The federal and state governments agree – on more and faster boosters, on more tests in maintenance and controls for the 3G rule. But experience teaches: When it comes to implementation, it is all over with unity. And is that even enough against the force of the fourth wave?
There is no shortage of pithy words this afternoon: The situation is “dramatically worrying and anything but all-clear,” said Bavarian Health Minister Klaus Holetschek at the press conference after two days of conference with his colleagues from the federal and state governments. For the first time in months we have come together again in presence.
Federal Minister Jens Spahn adds: There are now the first regions in the country from which Covid patients would have to be relocated “because the wards are full”. The fourth wave comes “with full force”. The numbers from the Robert Koch Institute for the day – 37,120 new infections, an incidence of almost 170 – flank the health minister’s gloomy outlook.
Of these more than 37,000 newly infected people, he estimates that around 350 to 400 will come to the hospital in a few days. The number, extrapolated to the daily increase, makes it clear that the clinics “have reached a critical limit”, as Uwe Janssens calls it, board member of the intensive care medicine association Divi, and also participant of the conference.
“Many are now burned out”
Almost all of the afternoon’s statements refer to him and an intensive care nurse who Janssens brought to the ministerial conference: Apparently the lady understood how to impressively describe to politicians how difficult it is to bear the situation in the isolation wards again. “You can tell that the nurses are passionate about their work, but many of them are now burned out”, summarizes Jens Spahn. “We have very difficult weeks ahead of us.”
So much for taking stock, but the aim of the Conference of Ministers of Health (GMK) should be to coordinate effective measures to fight the virus. It is important to “break the momentum that is now there,” says Bayer Holetschek. “With the experiences from Israel” one now wants to “enter this wave very strongly”. The reference to Israel, which with booster vaccinations also got the fourth wave under control for younger people, is crucial: It indicates that Jens Spahn has apparently succeeded in getting his country colleagues to his side in the struggle for the third vaccination for all to fetch. At the beginning of the week, the Association of Statutory Health Insurance Physicians vehemently opposed offering the third vaccination to people under 70 years of age.
The joint approach, “resolute and closed” according to Holetschek, now provides for the following: 3G – that is, vaccination, recovery or being tested should be more strictly controlled as a prerequisite for participation in certain events. Spahn also announced that there was “for the first time a consensus between the federal and state governments that there must be 2G” as an option for regions with a very high infection rate. The state of Saxony has already decided on this problem and the cabinet decided on state-wide 2G rules that evening.
There is also agreement about this: The obligation to test for old people’s and nursing homes is to be expanded. In future, vaccinated and convalescent people should also be obliged to take a quick test before entering a care facility. “Ideally” Jens Spahn would like daily testing in the homes, for both staff and visitors. However, this also depends on the respective incidence. A place “where particularly vulnerable people live” needs special protection.
“We need more speed”
And finally the booster vaccinations: The “booster after six months should become the rule, not the exception,” says Spahn. There is also agreement that, in addition to doctors’ surgeries, there is also a need for public bodies for vaccination services, such as vaccination centers or vaccination buses. “We need more speed.”
“United”, “closed”, “together” – as often as the representatives of the federal and state governments present sprinkle these terms in their statements, it becomes clear at the conference how little that means in detail. “I won’t do it,” says Monika Bachmann, Minister of Health from Saarland, when asked whether she wants to reopen the vaccination centers in her state. “If I did it, it would take about 14 days to bring them back up from standby,” she explains. At the same time, the Association of Statutory Health Insurance Physicians assured: “We doctors, we can do it”.
At first glance, this looks like a direct contradiction to Spahn’s announcement that the federal states wanted to create public vaccination options again. But the Saarland not only has the second highest vaccination rate in Germany at 74 percent, but has also been running various vaccination vehicles in the state throughout the fall. In contrast to many other countries, the public authorities have never been completely shut down and can therefore rely on a functioning infrastructure.
Other concepts are being pursued in other federal states. North Rhine-Westphalia, for example, leaves it to the districts to monitor the local vaccination process via so-called “coordinating Covid vaccination units” and to plan “nationwide booster vaccinations for the general population”. So it depends on the agility of the district whether a vaccination mobile drives through the area or whether the vaccinees have to make an appointment at a doctor’s office. In times of autumn infections and flu vaccinations, this often means several weeks of waiting time, even for the elderly.
So it will only be decided in the coming weeks whether this GMK will have a measurable effect on the incidences, and above all whether this is sufficient to actually “break the dynamic”, as Minister Holetschek said in the introduction. Because the three central resolutions – more control over 3G, stricter test regime for old people’s and nursing homes, expansion of booster vaccination – are opposed to at least two registers that are obviously not being pulled at the moment.
Free tests won’t come
There will be no reintroduction of the free corona tests. This is demanded from many sides, because on the one hand more control over possible outbreaks is possible through many tests, on the other hand also vaccinated and convalescent people still carry a risk of infection. The calculation to induce vaccination skeptics to vaccinate through chargeable tests has also not worked out. However, the federal states do not want to use the “free tests” instrument.
The federal and state governments are also currently unwilling to introduce a mandatory vaccination for nursing staff. France and the US have already done that. After initially furious protests, however, there has been no wave of dismissals by nurses in either country. Nevertheless, Spahn shies away from compulsory vaccination out of fear of a division in society. From his point of view, the tensions on the subject of vaccination are already very high. But “as long as a conversation is still possible, a society stays together”.
Demonstrating solidarity is a noticeable goal of the representatives of the federal and state governments on Friday as well. However, experience has shown that it is still very open how far the joint decisions will go when it comes to implementation. Just like the question of whether the measures that have now been agreed are actually sufficient in the fight against the Delta variant. Because a prime ministerial conference is currently not being planned. The GMK’s resolutions are currently everything that Germany brings up against the corona virus.