Corona strategy paper: Efficient testing for the “best case”

In a confidential strategy paper from the Ministry of the Interior, experts go through various scenarios of the pandemic process. As a result, they are pushing for “efficient testing and isolation”.

By Markus Grill and Georg Mascolo NDR / WDR

In the fight against the coronavirus, the Federal Ministry of the Interior is guided by the example of South Korea: the Asian country was able to use mass tests and isolating the sick to greatly slow down the spread of the pathogen without bringing public life to a standstill. The greatest possible increase in test capacities in Germany is therefore “overdue”, according to information from WDR, NDR and “Süddeutscher Zeitung” in a confidential strategy paper from the Ministry of the Interior entitled “How we can get Covid-19 under control”.

The government must work towards a scenario called “quick control” to avert worse consequences for health, the economy and society. By far the most important measure against the virus, according to the experts, is “testing and isolating the infected person”. “Both people with self-suspicion as well as the entire circle of contact persons from positively tested people should be tested”. This does not correspond to current practice in Germany, where according to the Robert Koch Institute (RKI) only people who show symptoms and have had contact with infected people or who belong to a risk group should be tested.

Boost test capacities quickly

The authors of the Interior Ministry paper recommend that the test capacity in Germany should be started up “very quickly”. So they run through a scenario in which the test capacities are to be gradually increased to 200,000 tests a day by the end of April. According to Health Minister Jens Spahn, 300,000 to 500,000 coronavirus tests are currently possible per week. A worst-case scenario can only be averted with significantly increased testing and consistent isolation of infected people, according to the conclusion.

The previous method according to the motto “We are testing to confirm the situation” must therefore be replaced by the approach “We are testing to get to the situation”. In this regard, South Korea is an “impressive” role model. Unlike China, for example, South Korea has not issued any exit bans. Innovative solutions are required for broad-based tests, the strategy paper says.

Cost-effective containment possible for years

In order to protect medical personnel from infected people, citizens should do the necessary throat swab themselves, for example in “drive-ins” or telephone booth test stations. However, this is controversial among experts because even when taking a sample, one often does not get deep enough in the throat.

In order to facilitate the search for contacts by people who tested positive, long-term computer-based solutions and even the “location tracking” of mobile phones should be used. All those who tested positive would have to be isolated, at home or in a quarantine facility. As soon as these procedures have been established, “they can contain the small outbreaks that are likely to flare up again and again relatively inexpensively over several years,” the paper says.

Population must be mobilized

Federal Interior Minister Horst Seehofer commissioned the study from his planning staff on March 18. It was created within a few days with the help of the RKI and other experts, including from foreign universities. In the meantime she is also available to Chancellor Angela Merkel, Defense Minister Annegret Kramp-Karrenbauer and Health Minister Jens Spahn.

From the experts’ point of view, it is crucial for success that the federal government succeeds in mobilizing the population. The paper states that it is therefore necessary to convince people even more than before of the seriousness of the situation and to clear up common misconceptions. It is a misconception that the virus only affects the elderly or is harmless to children.

According to the experts, all citizens should recognize that they too could find themselves in a dramatic situation, for example because critically ill relatives would be turned away from overcrowded hospitals. A “Germany-wide and transparent education and mobilization campaign” was therefore necessary.

“Concealment of worst case not an option”

The authors of the Interior Ministry paper assume significantly higher death rates and critically ill people than the RKI. For example, while the institute assumes that 0.56 percent of those infected will die from the coronavirus in Germany, the Interior Ministry expects 1.2 percent. The scenarios that the paper goes through are correspondingly more serious.

As part of a campaign, the authors want to commit all Germans to the common goal of avoiding a worst-case scenario in which the disease would spread unchecked for months, with many deaths and massive consequences for the economy and society. “In order to mobilize social perseverance, hiding the worst case is not an option,” it says.

It is common for business games of this type that experts go through the worst scenario: In this case, the experts assume that if the virus continues to spread unchecked, i.e. in a scenario without distance rules, without school closings, without home office and without travel restrictions, this may occur in May 80 percent of patients who should actually go to the intensive care unit would be rejected by the hospitals.

After the hammer comes the dance

The most positive scenario, however, that the authors from the Interior Ministry are aiming for is called “Hammer and Dance”. It means that the virus will initially be contained with exit restrictions and school closings, and the number of cases will decrease significantly within six weeks. After this phase of the wooden hammer, for example at the end of the Easter holidays, the “dance” or dance phase could then begin: Kindergartens and schools would open again, the infection would then be checked through intensive testing, tracking contacts and isolation. Social and economic life will then “largely return to normality”, the paper says. In this scenario, the slump in gross domestic product could be limited to around four percent, which is the economic “best case”.

Without the extensive test program, however, scenarios may arise in which the crisis recurs in waves, or in which rapid containment fails and exit restrictions over months are necessary.


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