During an interview with the Tagesspiegel on Sunday, Drosten discussed the end of the pandemic, Germany and other countries’ political failures and possible vaccines being administered through the nose.
When asked if Germany could soon declare the pandemic over and enter the endemic phase, Drosten said: “We are in that process now. But because of the high proportion of older people in the population, we have to do this (build immunity) in Germany through vaccination. If not, far too many people would die through natural infections.
“We have already gone a long way along this path through vaccination. We must now complete this process so that we can reach the endemic phase in the course of 2022 and declare the pandemic state to be over.”
Drosten said some countries are already near the end of the pandemic, such as South Africa and India, because there have been lots more infections in the population “but it’s also at the price of many deaths”, he added.
‘Masks likely needed next winter’
The Berlin Charité Hospital virologist, who regularly advises the government, gave his predictions on what will happen in 2022.
“Next winter, I expect another strong increase in incidence,” he said. “And we will probably have to wear masks again indoors, because the protection against transmission will drop again a little, and the vulnerable in the population will have to be protected, especially the elderly who are vaccinated and the unvaccinated of all ages.
“However, really significant restrictions will probably no longer be necessary. We will just have to continue to take into account the part of the population that is at risk.
“So it will not yet be like it is now in a normal influenza season. Because the population immunity against influenza is not only based on vaccination, but on several infections that an adult has usually already had in his or her lifetime. We are simply not there yet with Sars-Cov-2.”
Drosten said that everyone will get the virus in the long run, but that it shouldn’t spread unchecked throughout the population.
“The virus has to spread, but it has to do so on the basis of a vaccination protection that is anchored in the general population,” he said.
When asked if Omicron having a reduced disease severity could be a chance to enter the endemic phase he said: “It would be a chance now, assuming broad immunity.”
He didn’t, however, rule out the possibility that a new variant could emerge in future that may escape immunity like Omicron, but have an increased disease severity like Delta.
Yet he said if this happened, it would “no longer be a catastrophe” because population immunity should continue to build.
“But maintaining population immunity is not the same as building up immunity,” he added. “In our ageing society, we have to build up immunity through vaccinations, while the virus has to maintain it. Supported, of course, by booster vaccinations, just like with influenza.”
On the question of a general vaccine mandate, on which the German Bundestag will vote on in the coming weeks, Drosten said the controversial question was “for the politicians to decide”.
“As a virologist, I can only emphasise again and again how important it is that we close the vaccination gap as completely as possible, especially in the age groups that are at risk,” he added.
“It will not be possible to achieve transmission protection of those at risk via population immunity, i.e. what is commonly called “herd immunity”: a state in which the virus does not spread further, so that even those parts of the population who are not vaccinated are protected. That will not be achievable with this virus.”
Germany has ‘handled pandemic well but mistakes made’
When asked about the biggest political mistakes in Germany and elsewhere in the pandemic, Drosten said that the UK “made the big mistake in the first wave of not listening to science and doing the lockdown too late. Two weeks would have made a huge difference then, would have saved tens of thousands of lives”.
“That was not the case in Germany,” he said, but added that an error was made in Germany in November 2020 with the “very half-hearted approach taken at the time”.
“No consistent action was taken and it was accepted for several weeks that the infection rates remained constantly high,” he said.
Drosten said the second serious error for Germany was in autumn 2021 “when it was misjudged that a new wave was coming – the Delta wave – and that something had to be done about it”.
“It was communicated that all we had to do now was protect old people’s homes, and that there would be no winter wave because we had vaccinated – whereas science had warned emphatically against it, really long enough beforehand,” he said.
However, he said Germany has handled the pandemic fairly well overall, adding that few countries have had “so few deaths for a comparable population size, demographic and socio-economic structure”.
“Compare this to the frequently cited example of Sweden – there were many deaths and immense economic damage,” said Drosten. “And even in autumn 2020, the government there admitted that its approach had failed. And it would have failed even more if the population there hadn’t behaved in such an educated, cooperative, self-motivated, self-responsible and cohesive way.”
What does the future hold?
When it comes to research, Drosten said the world needs a so-called “live vaccine”, with an “attenuated virus or a modern variant of it”. He said it would be “administered in the nose to trigger mucosal immunity”.
“That would be a much better protection against transmission, it would be the next milestone,” he said.