Thus a small town in West Germany became a huge field of experiments for corona sciences

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Carnival: The first to discover the loss of sense of taste

Prof. Hendrik Strik was the first virologist to identify the loss of sense of smell and taste as one of the main symptoms of corona virus. It was early March, when he and a team of nearly 40 doctors and students from the University of Bonn “landed” on the small town of Ganglet in Heinzberg County in the west of the country, to scrutinize what became Corona’s biggest outbreak in the country.

Prof. Strick / Photo: PR

They raided residents’ homes, examined patients and their families, took samples from toilets, drinking glasses and door handles, interviewed and monitored for symptoms and severity and examined the chances of infection in various public places.

To this day, the “Heinzberg Protocol” formulated and published in a scientific paper remains one of the most in-depth and thorough descriptions of the deceptive dynamics of the way the corona virus spreads.

They found, surprisingly, that spouses’ risk of becoming infected in the same home is less than 50%, but that it increases with the presence of children; They found that many of the patients were not contagious at all, but also pointed to the mass events – in the case of Heinzberg it was a compound where the traditional carnival was celebrated during February – as the most significant vector of the plague. Some of the lessons from Heinzberg, which have since been verified in other studies, are at the heart of the government policies of Germany and other countries.

Prof. Strick, 43, a boyish-looking man who heads the Institute of Infectious Diseases at the University of Bonn and has become an official adviser to the North Rhine-Westphalia government, has become a familiar face throughout Germany. In a special interview with “Globes”, Strick says that humanity must reduce the level of anxiety about the virus.

He says he is surprised by the rapid jump in the number of cases in Israel and Spain after the closure is lifted, but measures such as eliminating mass incidents and maintaining basic hygiene and using masks can reduce not only the spread but also the lethality of the virus.

“It’s not just if you get infected, but also how you get infected,” he explains to Globes. As a professor of virology who has been dealing with AIDS for years, Strick casts some doubt on the ability to develop vaccines, saying that it is not worth basing all government policies on waiting for a vaccine.

He also explains the follow-up study in Heinzberg where he is starting these days with his team, to see what happens in the fall in the area – whether those who have been ill in the past will be vaccinated or have a mild illness, and if, he speculates, one in six people will be infected. Lower wave of morbidity. “The findings could be significant for Israel,” he says, “because you have a jump in the number of cases in the summer.”

Distribution: One bartender armed with a whistle

The strike refers to an increase in the number of corona cases in recent weeks in Israel and Spain.

“First,” he says, “I have to make a reservation and say that it is difficult for me to judge what is happening in other countries. If I am not in the place myself and see how things are going, it is difficult to express an established opinion. Sometimes in epidemiology, what makes the difference is local culture. , The way they are in contact with each other.These things may be incomprehensible to those who are not there.

“But I must say I was a bit surprised by the rapid jump in the number of infections in countries like Israel or Spain after the closure was lifted. In Germany, and it may be completely different from your situation, we see a link between the corona and the weather and season. “Even in the fall, compared to summer. The virus does not go away, the spread does not stop completely, but we experience a decrease during the summer. We believe it is due to the heat itself – the virus is less stable in aerosols in hot air – and at the same time we tend to be more distant from each other in summer.”

Strick testifies that in Germany, for example, “We do not sit together in closed rooms with bad air but go out, where there is more space and there is ventilation and circulation. Both of these factors lower the risk of infection. I am a little surprised that this does not happen in Spain and Israel, for example. It may be related to the use of air conditioning or to reasons we do not know or experience here. ”

I point out to Strik that one of the explanations for the outbreak in Israel is that many weddings participating after the closure are responsible for the outbreak. To this he replies: “It could be. Mass events are very critical in this epidemic. In Germany and around the world we talk a lot about the coefficient of infection, R – how many people on average one person is infected. But another very important epidemiological factor that should not be ignored, especially regarding For Corona, it promotes the K – ‘cluster effect’.

“We know that this specific virus has a very high K coefficient. It is not that every patient infects three people or even one, but that out of nine people diagnosed, eight of them do not infect anyone – and only one patient infects ten others. We call these patients super-distributors. (Super Spreaders), and we do not quite know what makes a particular patient such. In any case, this is why mass gatherings create a high risk of creating larger hotspots. If a super-distributor is found in the event, the event may become a ‘super-distribution event’, That could lead to hundreds of infections. ”

Strick gives as an example the incident that took place at a bar at the Ischgl ski resort in Austria. “According to the information, one bartender caught up with hundreds of people during one evening of a stay in a closed space, where a skiers’ party was held. In this case, the bartender apparently went with a whistle, and walked around the bar whistling at it, effectively spreading the sticky aerosols throughout the club.” .

A similar case apparently occurred in Germany. “At the Heinzberg Carnival there was no doubt that there was a super-distribution event,” says Strick. “During the festivities, 44% of people who visited the closed carnival complex were infected in Corona. It is close to 200 people who were all infected in one event. We assume there was one super-distributor. “Or some super-distributors. So far we have not been able to identify where the virus came from.”

Internalization: The virus is a part of our lives right now

Ostensibly, one of the solutions from the study is that major events should be avoided all over the world. According to Strick, “it will undoubtedly reduce large outbreaks. Crowds are perhaps the most significant foci for the spread of this disease.” But he explains that this is not really possible.
“What makes people human is the need to be together and alongside other people. This is especially true at prayers, birthdays or funerals. These are situations where you want to be close, show affection, embrace each other. You want to be socially interacted. Of course there are gatherings too. “Necessities like work or public transport. On the one hand we want to maintain our health, so we must reduce large crowds, but on the other hand we can not lose and give up what defines us as people.”

Thus, Strick believes that one should “live alongside the virus,” and that the way to do so is first and foremost in recognizing the true state of affairs. “We just have to accept the fact that the corona virus is here now and has become a part of our lives. Maybe science will change that in the future (using a vaccine – AA), but we can not be sure. We need to change our attitude and look at this plague in a different way, more calm and with a little less fear. It is important to see that most infections are asymptomatic. In Heinzberg about 20% of the cases were asymptomatic, elsewhere the rate is much higher. We must realize that not everyone who is ill is in danger of death. ”

Math: Those who are close to the focus will get sick harder

What, then, is the right recipe for living with the virus? According to Strick, “We know based on the basic principles of hygiene medicine, according to the situation regarding other respiratory viruses and in fact of almost any other virus, that the size of the viral infection that makes us ill significantly affects the severity of the disease and symptoms. This is true for bacteria. It is possible that the bacterial threshold in the water will rise above a certain threshold, because otherwise you will be sick, but if it is below that threshold, you will be fine.

“We saw in Heinzberg, for example, that those who were in the carnival tent experienced more severe symptoms than those who were not in the carnival. People became infected in different places, but those who stayed indoors experienced more severe illness. At the same time, the longer the patient spent in the tent, the more severe symptoms. “This understanding gives us a tool to try and control the spread of the plague, but also to keep our lives as normal as possible.”

The idea that the trick is talking about is to reduce exposure to the virus. “What we do when we wear masks, when we keep our distance and wash our hands frequently – is to reduce the potential for the viral load we are exposed to, even when we are near a patient. Even taking a step back when talking to someone lowers the viral load to be exposed to it. “So, even if you are infected, hypothetically, the chances of you experiencing asymptomatic infection increase. In my opinion, basic hygiene measures – mask, distance, hand washing and general hygiene – are the best way to control the spread of the epidemic, along with preventing mass events.”

It seems to be supported by data from the last few months, doesn’t it? There are more corona cases, but fewer deaths.

“It’s still speculative at this point, but I think people have become aware of the virus and have adopted the hygienic restrictions that help fight the epidemic. “And in the number of deaths in the summer. At the same time, the care of the patients has become better, they know better how to improve their condition and save lives.”

Regarding the prospect of a vaccine, Strick says that “as someone who comes from an AIDS vaccine field, and as someone who is aware that there are no ‘super-killer’ vaccines in the field of infectious diseases such as tuberculosis, malaria, dengue and more – we can not say that vaccination is only a matter of time. There are some encouraging signs for the possibility of a vaccine, but it is not safe and it is not worthwhile to base government policy on the assumption that a vaccine will arrive sometime. ”

Optimism: Autumn in Israel may be less terrible

“It’s true that we are following this epidemic as closely as we have ever done in history, and sometimes we pay too much attention to the virus,” says Strick. “Another thing I regret is how much the issue has become political. The virus is a virus, it has nothing to do with politics. It is important that we understand that science is on the beneficial side, and we will not throw political controversies at it.”

These days, Prof. Strik and his team are starting a follow-up study in Heinzberg. “Currently, we do not know 100% whether those who become infected and recover are vaccinated against the virus, or whether there is a risk that they will be re-infected, and how. This is a particularly important question ahead of the fall, when an increase in the number of cases is expected.

What we are going to check is the situation in Heinzberg, and specifically in the town of Ganglet where 15% of the residents are already infected. We regularly check the level of antibodies among those who have recovered, conduct regular tests and see what happens there in the fall. Our hypothesis is that there will be a lower spread relative to other places. This is a question that will be very relevant to Israel, for example. “If you have a large number of people who have contracted the disease in recent months, it is possible that in the autumn you will have a slower spread than countries that are well protected against infection.”

A trick also refers to the way it protects itself from infection. “I follow the basic rules. I think in all of Germany, I am the doctor who met with the most Corona patients. I visited them at home, spent hours with some of them, and did not get infected. We just talked about it within the team, we were all long days in Heinzberg but none of us , And it is about 40 people, not infected.

“You have to follow the rules – keep your distance, put on a mask if you are close to someone, be in the open air whenever possible. You can protect yourself, it’s not really hard. Just live life. You can not be afraid of this virus all your life.”

“Heinzberg Protocol” – Research Finds from the Carnival in the town of Ganglet in Heinzberg

1,007 are tested in the town of Ganglet in the province of Heinzberg

15.5% of the subjects in the town were in Corona

Only 3% were detected in real time

7 deaths were recorded in the town

22% of patients had no symptoms

The risk of getting infected by those who participated in the original carnival – was twice as great

Those who became infected during the carnival experienced more severe symptoms

Spouse risk of infection:

If there were no children in the same house – 44%

If there were children in the same house -66%

Medical staff:

40 medical staff raided the town – 0 became infected

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