Pass the salt: The minute details that helped Germany build virus defences

[snoop1130]

Pass the salt: The minute details that helped Germany build virus defences

By Jörn Poltz, Paul Carrel

 

FILE PHOTO: A member of the medical staff shows a used sample container at a test centre for coronavirus disease (COVID-19) at Havelhoehe community hospital in Berlin, Germany, April 6, 2020. REUTERS/Fabrizio Bensch -/File Photo

 

MUNICH (Reuters) - One January lunchtime in a car parts company, a worker turned to a colleague and asked to borrow the salt.

 

As well as the saltshaker, in that instant, they shared the new coronavirus, scientists have since concluded.

 

That their exchange was documented at all is the result of intense scrutiny, part of a rare success story in the global fight against the virus.

 

The co-workers were early links in what was to be the first documented chain of multiple human-to-human transmissions outside Asia of COVID-19, the disease caused by the coronavirus.

 

They are based in Stockdorf, a German town of 4,000 near Munich in Bavaria, and they work at car parts supplier Webasto Group. The company was thrust under a global microscope after it disclosed that one of its employees, a Chinese woman, caught the virus and brought it to Webasto headquarters. There, it was passed to colleagues - including, scientists would learn, a person lunching in the canteen with whom the Chinese patient had no contact.

 

The Jan. 22 canteen scene was one of dozens of mundane incidents that scientists have logged in a medical manhunt to trace, test and isolate infected workers so that the regional government of Bavaria could stop the virus from spreading.

 

That hunt has helped Germany win crucial time to build its COVID-19 defences.

 

The time Germany bought may have saved lives, scientists say. Its first outbreak of locally transmitted COVID-19 began earlier than Italy’s, but Germany has had many fewer deaths. Italy’s first detected local transmission was on Feb. 21. By then Germany had kicked off a health ministry information campaign and a government strategy to tackle the virus which would hinge on widespread testing. In Germany so far, more than 2,100 people have died of COVID-19. In Italy, with a smaller population, the total exceeds 17,600.

 

CHART: Contrasting curves reut.rs/3c2UZA4

 

“We learned that we must meticulously trace chains of infection in order to interrupt them,” Clemens Wendtner, the doctor who treated the Munich patients, told Reuters.

 

Wendtner teamed up with some of Germany’s top scientists to tackle what became known as the ‘Munich cluster,’ and they advised the Bavarian government on how to respond. Bavaria led the way with the lockdowns, which went nationwide on March 22.

 

Scientists including England’s Chief Medical Officer Chris Whitty have credited Germany’s early, widespread testing with slowing the spread of the virus. “‘We all know Germany got ahead in terms of its ability to do testing for the virus and there’s a lot to learn from that,’” he said on TV earlier this week.

 

Christian Drosten, the top virologist at Berlin’s Charite hospital, said Germany was helped by having a clear early cluster. “Because we had this Munich cohort right at the start ... it became clear that with a big push we could inhibit this spreading further,” he said in a daily podcast for NDR radio on the coronavirus.

 

Drosten, who declined to be interviewed for this story, was one of more than 40 scientists involved in scrutiny of the cluster. Their work was documented in preliminary form in a working paper at the end of last month. The paper, not yet peer-reviewed, was shared on the NDR site.

 

ELECTRONIC DIARIES

 

It was on Monday, Jan. 27, that Holger Engelmann, Webasto’s CEO, told the authorities that one of his employees had tested positive for the new coronavirus. The woman, who was based in Shanghai, had facilitated several days of workshops and attended meetings at Webasto’s HQ.

 

The woman’s parents, from Wuhan, had visited her before she travelled on Jan. 19 to Stockdorf, the paper said. While in Germany, she felt unusual chest and back aches and was tired for her whole stay. But she put the symptoms down to jet lag.

 

She became feverish on the return flight to China, tested positive after landing and was hospitalised. Her parents also later tested positive. She told her managers of the result and they emailed the CEO.

 

In Germany, Engelmann said he immediately set up a crisis team that alerted the medical authorities and started trying to trace staff members who had been in contact with their Chinese colleague.

 

The CEO himself was among them. “Just four or five days before I received the news, I had shaken hands with her,” he said.

 

Now known as Germany’s “Case #0,” the Shanghai patient is a “long-standing, proven employee from project management” who Engelmann knows personally, he told Reuters. The company has not revealed her identity or that of others involved, saying anonymity has encouraged staff to co-operate in Germany’s effort to contain the virus.

 

The task of finding who had contact with her was made easier by Webasto workers’ electronic calendars – for the most part, all the doctors needed was to look at staff appointments.

 

“It was a stroke of luck,” said Wendtner, the doctor who treated the Munich patients. “We got all the information we needed from the staff to reconstruct the chains of infection.”

 

For example, case #1 - the first person in Germany to be infected by the Chinese woman - sat next to her in a meeting in a small room on Jan. 20, the scientists wrote.

 

Where calendar data was incomplete, the scientists said, they were often able to use whole genome sequencing, which analyses differences in the genetic code of the virus from different patients, to map its spread.

 

By following all these links, they discovered that case #4 had been in contact several times with the Shanghai patient. Then case #4 sat back-to-back with a colleague in the canteen.

When that colleague turned to borrow the salt, the scientists deduced, the virus passed between them. The colleague became case #5.

 

Webasto said on Jan. 28 it was temporarily closing its Stockdorf site. Between Jan. 27 and Feb. 11, a total of 16 COVID-19 cases were identified in the Munich cluster. All but one were to develop symptoms.

 

All those who tested positive were sent to hospital so they could be observed and doctors could learn from the disease.

 

Bavaria closed down public life in mid-March. Germany has since closed schools, shops, restaurants, playgrounds and sports facilities, and many companies have shut to aid the cause.

 

HAMMER AND DANCE

 

This is not to say Germany has defeated COVID-19.

 

Its coronavirus death rate of 1.9%, based on data collated by Reuters, is the lowest among the countries most affected and compares with 12.6% in Italy. But experts say more deaths in Germany are inevitable.

 

“The death rate will rise,” said Lothar Wieler, president of Germany’s Robert Koch Institute for infectious diseases.

 

The difference between Germany and Italy is partly statistical: Germany’s rate seems so much lower because it has tested widely. Germany has carried out more than 1.3 million tests, according to the Robert Koch Institute. It is now carrying out up to 500,000 tests a week, Drosten said. Italy has conducted more than 807,000 tests since Feb. 21, according to its Civil Protection Agency. With a few local exceptions, Italy only tests people taken to hospital with clear and severe symptoms.

 

Germany’s government is using the weeks gained by the Munich experience to double the number of intensive care beds from about 28,000. The country already has Europe’s highest number of critical care beds per head of the population, according to a 2012 study.

 

Even that may not be enough, however. An Interior Ministry paper sent to other government departments on March 22 included a worst-case scenario with more than 1 million deaths.

 

Another scenario saw 12,000 deaths - with more testing after partial relaxation of restrictions. That scenario was dubbed “hammer and dance,” a term coined by blogger Tomas Pueyo. It refers to the ‘hammer’ of quick aggressive measures for some weeks, including heavy social distancing, followed by the ‘dance’ of calibrating such measures depending on the transmission rate.

 

The German government paper argued that in the ‘hammer and dance’ scenario, the use of big data and location tracking is inevitable. Such monitoring is already proving controversial in Germany, where memories of the East German Stasi secret police and its informants are still fresh in the minds of many.

 

A subsequent draft action plan compiled by the government proposes the rapid tracing of infection chains, mandatory mask-wearing in public and limits on gatherings to help enable a phased return to normal life after Germany’s lockdown. The government is backing the development of a smartphone app to help trace infections.

 

Germany has said it will re-evaluate the lockdown after the Easter holiday; for the car parts maker at the heart of its first outbreak, the immediate crisis is over. Webasto’s office has reopened.

 

All 16 people who caught COVID-19 there have recovered.

 

-- © Copyright Reuters 2020-04-09

Follow Thaivisa on LINE for breaking COVID-19 updates

[Andrew65]

It's been suggested that Germany might have been reporting some CV deaths as deaths from underlying causes, so making their CV death rate look much lower, not sure how much truth there is in that?

[Justgrazing]

You wouldn't expect anything less from the efficient Germany .. Test and trace is their mantra and test they have and though they do expect an increase in mortality their approach does appear to show it is a way of slowing the virus proliferation .. And Germany have a superb health care system for treating those who contract it ..

[Andrew65]

7 minutes ago, Justgrazing said:

You wouldn't expect anything less from the efficient Germany .. Test and trace is their mantra and test they have and though they do expect an increase in mortality their approach does appear to show it is a way of slowing the virus proliferation .. And Germany have a superb health care system for treating those who contract it ..

They also have some of the best engineering & cars in the world, but that didn't stop them cheating with the VW "dieselgate" scandal!?????

Edited April 9, 2020 by Andrew65

[timendres]

21 minutes ago, Andrew65 said:

It's been suggested that Germany might have been reporting some CV deaths as deaths from underlying causes, so making their CV death rate look much lower, not sure how much truth there is in that?

5 minutes ago, Andrew65 said:

They also have some of the best engineering & cars in the world, but that didn't stop them cheating with the VW "dieselgate" scandal!?????

Got a beef with the Germans?

[Andrew65]

Just now, timendres said:

Got a beef with the Germans?

Not at all, I've spent quite a bit of time there, had German friends & colleagues, and even drive a German car.????

[Tropicalevo]

18 minutes ago, Andrew65 said:

They also have some of the best engineering & cars in the world, but that didn't stop them cheating with the VW "dieselgate" scandal!?????

And this is relevant in today's covid 19 world?

Please take your grudge somewhere else.

Edited April 9, 2020 by Tropicalevo

[Andrew65]

Just now, Tropicalevo said:

And this is relevant in today's covid 19 world?

It was in reply to another comment:

 

"You wouldn't expect anything less from the efficient Germany .. Test and trace is their mantra and test they have".

I used to think that, but the VW scandal changed my view a bit. And the diesel-gate scandal happened in one of the 'greenest' countries in the world.

[timendres]

1 hour ago, Andrew65 said:

It was in reply to another comment:

 

"You wouldn't expect anything less from the efficient Germany .. Test and trace is their mantra and test they have".

I used to think that, but the VW scandal changed my view a bit. And the diesel-gate scandal happened in one of the 'greenest' countries in the world.

I think the primary difference here is that, in the case of COVID-19 and the article, it is primarily the government who is front and center. In the case of the VW scandal, it was shady corporate executives.

[Andrew65]

11 minutes ago, timendres said:

I think the primary difference here is that, in the case of COVID-19 and the article, it is primarily the government who is front and center. In the case of the VW scandal, it was shady corporate executives.

Yes, you're probably right.

[sallecc]

2 hours ago, Andrew65 said:

It's been suggested that Germany might have been reporting some CV deaths as deaths from underlying causes, so making their CV death rate look much lower, not sure how much truth there is in that?

It's been suggested with other countries, primarily China, not much as Germany... anyway there's no any way to check it, so expect speculating there's not much to do.

[baansgr]

Makes you wonder...with tracing like thia from the start, if China had been open from the first infections back in early December...would this worldwide catastrophe even be happening.

[Crazy Alex]

3 hours ago, Andrew65 said:

It's been suggested that Germany might have been reporting some CV deaths as deaths from underlying causes, so making their CV death rate look much lower, not sure how much truth there is in that?

It would be interesting to see Germany's overall death rates for the past years. Did more people, other than those with CV, start dying? That would tell the story.

[Andrew65]

47 minutes ago, sallecc said:

It's been suggested with other countries, primarily China, not much as Germany... anyway there's no any way to check it, so expect speculating there's not much to do.

It's also been speculated that Japan only showed a big spike in CV deaths after it became certain that the Tokyo Olympics wouldn't be happening.

We'll probably never know these things for sure though.

[pacovl46]

9 hours ago, Andrew65 said:

They also have some of the best engineering & cars in the world, but that didn't stop them cheating with the VW "dieselgate" scandal!?????

The irony is it would have cost VW only 300 Euro more per car to do it without cheating! It wasn’t just VW, though. It was essentially all the German car manufacturers who cheated. 

[DoctorG]

We always knew that salt was bad for our health.

[pacovl46]

6 hours ago, Crazy Alex said:

It would be interesting to see Germany's overall death rates for the past years. Did more people, other than those with CV, start dying? That would tell the story.

Over the past 10 years between 2300 and 2600 people have died on average in Germany per day. 

[nobodysfriend]

9 hours ago, Andrew65 said:

Not at all, I've spent quite a bit of time there, had German friends & colleagues, and even drive a German car.????

 

This one ?

 

[Andrew65]

1 hour ago, nobodysfriend said:

This one ?

 

No, but looks very similar, a BMW 320i????

[Andrew65]

1 hour ago, pacovl46 said:

The irony is it would have cost VW only 300 Euro more per car to do it without cheating! It wasn’t just VW, though. It was essentially all the German car manufacturers who cheated. 

As I implied in my comment, it went totally against how I (positively) regard Germans & Germany, great engineering, but also where things are done correctly.

I wasn't being anti-German at all, they'd disappointed me.

Edited April 10, 2020 by Andrew65

[Proboscis]

11 hours ago, Andrew65 said:

It's been suggested that Germany might have been reporting some CV deaths as deaths from underlying causes, so making their CV death rate look much lower, not sure how much truth there is in that?

I think if you look at the testing regime (Germany is testing 10 times the number of people that the UK is testing) and the level of contact tracing that is going on in Germany right now, I very much doubt that the Germans are trying to hide cases or mortality. The more cases you find, the lower the mortality rate and the lower the mortality anyway as you get ahead of the virus rather than just reacting to it,

[CGW]

2 hours ago, DoctorG said:

We always knew that salt was bad for our health.

Try go without it ????

[CGW]

2 hours ago, pacovl46 said:

Over the past 10 years between 2300 and 2600 people have died on average in Germany per day. 

This is a good remark IMO, society tends to shun away from death, it is rarely in the news - now we are bombarded with it, folks have no idea of the normal mortality rate, nothing to compare the "new" figures they are hearing with!

On a normal day in this world 150,000 people die, take the daily deaths now and compare with the average numbers daily, statistically there would be no change!

Edited April 10, 2020 by CGW

[grumpy 4680]

      It should be noted in this case, that the Chinese parent's had the decency to notify the bosses at Wymoto to help with the prevention of further spread.

[Baerboxer]

17 hours ago, Justgrazing said:

You wouldn't expect anything less from the efficient Germany .. Test and trace is their mantra and test they have and though they do expect an increase in mortality their approach does appear to show it is a way of slowing the virus proliferation .. And Germany have a superb health care system for treating those who contract it ..

 

You still believe all the myths.

 

My best friend's wife was a senior long serving Krankenschwester (senior nursing sister). She left after decades of service about 10/12 years ago because of how bad the 'system' was with its money focus. 

 

 

[pacovl46]

7 hours ago, CGW said:

take the daily deaths now and compare with the average numbers daily, statistically there would be no change!

Not true. You have the average numbers now plus the Covid19 deaths on top of that. The “normal” fatalities are not listed in the Covid19 lists. 
 

Worldometers dot info has a “life feed” of how many people are born and die globally amongst other thighs. They also have a list about Covid19. You can choose at the top of the page. It’s quite interesting. 

[snowgard]

But they done the same as the rest of the world. They talked the virus in public harmless and that the seasonal flu is more dangerous and that masks not help and that they are ready to fight the corona virus. And now are more as 118.000 germans infected and more as 2.600 died.  

Everyone saw what was happen in china and how they fight against it. But this were only the stupid chinese. Europeans are much more clever.

 

If the germans and the rest of the world had done the same as china and forced people to wear masks they had a much smaller amount of infected people and death people. STUPID EXPERTS & POLITICANS!!!

Edited April 10, 2020 by snowgard

[Muzzique]

As a Brit living in German I see at first hand the efficiency. I have had 2 CV19 tests even though I have had no symptoms or contact with anyone that might have it. They are preformed routinely if you have a hospital appt or visit a consultant for anything.

 

Also they have a mobile service that comes to your house if you feel unwell and you are checked for CV19 regardless of your symptoms. They swap your mouth and 20-30 mins later you are told the results. This runs alongside their tracking process for confirmed cases.

 

In January the Germans had developed their CV19 tests and started mass producing. By the end of Feb Landt had 4 million test kits ready and they currently supply about 1.5 million a week for other countries.. Germany set up tests labs in all hospitals and other Private clinics, A total of 50,000 laboratories have the testing capability available.

 

A single hospital in each city was set up as CV19 designated and other patients transferred. Consulting rooms became wards and the A&E subdivided to those with or without CV19. On arrival all patients were screened for CV19 and after the results (which take about 30 mins) moved to either the fully isolated triage area or to a normal A&E team.

 

Anyone who tests positive triggers a track and trace procedure where they test everyone who may have had contact and go through the network till they have tracked down everyone they can.

 

The high number of infections that Germany shows include a large number of the people that show no signs of the disease and are picked up through the current track and test process or routine screening. So far in Germany they have undertaken 1.4 million tests whereas in the UK its about 240,000

 

Public transport is secured with drivers having been screened off completely from the passengers for about a month now. People here are sticking to the social distancing and isolation guidelines as you would expect the Germans to do. Supermarkets limit the numbers who can go inside at any one time and masks and gloves are provided. There are few if any queues.

 

There is no sense of panic here and people seem to have adjusted to this lifestyle pretty well. I simply order up a few crates of beer and a grocery delivery and it comes direct to my door the next day. It all feels very relaxed here and well under control.

[Assurancetourix]

19 hours ago, Andrew65 said:

I used to think that, but the VW scandal changed my view a bit. And the diesel-gate scandal happened in one of the 'greenest' countries in the world.

I'm sorry to contradict you; the Germans shut down their nuclear power plants under the pressure of environmentalists and reopened coal power plants to replace them;
the CO2 balance is of course disastrous.
There are still 7 nuclear power plants in operation ...

 

But here, we are totally off topic

 

https://en.wikipedia.org/wiki/Nuclear_power_phase-out

[manhood]

What the hell you guys compare the "diesel case" with the health system and the competence of the virologists and epidemics in Germany as they defenetly know hiw to handle the situation and the government folliw them and not think they know better such as Trump or Johnson And in Germany there are researches of virologists in the field and cities that had a lot of infection cases and they interview all households and peoples to find out more deeply how they communicated with others. Also checked many places as door nobs, kitchen,  peds and all places in the houses to find evidence for Corona.  Nowhere else in the world that was done yet.  So better follow up the german scientists than any others, esperially here in Thailand!!!!