On March 3rd, the federal government and state leaders will meet for the next time to decide on the corona rules. This time on the agenda is also the resolution of a plan under which conditions easing in the federal states and counties could be possible – and what should be done if the number of cases increases again.
The orientation and decision is a political one, but science also provides approaches for the discussion. Or scientists – because there is no clear strategy recommendation from all researchers from all disciplines.
The results of a regularly conducted “Cosmo” survey led by Erfurt psychology professor Cornelia Betsch shows that trust in the federal government has declined in recent weeks. In February, 36 percent of 819 respondents said they still trust the federal government, in December it was 48 percent.
The current lockdown measures are rejected more strongly in February with 31 percent than at the end of 2020 with 23 percent.
The majority of pandemic researchers therefore advocate a clear political orientation towards a strategy – instead of checking the status quo every few weeks and making short-term decisions. Because people could no longer support the agreed rules to contain the virus due to unclearly formulated perspectives. “When we talk about people being tired of solidarity, this is often due to the feeling that the rules are perceived as unfair and inconsistent,” says political scientist Barbara Prainsack, who is researching at the University of Vienna on the motivation for Corona -Rules are no longer observed.
Now, even with the proposals from science, it is difficult for the layperson to get an overview. No Covid, step-by-step plan without the yo-yo effect and “elastic” step-by-step plan: there are now many concepts that politicians can use as a guide. But where are the differences – and which corona expert stands for what?
No Covid: Zero as a goal and green zones as an incentive
With the help of a “proactive local elimination strategy”, some researchers are proposing a “No Covid” strategy, the goal of a sustained low incidence – ideally zero. As a society, this approach includes the principle of not wanting to and not being able to live with the virus. It is about the formulated goal of wanting to end the uncontrolled retransmission completely and sustainably. “This applies to every municipality, every federal state, for Germany, Europe and worldwide,” says the concept. This pre-empts the infection process instead of being overtaken and left behind by it.
The se arise at an incidence of 10 and less. From this point on, the first easing is conceivable. Extensive and permanent openings are only possible if there are no more corona infections for two weeks afterwards. This principle creates “positive competition between regions”, write the authors of the concept. After reaching the goal, it is important to monitor the infection process well in order to detect outbreaks at an early stage and to take countermeasures again. If there are areas with infections in the vicinity of the green zone, mobility there must be restricted.
The “Green Zones” are not about establishing a collective complete shutdown to zero in Europe, in which the economy is to be shut down completely. Rather, an incentive should be created to persevere with the measures.
An interdisciplinary team stands behind “No Covid” – including the virologist Melanie Brinkmann and the physicist Michael Meyer-Hermann from the Helmholtz Center for Infection Research in Braunschweig, the economist Clemens Fuest from the Ifo Institute for Economic Research at the University of Munich, the RKI physicist Dirk Brockmann from the Humboldt University Berlin, the educator Menno Baumann from the Fliedner University of Applied Sciences in Düsseldorf and the internist Michael Hallek from the University of Cologne.
Elastic step-by-step plan without coupling to the incidence value
A group around the epidemiologist Klaus Stöhr advocates an “elastic and transparent step-by-step plan” that is not geared towards the 7-day incidence value. This can be used to meet the dynamic pandemic development through new variants, seasonality and population movements.
The elimination of a pandemic virus is not realistic in Germany. Decisive criteria for success would have to be determined “urgently” by politicians and a positive agenda established. A combination of the R-value trend, risk group-specific incidences, the burden on the health system, the occupancy of intensive care units and the development of deaths is conceivable for an assessment of the pandemic.
The group also advocates interdisciplinary working groups which should determine the escalation levels of the measures in the individual areas of life. How exactly these should look like remains vague so far. A separate package of measures is required at each stage: from daycare to retail, public transport to the workplace. If there are changes, for example a change to another level, it should be clear what will be changed in the measures. Success is based on minimizing the health effects.
In addition to the coordinator of the working group Klaus Stöhr, who headed the WHO Global Influenza Program for several years and was Sars research coordinator there, there are also the virologist Jonas Schmidt-Chanasit from the University of Hamburg, Reinhard Berner, board member of the German Society for Child and Adolescent Medicine and Rene Gottschalk, Head of the Frankfurt Health Department, are involved. Supporters include, for example, Hendrik Streeck, head of the Institute for Virology at the University of Bonn and the virologist Hans-Dieter Klenk (Marburg).
Middle way between No Covid and Stöhr approach: step-by-step plan without the yo-yo effect
A group of scientists is looking for a middle ground between No Covid and step-by-step plans that allow for higher incidences at the limit of capacity. Letting the infection process run without a safety buffer is too dangerous, keeping green zones is difficult to achieve in the current situation. It should therefore first be a matter of actually being able to hold the case numbers, which have fallen due to the month-long lockdown. “
The main goal of this strategy aimed at sustainability is to avoid a yo-yo effect, ie the constant recurrence of high numbers of infections due to premature loosening,” says the paper.
Because of a polarizing debate, mainly supporters and opponents of “lockdowns” are currently being identified. However, a differentiation between individual and targeted measures and the use of new tools such as rapid tests are required. Step-by-step plans should show in a transparent way which parts of public life can be opened in which order – and on the basis of which considerations.
The basic goal must be clearly formulated: “Only when a stable and safe incidence level has been reached can it be relaxed in a targeted, intelligent and regionally graded manner”, according to the authors.
In the medium term, the proposal aims at a weekly incidence of 10 per 100,000 inhabitants, and below this wherever possible. At the limit values of 25 and 35, cautious initial easing is possible – provided that the number of cases continues to fall.
The 50s incidence is a hard upper limit to which a sufficient safety margin should be sought. In addition, a lockdown is necessary – the faster and harder, the more effective it is and thus over faster. For the step-by-step plans, representative infection numbers are required, for example by means of random samples from the general population, which are recorded independently of symptoms.
The se would – broken down by region and age – also make it much easier to evaluate the various containment strategies.
Behind this approach are scientists such as the Frankfurt virologist Sandra Ciesek, the physicist Viola Priesemann from the Max Planck Institute for Dynamics and Self-Organization, the sociologist Armin Nassehi from the LMU Munich and the mathematics professor Anita Schöbel from the Technical University of Kaiserslautern.