On March 17th, the first case of the Novel Coronavirus in Europe was confirmed in Montenegro, and since then, Europe was drawn into the confrontation of the epidemic.
As of March 20th, the confirmed cases in Germany were 15,161, the accumulated discharged cases were 115 and the accumulated death one was 44.
Although the number of confirmed cases is still increasing, the mortality rate is only 0.28% that obviously lower than Italy.
Right in the epicenter, how does Germany manage to take good control?
What kind of strategies are adopted?
Medical Condition in Germany
First we need to have a clear sense of medical condition in Germany.
Technically, in Europe, Germany has the highest hospital bed density. Within the 497,000 ordinary beds, there are 28,000 intensive care beds and 25,000 of them are equipped with ventilators.
At the same time, with the increasing severity of epidemic around the world, Germany has already ordered 10,000 ventilators from Chinese suppliers. The German Hospital Association (DKG) appeals to over 1,200 hospitals to make room for the patient in need of a ventilator. Simultaneously, the database has been established so as to conveniently make queries to available intensive care beds.
By the data published by Critical Care Medical in 2012, the number of critical care beds per 100,000 citizens in Italy is 12.5 while Germany is 29.2.
What kind of strategies are adopted by Germany?
Currently, the strategy adopted by Germany is “Withdraw in Three Steps”.
On February 12th, the Robert Koch Institute announced the plan in the 7th Epidemiologische Bulletin, in which the first step is “Containing”; Then, if the patient without an identified source of infection was confirmed, accordingly, it would be recognized as the sign of rampant epidemic and need to take action to protect the high-risk population as far as possible, namely “Protection”; At last, if the situation is still losing control and the medical system could not protect all the high-risk population, then the action should be moved backward to the third step that makes every effort to ensure the medical system and the social order systematically, i.e., “mitigation”.
Containing
Initially, there were no more than twenty confirmed cases in Bayern, and the Bavarian State Ministry of Health and Care led them to receive treatment in isolation as well as traced all the close contacts. Finally, they managed to stop the spread of infection.
Apparently, the prevention and control took by China and Germany share a couple of similarities.
Till the end of February, influenced by the outbreak of the novel Coronavirus in Italy and the widespread of the epidemic in communities causing by the carnival in Nordrhein-Westfalen, the whole Germany was hit by this epidemic. Hence, Germany is not capable of tracing back the origin of the epidemic under the circumstance of the outbreak of infected cases and the close contacts grow geometrically.
So far, the government has already admitted the fact of losing control of the epidemic. Then, Germany moves backward to the second step “Protect the high-risk population”.
The treatment is paying more attention to critical patients. Most of the asymptomatic patient or with mild symptom was told to receive treatment at home, the medical resource in the clinic and hospital was allocated to the critical one. Meanwhile, the citizens over 60 years old are suggested to inoculate the pneumococcal vaccine.
Process of multi-level diagnosis and treat. No matter you meet the criteria of the suspected case or in the risk of infection of doubt, you would not be allowed to go straight to the clinic and hospital without a call to the local health center or accept the medical inquiry by the family doctor and keep waiting at home. Under the criteria of diagnosis and treatment as well as the personal condition, the medical personnel will determine the subsequent execution of medical detection or just still home isolation. And it is the same with people in an emergency, without notification to the emergency center by phone, no one would be allowed to go to the hospital directly.
Due to this strategy, Germany ensure the maximum treatment for the critical patient with effective rescue capability, the mortality rate is under great control.
With the continuously increasing confirmed cases in Germany, Chancellor of Germany, Angela Merkel announced that the final infection rate may reach to 60%-70% and Germany should be prepared for the situation of infected pandemics.
Obviously, Germany has quite a clear sense of the possibility of losing control and the medical system could not protect all the high-risk populations. Therefore, the action should be moved backward to the third step, “mitigation”, sparing no effort to assure the medical system and the social order regularly. For keeping the medical system in good condition, it is significant to avoid the crash of the simultaneously outbreak of patients causing by the seasonal flu and the novel Coronavirus.
Once all the patients went into the hospital, not only did they would be infected by each other and also the dislocation of medical resources which may lead a situation of no treatment for the intensive patient, and, a rocket-like rise of the mortality rate.
Actually, the strategic adjustment of confronting the epidemic is highly related to a most influential virologist, Prof. Dr. Christian Drosten.
Born 1972 in Lingen, Christian Drosten was one the co-discoverers of the SARS (Severe Acute Respiratory Syndrome) virus in 2003, which brought him into immense fame at the age of 31. He was awarded the Federal Cross of Merit in 2005. From 2007, Drosten headed the Institute of Virology at University Hospital Bonn and in 2017, he accepted a call to the Charité in Berlin, where he heads the Institute of Virology. The world’s first diagnostic test for the coronavirus has now been made publicly available right by Christian Drosten.
Being the Germany’s corona-explainer-in-chief. Since he came to national prominence as an expert on the implications and actions required to combat the outbreak in Germany, the media praised him as the right-hand man for helping Angela Merkel.
After the outbreak of epidemic, Christian Drosten developed his statement in media and helped the Federal Ministry of Health to make decisions and participated in the press conference.
Christian Drosten, in a television interview, once told in the initial stage of the epidemic in Germany,
“We should not pay any attention to try to fully contain the spread of the epidemic, (Literally he means it is kind of unpractical to stop the spread of such epidemic disease in the late stage) or figure out the stock of masks and the available bedss. The genuine point is that how to put off the outbreak of epidemic as far as possible by trying to live with the novel coronavirus in some way on a large scale. It would be so much better to slow down the speed of spread to this summer, and it is not supposed to mean that in summer the virus would not be in existence, but is the stress from hospitals would be relieved by the decreasing number of patient with flu.”
His statement sets the tone for strategies of confronting the novel coronavirus in Germany.
As a virologist, the unique status he owned makes his statement convincible and powerful.
And the people in Germany was comforted by him to a great extent. With his help, the government has gained supportive scientific support and the people still have their confidence and faith to conquer this epidemic.
