Science

In Germany, a year of vaccination against Covid: “The pandemic will not end in 2022”

With more than a million doses injected per day, just before the Christmas period, or around 12 people per second, the withdrawal campaign against Covid-19 is underway in Germany. As in France or anywhere else on the planet, and despite a year of vaccination, the appearance of new variants (Delta, Omicron …) has pushed back the hope of returning to the “old life”. And he invoked this need to “boost” immunity. The similarities between Germany and France go further. Since the onset of the disease in the spring of 2020, our neighbors have ordered all their serums through the European Union and have strictly followed the recommendations of the European Medicines Agency before injecting them.

However, the differences between the two countries are also significant. Less affected by the different waves since the beginning of the epidemic, Germany has recently suffered a very strong epidemic outbreak, with records of contamination and deaths as a result. Then, distrust of vaccines intensified, to the point of becoming one of the most important in Western Europe. Today Germany is still struggling to convince new people to get vaccinated with an injection. The gaze of the professor at the University of Göttingen, Matthias Klumpp, an expert in pharmaceutical logistics and health services management, a keen observer of this long vaccination campaign.

L’Express: Since your designated start on December 26, has vaccination been a success in Germany?

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Matthias Klumpp: The vaccination campaign was quite good. However, I think we had two main problems. The first is that we got off to a relatively slow start. We started in December, but we didn’t reach a high number of injections until about four months later, around April, in line with the start of the vaccination centers. A bit like in France, after all. The second problem is that after August 2021, the injection rate dropped significantly. There was mistrust. But above all, the vaccination centers were closed.

As for the retreats, which took place a little later, it is a real success. Since October, more than 35% of the population already twice vaccinated has received a booster. Germans see the need, due to a very strong fourth wave of Covid. We all have a friend, a relative who this time contracted the disease. Therefore, the motivation increased. However, we have learned “the hard way”.

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What were your fears before the start of vaccination in Germany?

I expected this rather slow start for logistical reasons, the storage conditions of the sera were special and some required cold. And that’s what happened then. My second fear was that we did not reach enough people. But there, it was not a logistics problem, just trust. A problem that also affects all German speakers, because the doubt about the vaccine is also strong in Austria and Switzerland.

The phenomenon seems surprising, seen from France, where interest in vaccination was very low before the start of the campaign. At present, France is slightly ahead of the number of vaccinated in proportion (76% of the immunized population, compared to 70 in Germany).

How do you say. One would have thought that Germany is achieving high levels of vaccination. The phenomenon remains difficult to understand, given that we have not faced similar health problems in the past. I would try to explain this by the loss of confidence in the government in recent years and in politicians in general. The vaccination campaign was primarily politically driven, which I fully understand given the speed at which this crisis has emerged. Subsequently, it would have been good to entrust more attention to doctors and health experts. Everyone still believes in their doctor. At least I hope so. The arrival of the new government is perhaps an opportunity to convince the latest dissidents. If we eliminate the people who cannot be vaccinated, those who have been cured for less than six months, there is still between 15 and 20% of the population to be searched.

How do you see next year? With new vaccines? New logistics needs in the face of the pandemic?

Either way, we have to use whatever tools we have on hand. Right now they are the drivers. In fact, tomorrow there will be new vaccines specially developed against variants like Omicron. The most important message in my opinion is to inform the population, to make it clear that the fight continues. The pandemic will not end in the spring of 2022. The variant will mutate over and over again.

Like the flu, Covid is here for a long time.

Therefore, we must develop a vaccination system, as in the case of the flu. In Germany, 23% of people are vaccinated every year against this disease, especially the elderly. We can adapt to make a dose against Covid-19, every year, to avoid closures and waves as we have seen. Logistics will be very important, by the way, politicians may not have understood all.

We need to decentralize. Recently, the new Minister of Health ordered another 20 million doses. One person is responsible for replenishment for the whole of Germany, this is not sustainable. Another problem: we store vaccines at our military facilities. That is not sustainable either. Even at the European level, finally, it is the Commission alone that negotiates with the laboratories. Faced with this challenge, in the long term, we have to be much more flexible. The centralization of decisions was logical at the beginning of the crisis, in the urgency, now it is necessary to evolve.

What lessons have you learned after a year of vaccination?

Despite the doubts, we are not far behind in terms of vaccination coverage, vaccine production, distribution. But we can see it in the UK, or elsewhere, this tool, even if it represents our main hope, is not enough. In Germany, 70% of the population is vaccinated, which did not prevent the highest peak of contamination from occurring.

Our high mobility index continues to be our great vulnerability.

The test was brought to us again by the Omicron variant, which came so quickly from South Africa. Our foundations today, namely our freedom of movement, our tourism, our international trade, make us vulnerable. Therefore, we must develop better surveillance systems to counter the virus and become even more aware that it is a global problem.

Two points will define our future: will we be able to vaccinate the entire world? Less than 15% of people on the African continent, for example, have received at least one dose. Can we make vaccines available? In our logistics research, we are currently trying to figure out how to bring serum production closer to the countries that need it most. We should be able to get production back in a few weeks in a country, like South Africa, recently a victim of Omicron. Then distribute it more quickly, in specific regions. Contracts between the European Commission and laboratories should normally allow this, without necessarily implying the lifting of patents.

Our responsibility is great in Europe, especially towards those who cannot benefit from the vaccine. It is a pity in Germany that we can vaccinate strongly and that some do not want it while, in other countries, many people do not have the means to obtain it. German public opinion is beginning to scold for this. I conducted a study (pre-printed, not yet peer-reviewed) on this topic: policy approaches and decisions that favor higher levels of redistribution would be supported by public opinion in the country.

Rationality, pragmatism, efficiency … Germany seemed quite efficient for several months, before going through difficult times. How can you become an example again in the fight against Covid-19?

When you look back, you realize that there was no good long-term strategy. When the vaccination was launched, we observed with admiration Israel, the United Kingdom, who were moving very fast in this area. In Germany, we are glad that we had some waves without straining our hospital system and without limiting the number of deaths compared to our European neighbors. Then Israel also went through difficult times, as did the United Kingdom. So do we, finally, during our fourth wave. The pandemic is changing so rapidly that it must constantly adapt, every week, every month. Create insecurity, that’s for sure. Omicron was seen four weeks ago, the wave is already upon us. It is impossible to know what will happen in three months.

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This insecurity also feeds the extremes, the fake news … And finally, it feeds this mistrust that penalizes Germany in terms of vaccination.

A member of parliament from the far-right anti-restraint and anti-vaccine AfD party, Bernd Grimmer, recently died from Covid. I think something is happening. In Germany, little by little we are noticing that extreme and populist positions are helping even less in the face of the epidemic. That its positioning is the deadliest possible. One of the most obvious examples to me is the case of the new Health Minister, the epidemiologist Karl Lauterbach. The man stood out on televisions, in the media, for his analysis of the epidemic, but also for a particular style, alternating alarmist views on the handling of the epidemic and affirming his desire to make vaccination mandatory. You would have thought it was annoying, that it was breaking up. And yet his popularity is enormous when he takes office. We understand that facts, rigorous science, are the best ways to help people.

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