widthHe recently read in Bild that it sounds like liberation to many people. With these words, the end of the long-awaited coronavirus measures does not seem to be far away: “Finally,” the incidence rate should no longer be a measure of everything. The number of new infections registered per 100,000 inhabitants in Germany determines whether children are allowed to go to school and restaurants are allowed to serve guests, which recently dropped below 10. The Federal Emergency Brake is closely linked to them. Is it over now? The daily newspaper cited an internal document from the Robert Koch Institute (RKI): the number of Covid patients admitted to hospital as a further leading indicator.
The Ministry of Health immediately stated: This will not change the political strategy-morbidity is still an important parameter. If the government is now expanding its view of the situation in hospitals, it is adapting to experts who have been calling for months to consider as many data points as possible in the fight against the pandemic—rather than linking everything to one value. For many people, this is not enough. Even after more than a year of pandemic, this country even needs to put in a lot of effort to record the number of patients in hospitals.
In order to evaluate the usefulness of certain data, you must first be clear about what you are actually pursuing. For example, if you want to minimize the risk of transmission of coronavirus mutants, you must keep the absolute number of infections low. The fewer people who should be infected, the better. Morbidity can help here, it provides information about the course of infection-but the quality of the data is also important. One problem is that there is a certain delay in health authorities reporting the number of infections to RKI, especially on weekends. The German Statistical Working Group stated that this led to a systematic underestimation of the current 7-day incidence rate. In addition, there is an unreported number behind the incidence rate-undetectable infected persons with weak or no symptoms have been missed. The number of unreported cases can only be answered by testing a representative sample of the population. There is such a project in the UK. This is what German statisticians have been calling for for months. They did not get a reply.
The paradox of corona measures
Another goal in the fight against the pandemic is to protect hospitals from being overburdened. This is the reason why most corona measures are taken in Germany. This is contradictory: the measure depends on the incidence, however, it hardly fits this goal. The number of new infections can point to possible trends in the population, but it is decoupled from the disease process. There are two reasons.
First, the rate of occurrence depends on the detection strategy. When you test young people, such as high school students, the incidence rate rises, but the hospital has little change. This problem can be partially solved by understanding the reason for the test. For months, scientists have been calling for this in vain. If the test result is positive, the emergency solution will be to provide at least information about the symptoms. What will happen to the health system in the next few days can be estimated from the number of people with symptoms. But this is where bureaucracy fails: Although the registration form provides a field for symptom information, that information is missing every four reports to RKI.
The second reason for the decoupling of morbidity and disease is the vaccination campaign. High-risk groups that were once highly endangered, that is, people over 80 years of age or severely ill, are now basically vaccinated to protect them from serious diseases. Therefore, even if the incidence is high, they will not go to the hospital as often as last year.
