In Europe there is growing concern about access to doses of vaccines during the winter wave of Covid-19. But one city claims to have found a formula to prevent high mortality without a draconian blockade.
The southern German city of Tübingen was hit hard by the virus in the spring, but measures such as widely available evidence and even subsidizing taxi rides have managed to protect the elderly, who make up the majority of fatalities. .
At the height of the first wave of April, the city had 70 Covid-19 patients at its largest hospital – 89,000 – including 33 in intensive care, forcing doctors to cancel the elective surgery. Now, at the peak of the current rise, patients are only 35, many transferred from other regions. Fifteen of them are in intensive care, of which less than half are residents of Tübingen. The hospital has not canceled the non-urgent surgery.
Local authorities say these figures are not accidental. The city, they point out, began before most German municipalities to conduct frequent Covid-19 tests on nursing home staff, residents, and visitors. It subsidizes taxi travel for people over 65, so they don’t have to use public transportation. Younger residents are advised not to buy between 9 a.m. and 11 a.m. to prevent older people from having to mingle with people more likely to carry the virus without symptoms.
Tübingen’s pandemic policy has so far cost him half a million euros, all financed through the city’s budget. A week of the current closure, with restaurants and non-essential shops closed, costs the German economy and the state between 27 billion and 57 billion euros in loss of production and subsidies, according to estimates by the Ifo Institute, an economy funded by the tank government in Munich.
Tübingen, like other cities in Germany, is under a national closure announced earlier this month.
Photo:
Sebastian Gollnow / Zuma Press
On Wednesday last week, Germany recorded 32,195 infections in one day, close to its record, according to the Robert Koch Institute of Infectious Diseases. The previous day it had recorded 962 deaths, the highest number recorded in a single day.
Although the country suffered far fewer Covid-19-related deaths than most of its neighbors in the spring, it had more fatalities relative to its population than France and Spain in the past 14 days, and close to the level of the United Kingdom. care units across Germany are working hard, forcing authorities to transport serious cases to less affected hospitals across the country. More than half of the people in Germany who die of coronavirus are residents of nursing homes.
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Not so in Tübingen. Although the average incidence of infections among the general population is similar to that of neighboring regions, infection rates in the elderly are drastically lower. By mid-December, only 10% of those infected during the fall hike were over 65, compared to 23% nationwide, according to authorities. As a result, mortality in the city is low. Since the onset of the pandemic, only 33 people have died of Covid-19 at Tübingen University Hospital, which treats most coronavirus patients in the city. According to a county spokeswoman, only two people have died from the virus in nursing homes since the spring, a sharp drop in the 26 residents who succumbed to Covid-19 during the early months of the pandemic.
City authorities say they did not report any outbreaks in nursing homes between May and early December, when some of the facilities reported several infections. Under the testing program, which is mandatory for nursing homes in the municipality, staff and residents must be tested twice a week and all visitors undergo testing before entering the venue. Although all care homes receive free test kits from local authorities, some privately run institutions do not adhere to the test recommendations, city officials said, explaining the recent outbreaks.
Local doctor Lisa Federle takes a nasal swab sample from a patient who has arrived.
Photo:
Thomas Niedermueller / Getty Images
In addition, the mobile units offer free trials in all the main squares of the city. Looking ahead to Christmas, hundreds of people used the service before visiting old friends and family at nursing homes or celebrating the holidays together, according to Lisa Federle, an emergency physician and head of the local Red Cross chapter.
Dr. Federle pioneered the testing program in early April and has since been testing people in the main square with a group of volunteers funded primarily with donations. On Wednesday, she and her team tested 500 people and 600 more on Thursday. In October, Dr. Federle received Germany’s highest civilian honor, the Federal Cross of Merit. His initiative has inspired city authorities to offer free mass trials to residents.
“The most important thing is to protect vulnerable groups as much as possible, and testing everyone is the best tool for that,” Dr. Federle. “I have grandchildren who want to do tests to spend Christmas with grandparents or people who want to help seniors with their Christmas shopping.”
The tests offered by Dr. Federle and the township are rapid antigen tests that can provide results within 15 minutes. Then, each positive case is confirmed with the so-called PCR, a more sensitive test that provides a result after several hours.
Boris Palmer, mayor of Tübingen, said his city was the first in Germany to offer free trials for everyone in September. He was also the first to offer complementary N95 masks to all citizens aged 65 and over in early November, a move that was later imitated by the federal government.
Tübingen Mayor Boris Palmer, who said orange, said the city’s approach had inspired other communities across Germany.
Photo:
Tom Weller / Zuma Press
In addition, as the fall of the fall in new cases progressed, increasing the testing capacity throughout Germany, Tübingen ignored federal guidelines for testing only people with symptoms. As a result, more than 40 asymptomatic cases were discovered in care homes, Palmer said, each of which could have planted an outbreak if they had not been detected early.
“Periodic tests in nursing homes prevented several outbreaks: we discovered people (especially staff) who were in an early stage of infection and therefore prevented them from transmitting the disease to the elderly,” said Palmer.
Tübingen’s efforts have inspired other cities across Germany, including 120 cities and towns in his home state, Baden-Württemberg, but Palmer said more could be done nationally. However, some affected communities in the east do not have the funding available for relatively affluent Tübingen. In addition, the 16 German federal states and even cities and municipalities have a high degree of autonomy in health policy and coordinating efforts during the pandemic has proved to be a challenge.
Michael Bamberg, head of Tübingen University Hospital, which has ordered all front-line staff and patients to be tested twice a week, noted data showing that 88% of people who die from disease in the region are over 70 years old.
“If we had applied intense testing and distributed N95 masks across the country long before,” he said, “we wouldn’t have needed this lock.”
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