The world is witnessing an abysmal pandemic in the form of the coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).During the lockdown period, Germany contained COVID-19 positive cases to a minimum possible, and the fatality rate remained the lowest compared to Italy, Spain and the UK. This was possible due to the higher number of tests performed, higher number of available intensive care beds with respiratory support and higher proportion of positive cases among younger people
The origin of this disease is believed to be Wuhan, the capital of Hubei Province in China, where the first case was identified in December 2019. The first death related to COVID-19 was reported by Chinese media on January 11. Till then, the global public health fraternity had considered this outbreak to be similar to recent region-specific epidemics like SARS in 2002-2004 that affected people from 29 countries and Middle East Respiratory Syndrome (MERS) in 2012. The first case of COVID-19 outside of China was reported in Thailand on January 13, and two days later the second case was detected in a Japanese national, a Wuhan returnee.
The first confirmed cases in Europe were reported in France on January 24; three individuals tested positive after returning from Wuhan.
A week later, two Chinese tourists in Rome tested positive for the virus.
During the next month, the virus spread rapidly in Europe, initiating a health disaster in Italy and Spain.
On the other hand, COV- ID-19 was successfully contained to a single patient in Germany for almost one month after its identification in a patient in Munich area. However, by February end, multiple cases were reported in Baden-Wuerttemberg in southwestern Germany; all these patients had returned from a skiing resort in Italy.
By the start of March, clusters of positive cases related to a local carnival celebration were detected in Heinsberg, a town in North Rhine-Westphalia state.
The first two fatalities in this cohort, in Germany, were reported on March 9.
Taking into consideration the rapid spread of the virus, Robert Koch Institute (RKI), the federal agency for disease control and prevention, suggested a pandemic management plan from March 13. The plan included mandatory closure of kindergartens, schools and academic semesters in the universities as well as shutting down of restaurants and bars, prohibiting visits to elderly care homes and limited visits to hospitals. Later on, the borders to neighbouring countries were closed.
By March 22, curfews were imposed in six severely affected states, while physical contact with more than one person beyond the household was prohibited in other states.
As an employee of one of the leading medical universities in central Germany, I was able to witness the preparations being made in combatting COVID-19 in our city of Halle (Saale) from scratch. The five major hospitals in the city had established a network for mutually dealing with the prospective inflow of COV- ID-19 patients. Multiple test stations were opened in the city. Emergency departments of the hospitals were kept on standby round-the-clock. Around one thousand extra intensive care beds with respiratory support were added.
Medical students in the higher semesters as well as retired physicians were advised to stay prepared for voluntary service. Fullfledged COVID-19 special wards isolated from main premises were established in all hospitals. The recently emptied old building of the university hospital was converted to a quarantine centre, capable of accommodating around 1,000 individuals.
Till then, not a single positive case was identified in the city. Similar arrangements were made in most major cities in Germany.
The first case was reported in Halle on March 9, where an inhabitant in an elderly care home tested positive. The kindergartens, schools, universities, restaurants and shopping centres were closed with immediate effect; only grocery stores and front-line service providers were allowed to continue their services.
The movement of people in the city was restricted.
'Working from home' concept was encouraged.
The lockdown continued till June, and the restrictions were loosened from July. During this period, Germany contained COV- ID-19 positive cases to a minimum possible, and the fatality rate remained the lowest compared to Italy, Spain and the UK. This was possible due to the higher number of tests performed, higher number of available intensive care beds with respiratory support and higher proportion of positive cases among younger people. This was well supported by Germany's strong health care system.
With the emergence of the second wave of COV- ID-19 in fall 2020, a partial lockdown was re-imposed from November 2 with tightened physical distancing while kindergartens and schools remained open. With an upsurge in positive cases, a complete lockdown was deployed from December 15 to January 10 in the first stage. The lockdown has been extended till February 14 with more restrictions, such as limitation of movement within a radius of 15 kilometres from the place of residence and mandatory use of surgical masks on public transport and in shops.
With the development of vaccines against COV- ID-19, vaccination with the BioNTech–Pfizer has started in Germany from December 26. The front-line workers, health care providers and elderly citizens are receiving the vaccine in the first phase. In our hospital, the vaccination programme was inaugurated on January 5.
By the first quarter of 2021, a combined total of 13 million doses of vaccines from BioNTech–Pfizer and Moderna are expected to be available in Germany.
The federal government has emphasised that vaccination against the coronavirus would be a priority.
This will definitely help in combatting the worst pandemic of our time, as German Chancellor Angela Merkel recently opined that vaccination was a 'big part of the way out of the pandemic'.
Dr Joshi is a senior scientist and assistant profofessor, Neurobiology at Martin-Luther University, Germany
