Christian Drosten, an eminent virologist and architect of Germany's relatively successful fight against coronavirus thus far, warns that "winter will not be an easy one." He urged people to follow health rules.
Christian Drosten: It's very difficult to make global projections. We have very different, difficult situations in countries around here in Europe. The winter will not be an easy one. While we will have vaccines [available] during the coming year, it could take until the end of the next year for significant parts of the population to be provided with a vaccine.
We won't get rid of masks anytime soon. So even when we start vaccinating, the majority [of the population] will still have to wear masks.
In countries like Germany and other European countries where the incidence [of infection] is low, there will be nothing like a population-based protection.
In other parts of the world, the situation is very hard to judge. In Africa, we have signs of lower transmission and less severe presentation perhaps due to the lower population age. However, what we are seeing [data for] now is for urban areas on the African continent, where the population composition is particularly young. We don't know what effect the virus will have as it spreads to the countryside. It is possible that in urban centers the epidemic is already slowing down, but it's equally possible that it is still to come.
Which regions around the world are you most concerned about?
India is the current biggest concern. It has a high population density. The virus is spreading in an almost uncontrolled fashion. Then, of course, areas in South America and in Africa.
In the northern hemisphere winter is coming. Some countries are heading into autumn with a high background incidence and where there is low trust in medical structures and the power of public health intervention. There are countries, including in Europe, that will have to impose stricter measures very soon.
There is a combination of reasons. The decisive point was probably that Germany reacted very early on — in terms of the relative point of time when contact restrictions, sometimes called a lockdown, were imposed as compared to the actual development of the epidemic.
The widespread availability of laboratory testing is [additionally] something that set Germany apart from other countries. We were really fast on the lab level to react.
Another explanation is that our epidemic started somewhat later. Our imported cases didn't start to become an epidemic until the end of February.
It seems that our early imported cases were controlled and didn't result in forward transmission.
These reasons explain why our intervention was extremely efficient and why, after our lockdown, the incidence in Germany was extremely low and has remained so. Even though we are seeing a slight increase in transmissions now. [September 17's tally of 2,194 new recorded cases was Germany's worst daily figure since April.]
Looking ahead to autumn and winter, what do you expect to happen in Germany?
We should look to other European countries like France, the UK and Spain. What we're seeing in those countries is what we will see in Germany if we don't react very early on in a way that needs to be bearable for the economy and at the same time targeted.
The big challenge is to recognize the turning point to modify the intervention measures that are in place now. This is when, in certain sections of society, the incidence has increased to a level where the virus is spreading widely.
This is very difficult to estimate now, in autumn. It was easier in spring where actually the transmission chain started from large events. The virus is spreading in a different way and it is distributed in sectors of the population that are not as easy to reach.
The virus has spread under the cover of low willingness to test. Young people are often reluctant to get tested because they have milder symptoms in general. Sometimes they acquire their infection from parties and other social activities that shouldn't have happened. This is the biggest challenge in the weeks to come.
Good communication poses another challenge because we will see an increase in incidences as in other countries of Europe.
As we're testing much more than in springtime, we expect more cases now. What we are seeing currently is a bigger picture than what we saw in spring, while the actual numbers may be the same.