Germany’s ‘real Covid fourth wave’ has started, says health expert

A sign telling customers to remember the Covid mask requirement at a restaurant in Waldkirch, Baden-Württemberg.
A sign telling customers to wear masks at a restaurant in Waldkirch, Baden-Württemberg. Photo: picture alliance/dpa | Philipp von Ditfurth
Germany is seeing an alarming rise in Covid-19 infections, with the 7-day incidence rising above 90 for the first time since May.

Health experts said the rising cases show the “actual fourth wave” is getting underway in Germany – and that the situation will get worse. 

For the ninth day in a row, the 7-day incidence in Germany increased. On Friday the incidence was 95.1 Covid-19 infections per 100,000 people within seven days. It’s the first time since mid-May that the incidence has risen above 90. A week ago, the 7-day incidence was 68.7.

On Friday, Germany recorded 19,572 new Covid infections within a day, and 116 Covid-related deaths.

In the past few months, Covid infections in Germany have been stagnating and decreasing at times, leaving many wondering if a serious fourth wave would emerge. But cases have been going up quickly recently.

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The Robert Koch Institute (RKI) and health experts are sounding the alarm.

“Since the end of September 2021, a rising trend in the 7-day incidences has again become apparent, which became visible in almost all age groups last week,” said the RKI in its weekly report. 

“It is to be expected that the rise in case numbers will accelerate more in the further course of autumn and winter,” the RKI added. 

The chart by Our World in Data below shows the number of Covid cases per million people in Germany compared to a few other European countries. Many neighbouring countries are seeing a trend of rising cases. 

What’s going on in hospitals?

The number of Covid-19 patients admitted to clinics per 100,000 residents within seven days – the government’s most important indicator for a possible tightening of restrictions – was 2.45 on Thursday.

Although it has risen slightly, it’s far off the previous hospitalisation rate peak which reached 15.5 in December last year. 

According to the DIVI intensive care register, the number of Covid-19 patients in ICU wards stands at around 1,540 (as of Thursday). Around 850 of these patients are receiving ventilation treatment. For comparison, at the start of October there were just over 1,300 Covid-19 patients in intensive care.

Health specialists say they are concerned, particularly because of a lack of ICU nursing staff.

The German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) said that in the coming weeks “a noticeable restriction in the care of the population is to be expected”.

Currently, 22,207 intensive care beds in Germany are available, compared to 26,475 at the beginning of the year.

The past months have led to many nurses leaving the profession, and not enough new nurses being taken on, DIVI said.

“A foreseeable difficult autumn and winter wave” with many Covid-19 patients, but also patients with other respiratory infections such as Influenza, could bring intensive care units in Germany “once again to and beyond its limits”, said Stefan Kluge, Director of the Clinic for Intensive Care Medicine at the University Hospital Hamburg-Eppendorf, Tagesschau reported on Friday. 

“The real fourth wave has now begun and is continuing to pick up speed,” DIVI director Christian Karagiannidis wrote on Twitter. He added that there is still a “very close correlation between incidence and new admissions to intensive care units”.

More vaccine breakthrough infections ‘expected’

According to the RKI report, more outbreaks have again been reported in medical facilities as well as in old people’s and nursing homes.

For the first time since the May, the 7-day incidence among people over the age of 90 rose again last week to over 50 cases per 100,000 people.

Health experts acknowledged that with increasing vaccination coverage especially among the elderly, outbreaks had gone down significantly. But they still occur and also affect vaccinated people, RKI said.

In general, the RKI says that more vaccination breakthrough infections can be “expected” over time.

This is partly down to the virus spreading quickly again.

“This increases the probability of coming into contact with the virus as a fully vaccinated person,” said the RKI.

According to the RKI, severe courses of the disease are, however, very rare in vaccinated people. 

READ ALSO: Why vaccinated people in Germany are still getting Covid


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