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“Realistic situation like in northern Italy”

Dusseldorf The corona virus will also kill people in Germany. This is what Professor Hartmut Hengel, medical director at the Institute of Virology at Freiburg University Hospital and President of the Society for Virology (GfV), assumes: “The fact that nobody has died in Germany will very likely change soon. We shouldn’t be kidding ourselves, ”he told the Handelsblatt. “It is quite realistic that we can find ourselves in a situation similar to that in northern Italy.” The mortality rate for Sars-CoV-2 is “definitely higher than for normal flu waves”.

The GfV President can also imagine drastic measures to contain the plague, such as in Italy, where Corona has previously claimed the greatest number of victims across Europe: “We have to make it clear that the measures in the fight against the virus always depend on which phase we are currently spreading. “

Compared to Italy, Germany was “still in an earlier phase”. It depends “on situational reactions. It’s like in war, where there are no always valid rules for tactics and strategies. “

According to Hengel, there were “gaps in Germany in preparation for the corona virus. That is indisputable, but it also belongs to the fateful side effects of every pandemic, which is always a unique event dictated by the respective new virus. ”

Nevertheless, Germany is “still in a controlled situation”. But that could change at any time. “And then it will be important to be able to quickly convey the then changing rules of the game in the fight against the virus to both healthcare professionals and society.”

Read the entire interview here:

Professor Hengel, how do you experience the reactions of the public so far: is sensible caution still dominating or irrational hysteria?
So far, a good pragmatism seems to prevail in the population. But I also perceive little of what is spread on social networks, for example.

They mean the many circulating conspiracy theories – for example, that the corona agent might have escaped from Chinese laboratories in Wuhan. Or even that the virus may have been created by humans with the economic interest of being able to promptly supply the world with the antidote that could be used to make a lot of money.
There seems to be a lot of nonsense on the net, especially. My horizon of experience is limited to the scientific world and classic media. Fortunately, there is still a great, constructive rationality. And we need that in view of the challenges.

Two years ago, over 20,000 people died of classic influenza in Germany alone. So isn’t that much more dangerous than Corona?
Every comparison lags, even if this is obvious. The figures available so far on infected and victims of the current coronavirus Sars-CoV-2 are still preliminary, incomplete and should therefore be treated with caution. But they clearly state that this infection is significantly more serious than normal influenza. This is shown not only by the official figures from Chinese hotspot regions such as Wuhan and Hubei, but also by those that we had to take note of from Italy in the past few days and weeks.

Hartmut Hengel

“We still have a tough fight against Corona.”

The measured mortality rates differ astonishingly …
… which also has to do with detection systems and the availability of virus diagnostics. That differs considerably from state to state. But the mortality rate is definitely higher than with normal flu waves.

In Italy over 5000 infections are already known, more than 200 people died, while there was still no death in Germany. Is our healthcare system better prepared, or was Italy simply unlucky?
The comparison is currently difficult because Germany is still in a much earlier phase of the epidemic. In all likelihood that nobody has yet died in Germany will soon change. We shouldn’t be kidding ourselves. It is quite realistic that we can find ourselves in a situation similar to that in northern Italy.

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And the infection didn’t even break out there, did it?
Right. The spread has so far been relatively limited even there. It is therefore wise that German politicians and those responsible for health protection are now thinking about how to take the expected dynamics out of the epidemic so that our health system does not reach its limits or is even overwhelmed.

It is sometimes criticized that the German healthcare system is already insufficiently prepared for such an epidemic anyway? How do you see that?
Of course there are gaps in the preparation for this epidemic. This is indisputable, but it also belongs to the fateful side effects of every pandemic, which is always a unique event dictated by the respective new virus. It is in the nature of things that these are not precisely predictable and accordingly the correct answers can only be developed in the course of the action. Basic preparation and precaution are extremely important, but they are never possible in detail. You will always find mistakes and gaps, new challenges. That is part of the conflict between society and viruses.

You have already warned that the chain of infection must be broken above all. Does this work?
So far, we have been demonstrably successful in Germany. The resources are still sufficient to meticulously follow the individual infection chains, such as in North Rhine-Westphalia, and to quickly isolate all newly infected people. So we don’t have what we call an endemic circulation. So we are still in a controlled situation.

Can that change?
At any time. And then it will be important to be able to quickly convey the then changing rules of the game in the fight against the virus to both healthcare professionals and society.

What do you mean specifically? For example that, like Italy, we only let football games take place in front of empty ranks?
For example, yes. If football matches still make sense. We have to realize that the measures to be taken to fight the virus always depend on the stage of its spread. And as I said, we are still in an earlier phase than Italy. It depends on situational reactions. It’s like in war, where there are no always valid rules for tactics and strategies. At Corona, too, we always have to react flexibly and intelligently. At the moment, I believe that we can still hold soccer games in Germany in front of a large number of fans. The risk is currently low. But that can change.

North Rhine-Westphalia became the focal point of a single infected person at a carnival event. Was the state lucky that the “fifth season” was almost over by then?
The carnival can intensify such an outbreak, of course. So it was lucky that the virus arrived in Germany relatively late. More importantly, there was no overlap between the influenza season and Corona.

You mean because the “normal” flu is already going down again in spring?
In any case, it would be much more complicated if both viruses circulated at the same time.

Because people could get infected with both?
Because even in Germany the necessary intensive care facilities that make both diseases necessary are limited.

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Wouldn’t we be able to cope with two such attackers at the same time?
That was at least one of the problems in China, where in addition to Corona, the flu also caused a high number of infected people. For us, the influenza season has at least peaked or even exceeded.

They were already drawing parallels to warfare. To what extent are viruses really good as a weapon?
Of course, a few viruses can be used as bio-weapons. The smallpox virus, for example, was used as a weapon in earlier times, for example against the indigenous population in America – and sometimes with terrible “successes”: In combination with measles, the Indian population in North and South America was decimated enormously. But I doubt that viruses developed in the laboratory would automatically be effective bio-weapons.

Why?
Because I think that the naturally occurring viruses, i.e. those developed in nature’s laboratory, simply because of their enormous diversity and biological adaptation, remain the more efficient weapons. A smallpox return would really be the global worst-case scenario.

Aren’t we vaccinated?
After the virus was defeated by vaccination, the general obligation to treat smallpox ceased in the 1970s and 1980s. So today there is no real immunity in the population. Even though smallpox viruses still exist in some countries.

Viruses are not even considered living beings, are they?
Right.

Then what are they? Some kind of software? Blueprints that are only brought to life by a host?
They are specific, ultra-small, cellular parasites that have genetic information and can thus conquer and reprogram cells.

Will viruses survive us humans?
They are something much larger than what we humans usually see in them, namely pathogens that are dangerous but actually completely useless for humans. Only a tiny fraction of them have been researched, especially since many viruses can cause infections, but they cannot cause diseases. If you examine a milliliter of sea water, you can find up to 10 to eight viruses in it. These do not play any role as pathogens for humans, they infect phytoplankton and bacteria, but are therefore extremely important for the entire ecosystem of the planet. It can certainly be said that viruses help to control our global climate, for example because they regulate the climate via the carbon cycles in the sea. Even human DNA consists of eight percent viral sequences.

What is the fascinating thing about viruses for you?
As a doctor, I see it as a potential enemy, as a virologist, an opportunity.

In what way?
Viruses can only reproduce in cells and are therefore extremely knowledgeable there. In this respect you can learn a lot from them about cells, i.e. life itself. If you understand the viruses, you learn the secrets of cell biology, cell metabolism and the immune system.

Is it true that Ebola, for example, is too deadly to be really dangerous – simply because this virus causes death so quickly in newly infected people that it cannot spread far?
In fact, a pathogen that kills its host as often as Ebola is not particularly successful. The virus is optimally adapted to bats. If it infects humans, the virus has actually gone astray. However, the recent Ebola outbreaks in the Congo and West Africa were surprisingly intense and long-lasting. So it could happen at some point due to the continued infection of humans that the Ebola virus adapts itself more and more successfully to humans. That would be fatal.

Are you surprised that the global economy is reacting much more violently to Corona than to the last Sars epidemic almost 20 years ago?
A key reason for this is likely to be that China is now playing a much larger role in the global economy than it did then. A second economic point is that due to advancing globalization, we are more dependent than ever in human history.

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Sounds like the viruses are also the greatest beneficiaries of the credo that the world has become a village.
The dependency of states and societies and thus the exchange of people and goods has increased dramatically. We are almost de-industrialized in some areas in Europe and have outsourced many productions and competencies to China or India. We may get to feel that now.

Speaking of which: Masks, gloves, protective equipment in the fight against Corona are apparently largely imported from the People’s Republic …
… and you can continue to do so for sectors such as medicines or laboratory reagents. We will see if, in case of doubt, Europe can still supply itself if the supply chains break at worst. It will therefore be very important to coordinate and fight the fight against the corona virus internationally. So far, we have not yet considered the probably most vulnerable countries with poorly developed health systems.

Corona briefing

Do you dare to predict what will happen to Sars-CoV-2?
Forecasts are always subject to the admission that errors or misjudgments have to be admitted later. There have also been pandemics that have been much more harmless than we were expecting from experts. But I think that Germany will face a high number of new corona infections. At the same time, we will definitely succeed in containing it. These are successes that we do not immediately recognize as such. It’s like vaccination: if you vaccinate successfully, there is no longer the disease that you were fighting against with the vaccine. The success of prevention is, to a certain extent, invisible and not so easy to explain to society.

Is that the tragedy of the successful virologist?
Yes, infection fighters often have to live with that. You can comfort yourself with a healthy population. But seriously: We still have a tough fight against Corona. I also think that this struggle will drag on for a while until sufficient immunity has built up in the population. The longer we can delay this process, the better. In the end, it will be very exciting for us virologists to see whether this virus can establish itself permanently in the human population.

So far it is not even clear whether someone who survives Corona is immune to it …
… or how long this immunity lasts, exactly.

Sounds like a kind of “sleeper” among the viruses.
This is how you can see it, especially since we have known for a long time that there are at least four other corona viruses that have been with humans for a long time and can infect them multiple times during their entire life.

What was your most dangerous contact with viruses personally?
As a virologist, you are at least safer in the laboratory than anywhere else, because we work with the most dangerous pathogens in the world under the strictest safety conditions. However, when I step onto the street after work, I am as safe or as at risk as any other person. So my private life is much more dangerous than my job.

Professor Hengel, thank you very much for the interview.

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