it would reconsider the requirement.
There seem to be reservations against the vector-based preparation in the younger population groups, with hundreds of thousands of doses recently remaining unused in the camps.
Studies have confirmed that the vaccine is highly effective after initially diffuse data.
The heads of government of Bavaria, Baden-Württemberg and Saxony rushed forward this weekend with the idea of releasing the AstraZeneca vaccine for everyone.
Lauterbach says that such a "quick shot" is "absurd".
From a statistical point of view, an 80-year-old would have a six hundred to a thousand times higher risk of death from Covid-19 than a 30-year-old, the health expert calculates.
Lauterbach believes that there are no reservations among the over 65s: "They are simply happy to be vaccinated." Nothing would be left behind if the invitations were made.
"Younger people in particular are hesitant because they believe they have a very low risk."
But it will be months before the vaccinations can effectively contain the spread of the virus.
Lauterbach therefore proposes a test program "in which we try to kill two birds with one stone".
On the one hand, people have to be encouraged to do systematic testing, and on the other hand, the desire to cautiously relax the shutdown must be taken up.
The SPD politician's idea: At schools and in companies, everyone should take a quick test at least once a week, with the help of trained staff.
Anyone with a negative result should then be allowed to go into stores for a day with the proof.
This would allow the shops to open in a timely manner, of course still requiring a mask - but at the same time preventing infections, says Lauterbach.
"Should the cook or the saleswoman do that?"
Anyone who does not go to school or work should be able to get a corresponding certificate from test centers.
Lauterbach, however, rejects rapid tests directly in front of shops or restaurants.
This is completely absurd: “Who should carry out and check these tests?
Who should monitor the implementation, should the cook or the saleswoman do it? «Self-tests, on the other hand, are too imprecise and may lead to the health authorities being circumvented, warns Lauterbach.
"It can happen that people do not go into quarantine despite a positive self-test result."
Instead, as part of its strategy, only rapid tests checked by the Paul Ehrlich Institute should be used.
If the result is positive, a PCR test and a report to the health department follow.
"So we would combine two things: It would be possible to open shops," says Lauterbach.
In addition, according to calculations by Harvard epidemiologist Michael Mina, this test strategy can significantly reduce the R value: "With one test a week by around 40 percent, with two tests a week even by over 55 percent."
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