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Germany: Herd Immunity is Impossible. Now What?

  • July 21, 2021

Are mandatory vaccinations plausible? So far, that rule has only been applied in states like Tajikistan and Turkmenistan, which generally aren’t big supporters of human rights. The Vatican has also instituted mandatory vaccination for all residents and employees. But where else?

In France, anyone who works in a hospital or a nursing home must be vaccinated by Sept. 15. Greece has imposed similar rules. In Italy, medical personnel with contact to patients have had to get vaccinated since the end of May.

Applying Pressure

French President Emmanuel Macron once campaigned as an economically liberal politician, but amid the pandemic, he has been increasingly relying on regulations. Starting this week, anyone in France wanting to attend a public event with more than 50 participants will have to show a “pass sanitaire,” or a proof of vaccination, or that they have recovered from the virus or had a negative test. Starting in the fall, the French will also need to pay for their own PCR tests. Beginning in August, the pass will also be necessary to access shopping malls, long-distance trains, restaurants and cafes. That’s not a mandatory vaccination, but it does increase the pressure – and pushes things close to the edge of what is possible in a free society.

And in Germany? Angela Merkel and Jens Spahn reiterated last week that they do not plan to make vaccinations compulsory for those working in daycare centers or schools, for instance. But they, too, want to ratchet up the pressure.

The pandemic is a large-scale experiment in how much solidarity a society can muster. There was solidarity with the elderly and the sick because they needed to be protected more than everyone else. But what about solidarity with those refusing vaccines and placing their own reservations above the health of the general public? On several occasions last week, Spahn suggested how things might go. He did say that in a later stage of the pandemic, testing could stop being free of charge for people who haven’t been vaccinated. Together with other restrictions, this could, as in France, become an indirect driver of people getting vaccinated.

German Interior Minister Horst Seehofer of the Christian Social Union (CSU), the Bavarian sister party of Merkel’s CDU, disagrees. “I don’t believe that people who refuse the vaccine should be forced to pay for the tests themselves in the future,” he told DER SPIEGEL. “Many would then refrain from getting tested. This would lead to us losing the overview of the infection situation, which would be disastrous.”

The opposition views things similarly and is instead calling for more incentives. “We need a large-scale education and advertising campaign for vaccinations, ideally with celebrities from the arts, sports and society in general,” says Michael Theurer, the deputy chairman of the parliamentary group of the pro-business Free Democrats (FDP).

Green Party parliamentary group leader Katrin Göring-Eckhardt is calling for “attractive vaccination opportunities” to be brought “as close to people’s daily lives as possible.” She argues that there is still too little advertising and not enough information about accessible vaccination options, and that not enough is being done to debunk myths about the vaccines. “The vaccination in the pedestrian zone, in front of the supermarket or in front of the university cannot be an exception or a one-off project,” she says. But the federal government is actually promoting vaccination with an ad campaign featuring former “Baywatch” star David Hasselhof.

Young adults are currently a big problem, because their infection numbers are rising particularly strongly. Germany’s health and education ministries are already worried about the universities’ winter semesters. In a letter, both authorities appealed to the heads of the German Rectors’ Conference and the Student Union that students “be informed on the local and regional levels about the importance and significance of vaccinations.”

Putting Vacation over Vaccination

But the problem isn’t just that people are refusing vaccines, it’s that it’s vacation season. As recently as spring, people were worried that they wouldn’t be able to travel without a vaccination. Now everyone can do so – which seemingly led many Germans to prioritize their vacation over their vaccination.

The number of vaccination shots being administered each day has been declining for weeks, and many appointments are not being kept. Recently, the idea of imposing penalties in such cases has been discussed. Those won’t be imposed, for now. Instead, the question is how to deal with those who are returning from vacation.

The issue was discussed last Tuesday by the Berlin COVID-19 crisis team. One possibility is requiring all travelers returning from vacation to carry either a negative test or proof of vaccination with them – no matter which country they are coming from, and whether they are entering Germany by plane, train or on foot.

Things could get uncomfortable for the unvaccinated, while, conversely, vaccination could offer travelers advantages. The crisis team is considering shortening the quarantine period for vaccinated people returning from so-called virus variant regions. At the moment, it is 14 days – with or without vaccination. “I’m strictly against mandatory vaccination,” says Interior Minister Seehofer, “but I’m definitely in favor of linking vaccinations to consequences, for example when it comes to rules for entering the country: no quarantine, no tests for vaccinated people.”

Deepening Divisions

The new normal will be bifurcated and will feel different for those with vaccinations than those without. This will deepen divisions – but the rift would be even deeper if nothing would change for those who had been vaccinated, and everyone had to make allowances for those who refuse the jabs.

But some things will be the same for everyone: new numbers and indicators. At the start of the pandemic, Germany stared obsessively at the absolute numbers and the so-called R value, the number of people, on average, that a person with the coronavirus passes the infection on to. By the time most people understood the latter, the incidence value – the number of new infections per 100,000 inhabitants in the past seven days – became more important. But another value beyond the incidence could attract new scrutiny in the future.

The more people there are who are vaccinated, the higher the incidence value can be without the healthcare system collapsing. Chancellor Merkel said last week that higher incidence levels could be permitted in the future. In the United Kingdom, the incidence is well over 300, but things are opening up nevertheless.

The Health Ministry doesn’t want to go that far, but officials there are also looking at a different value now: the hospitalization rate. Since last Tuesday, German hospitals have thus been collecting more data on their patients with COVID-19.

It’s a long, arduous road. The country is gradually learning to live with the pandemic, but it is struggling, partly because not all consequences are foreseeable. The new normal is only gradually becoming clear.

Long COVID Worries

Heyo Kroemer, for instance, the head of Berlin’s Charité University Hospital, recently had an encounter related to long COVID – when people who suffer from symptoms long after they were infected, like fatigue, shortness of breath, insomnia – that worried him.

“In a meeting with our deputy clinic directors last week, I was told that there is extreme demand from patients suffering from long COVID,” Kroemer says. His team believes that up to 10 percent of those infected with the coronavirus are affected.

“The severity of the infection and the severity of long COVID do not seem to correlate, based on our findings,” Kroemer says. That means a patient can have had a harmless progression of the disease and still suffer long-term consequences. That’s a scary prospect for a society, and Kroemer expects that long COVID will keep the healthcare system busy for some time to come. He expects university hospitals to set up central contact points for it.

What does that mean? Namely, that even if it’s all over one day, things still won’t be over.

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