Germany is back in crisis mode.
The country is trying to stop a new coronavirus outbreak from turning into a full-blown second wave of infections, after hundreds of people working at a meat processing plant in the western state of North-Rhine Westphalia became ill. It’s a serious situation, but the German government isn’t rushing to reintroduce the kind of strict nationwide lockdown measures it used to fight the virus earlier this year.
Instead, public health officials are hoping they will be able to contain the outbreak by introducing more nuanced local measures and going all in on testing and contact tracing. Their approach echoes similar tales from elsewhere.
Beijing introduced a partial lockdown last week when the first new outbreak emerged in the Chinese capital after 55 days free of new locally transmitted cases. In South Korea, local restrictions were reintroduced after a cluster of coronavirus cases emerged in Seoul’s nightlife district last month.
It’s a glimpse at what the new normal might look like – a perpetual game of whack-a-mole in which authorities race to contain the virus as it pops up in new places.
“In the absence of a vaccine, the best scenario that we can hope for is that there’s a very low level of virus spread in the general population, and that if there are local hotspots and outbreaks, that the local health authorities can work fast enough to contain it and prevent the spread,” said Dr. Thomas Kamradt, an immunologist and professor at the University Hospital at Friedrich-Schiller University in Jena, Germany.
The all-important R number?
The outbreak at the Toennies meat plant in Guetersloh sparked fear in Germany partly because it pushed the country’s reproduction rate way up. The obscure epidemiological concept became a household term, with front pages across Europe reporting “A huge spike in Germany’s R.”According to Germany’s center for disease control, the Robert Koch Institute, the rate now stands at 2.76, which means that one infected person is, on average, currently passing the virus on to 2.76 other people. Over the weekend, it went as high as 2.88.
The high reproduction number shows how easily the virus spreads when left unchecked. When it falls below 1, the epidemic is fading. When it’s higher than 1, it is spreading. If the rate stays above 1 for a long period of time, there could come a point when there are more sick people than hospitals can handle. That means some patients will end up missing out on the critical care they need – for example because there aren’t enough ventilators – and the overall death toll is therefore much higher.
Chancellor Angela Merkel has repeatedly stressed that in order to defeat the virus, the number – known widely as R0 or just R – must stay below 1. She suggested that new restrictions might need to be put in place if the rate goes up.
But while the R number is important, it doesn’t paint a complete picture. The rate in Germany jumped suddenly because 1,553 workers at the Toennies factory tested positive for the virus, even as the rest of the country saw very few new infections.
“R must always be seen in context,” said Marieke Degen, the deputy press officer at the Robert Koch Institute. “If you have low infection numbers in total – in Germany [it’s] some hundreds per day – and some larger outbreaks, R can rise quite quickly, but this is not that problematic,” she said. “It would be far worse if you’d have 50,000 daily cases and an estimated R of around 2-3.”
While the outbreak in the factory has been severe, authorities hope the virus has not been able to spread further. North-Rhine Westphalia’s Prime Minister Armin Laschet said Tuesday that so far, only 24 people without links to the factory had tested positive in the district. “The question is, how many people have met with those who have been infected?” Laschet said at a news conference.
Detective work
Experts are now working against the clock to figure that out. The district has already tested everyone connected to the factory, and sent out 100 mobile testing teams to contact as many people as possible. A special diagnostic center has been opened in the district to make sure anyone can get a free test. Dozens of soldiers, police officers, scientists from the Robert Koch Institute and members of the Red Cross have been deployed to help.
Clemens Toennies, a managing partner at the company, said on Twitter that the company would fund widespread coronavirus testing in Guetersloh to compensate the local community.
Speed is paramount. “You’re always behind the epidemic to some extent,” said Mike Tildesley, an associate professor at Warwick University. “We know people can be infected for several days before symptoms emerge … by the time you get to the stage you realize there’s a problem, there’s already a lot more [cases] in the population.”
Despite the mammoth effort, epidemiologists are cautious to say the epidemic is under control. “Twenty-four seems like a low number, but it’s a sign that the outbreak isn’t completely restricted to the workers and their families … there was enough time for it to spread outside,” said Dr. Martin Stuermer, a virologist and the director of IMD Labor, a coronavirus testing lab in Frankfurt.
The Toennies plant was shut down last week, with all of its 7,000 employees and their families ordered to quarantine themselves, but the wider lockdown of the district and its 360,000 inhabitants wasn’t announced until Tuesday.
Stuermer worries that that may have been too late. The rule of thumb Germany put in place when it started easing the restrictions last month was that if an area recorded more than 50 new cases per 100,000 inhabitants in any seven days, it should consider going into lockdown.
“From that point of view, it was done too late,” he said, adding that previous serious outbreaks at meat packing plants in Germany and elsewhere should have been a warning sign. “One should have been alarmed … Toennies started testing, they identified more and more cases, they identified infection herds and they put some kind of measures to stop the spread, but altogether, they failed to control the outbreak,” he said.
Tildesley said that compared to earlier in the pandemic, countries like Germany and the United Kingdom are now better equipped to stop local outbreaks from spreading further because they have managed to scale up contact tracing and testing.
But both Stuermer and Kamradt said that in order to succeed, every part of the system must work well: The health authorities must be able to step in quickly, people must respect the lockdowns and companies must behave responsibly.
Toennies, the firm that runs the factory at the center of the outbreak, has found itself under pressure. Clemens Toennies has apologized for the outbreak and said the company carried full responsibility, but the criticism hasn’t stopped.
CNN has repeatedly reached out to Toennies for comment.
“The cooperation from the factory was not very good, the authorities had to walk in there to get the data on the employees to be able to track them and to talk to them … it could have been done faster,” Kamradt said. Local officials including Laschet have even suggested Toennies should be held responsible for the outbreak.
Toennies said in a statement that it was “working around the clock” to help the authorities. Responding to the criticism from local authorities who said the company failed to provide addresses of the employees, Toennies said it had not been negligent and had not withheld any data. It blamed Germany’s data protection laws.“We were in an extreme situation and had to consider the privacy and data protection of several thousand people. Ultimately, we weighted the consequences and made the data available.” But the federal labor minister Hubertus Heil told German tabloid Bild that he had “pretty much zero” trust in Toennies.
Many of those infected are migrant workers from Romania, Bulgaria and Poland who are working in cramped conditions and on precarious contracts, for low pay. German health authorities are now desperately trying to reach this previously invisible community – the district is hiring 150 translators to help.
CNN’s Stephanie Halasz, Hanna Ziady and Zamira Rahim in London and Frederik Pleitgen in Berlin contributed reporting.
