Wolfgang Hierl is beginning to feel he is losing control. “You sense the avalanche is coming, and you’re standing there with your arms stretched out trying to stop it,” he said.
Mr Hierl is head of the local health authority in Rosenheim, a town in the southern German state of Bavaria that has seen a sharp spike in coronavirus cases in recent weeks. It is typical of a nationwide surge in new infections that has sent alarm bells ringing in Berlin.
That Mr Hierl’s agency is struggling is bad news for Chancellor Angela Merkel. Germany’s 400 local health authorities — the Gesundheitsämter — were the country’s first line of defence during the initial phase of the pandemic, and one of the main reasons why it suffered far fewer Covid-19 deaths than most of its neighbours. That they are now in crisis suggests Germany’s once robust defences against the virus are beginning to crumble.
The health authorities were set up decades ago to stem outbreaks of infectious diseases like measles, and have been engaged in contact-tracing for years. While other countries had to build up their test-and-trace capability from scratch when coronavirus hit, Germany already had all of the necessary infrastructure in place.
Yet with the virus now spreading at an alarming rate, the health authorities are coming under unprecedented strain.
Steffen Seibert, Ms Merkel’s spokesman, described the situation in the starkest of terms on Monday: there had been a “drastic increase” in new infections, the proportion of cases among the elderly population was growing, and hospitals and intensive care wards were filling up with Covid-19 patients. “In many communities it is no longer possible to do proper contact-tracing,” he said. “The infection numbers are just too high.”
As a result, some city governments are radically changing their strategies. Officials in Berlin, one of the worst coronavirus hotspots in the country, said last week that they would now leave it up to infected individuals to self-isolate and inform all those they had come into contact with to get tested — the job that used to lie with the health authorities.
“We are putting more emphasis on individual responsibility,” said Dilek Kalayci, Berlin’s minister for health. Contact-tracing would now be reserved for risk groups such as hospital patients and residents of care homes, or the homeless, she said.
Nicolai Savaskan, head of the health authority in Berlin’s southern district of Neukölln, said individual contact-tracing had worked in March and April when the pandemic had only just broken out in Germany.
“But such detailed detective work is not really suited to a situation where the source of the infection is diffuse and spread over a large area,” he said. “Containment is still a core element of our strategy, but we can no longer be so granular in our contact-tracing.”
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René Gottschalk, head of the health authority in Frankfurt, said he was taking a similar tack. His agency is now focusing on infected people who live with elderly relatives or sick partners, and ignoring outbreaks of the virus in young families, where it rarely leads to Covid-19. “Contact-tracing to the full extent is no longer possible,” he told ZDF TV last week.
Just a day after Mr Gottschalk appeared on TV, Germany reported 14,714 new infections — a daily record. On Tuesday, economy minister Peter Altmaier said he expected that figure to rise to 20,000 by the end of the week, warning that Germany was seeing “exponential growth” in cases. New infections were rising by 70-75 per cent compared with a week ago, he said.
Mr Altmaier’s comments came ahead of a critical video conference between Ms Merkel and the heads of Germany’s 16 states on Wednesday that is expected to result in tough new restrictions on public life.
Rosenheim, close to the Austrian border, has been particularly hard hit by the uptick in coronavirus case numbers. Mr Hierl said the Bavarian government had seconded soldiers, policemen and students to work as contact-tracers in Rosenheim’s health authority.
But despite the back-up, “we’re really reaching our limits”, he said. Staff who had been fighting the pandemic for more than eight months now “are complaining of exhaustion and over-work”. His staff were finding it increasingly difficult to ring up all an infected person’s contacts on the same or the next day, and if cases continued to rise unchecked, “we will be forced to change our strategy”, he added.
One option would be, he said, to move from containment to protection. That would mean focusing on the “shielding of vulnerable population groups, like care-home residents, hospital patients and asylum-seekers living in crowded hostels — all places that are at risk of super-spreading events”.
For Mr Hierl, the situation in Rosenheim now bears an uncanny resemblance to the emergency in March, “when we saw the number of daily corona cases in the town rise from 10 to 153 in 10 days”. So far, he is still hoping he can “stop the avalanche”. “My big worry, though, is that it will just crush us,” he said.