Sunday, April 26, 2020

Freedom Is the Comprehension of Necessity

Freiheit ist Einsicht in die Notwendigkeit” is a sentence from the preface of Georg Wilhelm Friedrich Hegel‘s ”Basics of the philosophy of law”. Here is the German text of ”Grundlinien der Philosophie des Rechts” tltr;.

The title of this blog is a common thread in the recent developments of the Corona pandemic in Germany.


Science and Reason


Despise just reason and science,
Man's* supreme gifts -
Then you have submitted to the devil
And you must perish.
*N.B. Other genders are included
Verachte nur Verstand und Wissenschaft,
des Menschen allerhöchste Gaben –
so hast dem Teufel dich ergeben
und mußt zugrunde gehn.


While in the initial phase of the fight against Corona Mephisto’s warning in Goethe’s Faust was the guiding principle, we are now entering a critical period of impatience and protest. The reason is that in Germany, due to the known and applied protective measures, the number of active Corona cases was on the decline and is now constant at about 2,000 per day.


Excessive Fascisization of Civil Life


The photo reminds me of Schiller’s Song of the Bell:
Dann werden Weiber zu Hyänen (Then women turn into hyenas).
This led to a „Hygienedemo“ in Berlin where the left and right-wingers along with religious zealots gathered in front of the Volksbühne to protest against the hygienic restrictions that are still in place.

Naturally, these people came in close contact with each other and the police. For them, the Coronavirus causes a "comparatively mild wave of infection," which in no way justifies a "de facto dictatorial emergency regime" and the "excessive fascisization of civil life." According to the protesters, the restrictions are being fired by a "conspiracy of global corporations" behind the measures.


Öffnungsdiskussionsorgien


Although the demonstration illustrated above is somehow unique, the cautious opening of public life last Monday has led to Öffnungsdiskussionsorgien (discussion orgies about opening measures). This new word coined by our chancellor has a great chance of becoming Germany’s word of the year. Angela Merkel, being a physicist, actually noticed that the interpretation of the opening rules agreed upon by the Federal Government and the German States twelve days ago went overboard.

The chancellor warned that Germany was on "the thinnest ice" and implementations of the rules “worry me ... they appear to be very bold, maybe too bold."

In fact, the country is loosening more and more. Even shopping malls are opening because every shop by itself is smaller than 800 square meters. The administrative court of Hamburg completely overturned the rule that only small shops are allowed to reopen. However, the basic idea behind the practice is to limit the density of people in shopping districts.


Who Needs a New T-shirt?


But there is deception on the other side, too. Instead of the expected rush of buyers in German cities last Monday, their number remained small. Some people are afraid to leave their houses because of the Coronavirus. In contrast, others don’t patronize shops because they are working reduced hours and keep and need their Kurzarbeitergeld (reduced-work compensation, i.e., 60% of their recent salary) for food and lodging. For many persons das Hemd ist näher als der Rock (Near is my shirt, but nearer is my skin or better Charity begins at home).

Who needs a new T-shirt or is looking for a new car? On the other hand, there is a boom in do-it-yourself and - in some sort of bunker mentality - deep freezers.


It Is a Marathon, Not a Sprint


This is a statement by Hong Kong epidemiologist Gabriel Leung referring to the fight against the virus while Governor Armin Laschet of North Rhine-Westphalia demands further relaxation in the hygienic restrictions.

Nobody really listens to Germany's leading virologists anymore. Berlin’s Christian Drosten said, "I very much regret to see these days that we are just about to completely lose our lead."

Virologist Melanie Brinkmann from the Helmholtz Centre in Braunschweig warns, "We will get a second wave of infection even more severe than this one because it will take place all over Germany and be less localized, as was the case with the first wave."

Listening to people who know something about the subject is out of fashion. How all this will turn out remains to be seen.


The Numbers


Click on the graphic to enlarge
Here are Germany’s total Corona cases (orange), the actual cases (red), as well as the number of recovered patients (green) as a function of time. The death toll is presented in black.


Although the number of people actually infected is decreasing, the criterion of whether a pandemic is under control is the reproduction rate R, i.e., how many persons one person afflicted with Covid-19 is likely to infect. If this figure is kept below one, the number of infected people will decrease with time.

Click on the graphic to enlarge.
Here are the most relevant parameters for Germany in the form of a table. From left to right: known infection cases, their daily increase in percent, doubling time of cases in days (flattening of the curve), reproduction rate, the total number of deaths, and deaths as a percentage of known cases.

Another significant value is the incidence rate IR. The average IR for Germany is 137 per 100,000 people. The highest values are found for the districts of Tirschenreuth in Bavaria and Heinsberg in North Rhine-Westphalia with incidence rates of 1,513 and 680, respectively. In the first district, a carnival session, and in the other district, the mid-lent strong-beer fest was at the origin of a significant infection cluster. This shows that alcohol-driven Volksfests are the ideal breeding grounds for SARS-CoV-2, a fact that finally led to the cancellation of “the” Oktoberfest this year.


Freiburg


Presently, the city of Freiburg has an incidence rate of 401 cases per 100,000 inhabitants. Here the Wine Festival (July 1-6), the Tent Music Festival (July 15 - August 2), and the Schlossbergfest (July 30 - August 2) will not take place on the planned dates.

The city of Freiburg is also putting its 900th-anniversary jubilee on ice. It is suspended until September 2020. Lord Mayor Martin Horn has proposed to the city council an extension of the anniversary until spring 2021. He said. "The Corona crisis is also a bitter setback for our anniversary. Now we want to replace the celebration with cohesion, solidarity, and creativity."


Mund-Nasen-Bedeckung (MNB)


This morning: An Antonov-124 unloads 9.6 tons of masks "Made in China" at Leipzig airport
The term „mouth nose cover“ was proposed by the Robert-Koch Institute to make a clear distinction between professional masks and Volksmasken.


Red Baron had promised not to take any more selfies. But a correction is necessary, so here is my acquisition of a sturdier mouth nose cover made of paper.

From Monday on, the wearing of MNBs is compulsory in shops and public transport all over Germany.

In an empty streetcar
Although experts keep telling us that MNBs only assure limited protection, it is an astonishing fact that since the city of Jena issued its order for wearing MNBs in public places already three weeks ago, no new Corona infection has been registered.


Presently this is my only mask made from fabric, although I ordered more of those fashionable accessories likely to arrive next week.


Denn für dieses Leben ist der Mensch nicht schlau genug


Some people still don’t comprehend the necessity of strict measures while Corona is roaming. As a reminder, they should read the statement of a lung specialist working on Corona patients in a German clinic, ”I can imagine how hard it is to make political decisions in a situation like this. It is too easy to look back and say this, that, and the other could have been done better. But honestly? I didn't have a better idea, either. Right now, we have the situation well in hand, and that is what counts.”

N.B.: In 1928, Bertold Brecht wrote the "Song about the Inadequacy of Human Planning" with the line, "For this life man* isn't clever enough."
*Other genders are included

Thursday, April 16, 2020

Caution Is the Mother of Wisdom

This is a German proverb although it is mostly used in its colloquial form, “Vorsicht ist die Mutter der Porzellankiste" (the case filled with chinaware, n.b. that’s no pun on China).

This proverb was the motto of the opening of the Corona lockdown in a toddling pace in Germany. Yesterday, the following easing measures were agreed upon and announced by the federal government and the governors of Germany’s states.

On Monday, April 20, some shops will be allowed to reopen, although only those with a surface of less than 800 square meters* provided the necessary protections are in place to enable strict physical distancing (1.5 meters minimum).
*8600 square feet

From left to right: Bavaria’s governor, Ministerpräsident Markus Söder,
Chancellor Angela Merkel, Hamburg’s governor, Erster Bügermeister Peter Tschentscher,
 Vice Chancellor and Federal Minister of Finances Olaf Scholz.
In the background government spokesman Steffen Seibert (©Bundesregierung/Steins).
The NYT observed: Highlighting a broad consensus, the chancellor was flanked at her hourlong news conference not just by her finance minister, but also by the governor of Bavaria and the mayor of Hamburg.

While in the past, the media had often rebuked the patchwork rug of rules due to our federal structure, this time, Markus Söder emphasized its strength of federalism. The Corona situation varies in different parts of Germany*and above all the cultural sovereignty is with the states, n.b., education.
*It is rather bad in Bavaria partly caused by a crowded strong-beer festival in Tirschenreuth in March

So the timing is up to the governors when schools will open step by step in their states. Older students might be allowed back to school as early as April 27, although in a radically changed setup involving small groups, face masks, and physical distancing in school buses.

Germany will cautiously start its Gratwanderung (balancing act) of easing the lockdown. Although the number of new infections is decreasing, it is a dangerous path, for we are still in phase 2 of the epidemic, i.e., mitigating the spread of SARS-CoV-2.

Professor Wieler of the Robert-Koch Institut (RKI) insists on massive testing* to regain control about the spread of the Coronavirus. He would like to go back to phase 1, where single cases can be followed closely, and contact persons are quarantined.
*Currently Germany is testing 100,000 people a day

Although this cartoon insinuates a black market for masks,
Red Baron was able to replace his torn mask with a sturdier model.
My pharmacy sold four masks for euro 9,90 (©T-Online/Mario Lars).
Our government strongly recommends the use of Mund-Nasen-Bedeckungen (coverage of mouth and nose) in enclosed public spaces like shops and public transport without making the wearing of masks mandatory.

And while our chancellor holds a doctorate in physics, she ended the press conference, as the NYT wrote, with detailed explanations of the science behind the government plan.

Ms. Merkel said, “The key variable is the so-called reproduction factor of the virus — the number of people an infected person passes the virus on to.”

“That factor currently stands at about 1,” she continued, “meaning that one person gets infected by every newly infected person. If that factor rose even to 1.1, the German health care system would reach capacity by October.”

“If it were allowed to rise to 1.2 — so out of five infected people one infects not one but two additional people — that limit is reached by July.”

“With 1.3,” Ms. Merkel continued, “we have reached the limit of our health care system by June.”

“So you can see how small our leeway is,” she said, “the entire development rests on having a number of infections that we can keep track of and trace.”


The chancellor ended, “We need to understand that we need to live with this virus as long as there is no vaccine and no treatment.”

Saturday, April 11, 2020

Living with SARS-CoV-2

Corona Selfies


A good friend of mine, Professor Brigitte X., donated me three paper masks. Contrary to the famous check, they were in the mail on Wednesday. Wearing them gives me a better feeling when I am in crowded places, i.e., supermarkets (I limit shopping to three times a week), streetcars (although they are mostly empty these days), and the Minster market (I visited today).

These welcome masks are a reason to take my first and only selfies in four configurations:


The grandchildren selfie showing drawings in the background they made when they still had one-digit birthdays.


The intellectual selfie I took in my study.


The selfie on my covered outside terrace with the onset of the Black Forest in the back.


The empty streetcar selfie showing that shooting the previous selfies stressed my mask.


Hydroxychloroquine




If we cannot get a vaccine against SARS-CoV-2 within a  year, maybe a medication against Covid-19 will be available soon? Laboratories around the world are testing existing drugs for their efficacy against the new Coronavirus.

One of the hopeful candidates is hydroxychloroquine, a medication for preventing and treating malaria. Red Baron found out that this compound is an over-the-counter drug, and even worse, it can be ordered online.

Plaquenil has severe side effects. Since March 27, 54 cases of heart problems have been diagnosed in France among self-medicated people, of which seven ended fatally. Three persons were saved by applying electric shocks.

The pressure is great to return to "normal" life in particular for people losing their jobs, but whether hydroxychloroquine is the drug to fight Covid-19 effectively still has to be proven. First results are not at all encouraging.


Cheated




Small businesses in the state of North Rhine-Westphalia experiencing financial difficulties due to the present lockdown were able to apply online for instant cash flow money. Those applicants were unwittingly guided to fraudulent websites. They entered their credentials into a form and then waited for the much-needed capital to arrive fast.

The crooks phished the data and entered them into the official forms of the state. With this simple trick, they diverted taxpayers' money to their accounts while owners of small businesses waited in vain for their cash. Nothing is yet known about the financial damage, but for now, North Rhine-Westphalia has simply shut down the possibility of applying for fast financial help online.


Heinsberg




The first significant spread of the Covid-19 pandemic in Germany was observed in the administrative district of Heinsberg, located in the state of North Rhine-Westphalia near the Dutch border. The outbreak was presumably started by an unknowingly infected couple who attended a carnival session with about 300 participants in the small community of Gangelt (12,000 inhabitants) on February 15, 2020. On February 25, the couple was tested positive, but it was too late. By the end of March, nearly 1500 people had been infected with SARS-CoV-2 in the district of Heinsberg.

At the end of March 2020, scientists under the direction of the virologist Hendrik Streeck of Bonn University started a COVID-19 study at Gangelt. This study is supposed to provide recommendations for dealing with the coronavirus pandemic. The approximately 1000 participants are expected to provide representative data about the spread of the SARS-CoV-2 virus and the estimated number of those actually ill.

According to a preliminary evaluation published on April 9, about 15% of the residents examined in the municipality of Gangelt were infected with the Coronavirus. They are now immune. If 15% of the population consists of resistant people, the speed of a further spread of Sars-CoV-2 is reduced accordingly. The mortality rate in the investigated area, measured by the number of people infected in total, was 0.37%, while the mortality rate in Germany as a whole is around 2%.

Professor Streeck concluded, "Based on these (interim) results, the strict requirements to contain the epidemic could be gradually eased, provided that hygiene and other behavioral measures were continued and are followed."

The study and the presentation of the preliminary results were subsequently criticized. Streeck and his team should have taken more time to evaluate before communicating the results. The specificity of the antibody tests is questioned, so the determination of the number of infected persons is dubious.

The media jumped on the results, taking the Durchseuchung (level of endemic infection) of 15% to call for an immediate loosening of the protective measures actually in place. Reputable virologists say that the magic figure for herd immunity in the case of SARS-CoV-2 is at least 70%.



A Grim Outlook



Epidemic hotspots around the globe on April 11 (Click to enlarge).
The doubling time for infections is a dynamic parameter for pandemics.
The harsh quarantine measures in Italy are bearing fruit.
One true and obvious statement by Professor Streeck was, "Wir müssen lernen, mit SARS-CoV-2 zu leben." (We have to learn to live with SARS-CoV-2). If we learn, what about those people living in developing countries?

Andrew Sullivan wrote in New York magazine, "For one thing, the virus will be getting hold in East Asia and Africa, and thus we'll have a route back from those places to places that have already 'flattened the curve.' If we open up business, will people still be afraid, going around in masks and avoiding other people? Will we have musical events and sports? I doubt it."

And still, Andrew Sullivan did not mention the suffering that lies ahead for the populations of those developing countries where people frequently live in slums and in close communities. Here the virus finds highly vulnerable prey.

Developing countries do not have the medical infrastructure industrial countries can mobilize. Starting with 28,000 beds for intensive care at the beginning of the pandemic, Germany now has about 40,000 of which 30,000 are equipped with respirators. Presently only 2000 of those beds are occupied by Covid-19 patients.


Not to Be Forgotten


The other challenge still lingering on is climate change.

Together for the climate
The two bunnies - I photographed this morning - wish you all a Happy Easter.

Sunday, April 5, 2020

Durchhalteparolen

i.e., calls for perseverance we hear all the time. It is official that during the Easter holidays, the restrictions in Germany I wrote about will not be softened.

It is not over yet! Covid-19 cases in the state of Hamburg (1.9 million inhabitants).
Note the number of recovered patients is about half of the total cases.
204 people are hospitalized, while 53 people are in intensive care (©Die Zeit).
The governors of Schleswig-Holstein und Mecklenburg-Vorpommern warned residents of Hamburg, and Berlin, respectively,  not to make short trips to the Baltic Sea over the coming weekend. "Anyone planning an excursion on Easter has not understood the rules of conduct in Corona times and is behaving incorrectly," and anyway, the beaches are closed. Moving to and living in a secondary residence is strictly forbidden. Meanwhile, the Federal Republic, its states, and local authorities are preparing for the climax of the Corona pandemic expected next week.


Local Preparedness


©BZ/Michael Bamberger
In Freiburg, the presently useless exhibition halls were converted into an outpatient fever clinic. Individuals experiencing fever must first report to the family doctor who decides on sending them to the center.

©BZ/Michael Bamberger
Inside a vast hall, patients will be medically screened and tested for Corona in ten well-separated treatment rooms. In case of a Corona infection, patients will either be sent home into quarantine or transported to the university hospital for treatment.


Intensive Care


On a national level, Germany currently has 40,000 beds equipped for intensive care, of which about 24,000 – with only a relatively few Corona cases so far - are occupied. Another 16,000 places are in preparation. Of the existing beds, 10,000 are equipped for artificial respiration. The bottleneck is the number of medical personnel trained to intubate patients in need.

The number of available beds varies from state to state, so for a centralized capture, the Robert Koch Institute (RKI) has established a register. In case of need, Corona patients shall be moved within Germany.

A helicopter of the Bundeswehr fetching a Corona patient in neighboring Alsace (©dpa).
Due to our free capacities in intensive care, 119 Corona patients from Italy and France are being treated in Germany at the moment.


Face Masks


Due to the shortage of face masks, the situation is much confused. By now, everybody worldwide has learned that the advanced protection of FFP (Filtering Face Piece) masks must be reserved for doctors and nurses in hospitals. In fact, due to the lack of protective equipment, we experienced local outbreaks of Covid-19 in various nursing and old age homes with devastating consequences.

But even simple face masks are presently not available. Delivery of a modest order Red Baron placed today is scheduled for the middle of May. Meanwhile, the RKI keeps repeating the mantra that a face mask worn by an infected person protects the people around him/her and not the wearer himself. The problem is that an infected person not having any Corona symptoms may already be contagious without knowing it.

Even when distances are kept, the wearing of simple masks should be obligatory in crowded places like groceries, supermarkets, and public transport. Red Baron is convinced that such a practice would contribute to decreasing the number of infections. "Presently, we are looking for every small step that can reduce transmission - it adds up."

"In East Asia, many people are used to wearing masks when they are sick or when it's hay-fever season because it is considered impolite to be sneezing or coughing openly. The 2003 Sars virus outbreak affected several countries in the region. So one key difference between these societies and Western ones is that they have experienced contagion before - and the memories are still fresh and painful."

Click on the graphics for an enlargement.
Sixty-million South Koreans accustomed to wearing masks cannot be wrong. Just look at their curve of Corona infections.


Presentation of Data



Here is the current presentation of the number of infections with SARS-CoV-2 for the eight most affected countries. Those curves look frightening. Will the increase in the number of infections ever stop?

New infections in Germany daily as a percentage of the previous day (©ntv)
Yesterday I learned from television that presently, the number of Corona cases in Germany is doubling every 9 days. I calculated that this corresponds to an average daily increase of 7.2%.
Hope!
These new distance rules still take some getting used to (©BZ/Klaus Stuttmann)
I was told that not until the doubling of cases declines to every two weeks (corresponding to an average increase of 4.7% calculated per day) can Germany hope that life will very slowly start coming back to normal again.

Such a low doubling rate would possibly allow for the opening of shops and department stores but with only limited access, i.e., keeping distance between customers. Are restaurants places of social distancing? Big sports events will remain forbidden for a long time.

The most significant decision to be made by our government is whether kindergartens, schools, and universities may take up teaching activities soon.

New infections in the US daily as a percentage of the previous day (©ntv)
Here are the daily Corona growth rates in percent for the States. Taking an average growth rate of presently 12%, the number of cases will double every 5 days.

For Germany, the lethality rate is only 1.4% but will increase in the coming days (©ntv)
The table shows (incomplete) data for the most affected countries worldwide.


A Grim Outlook


©NDR/Extra 3
There is a lot of pessimism in the air regarding the European Union. 

©NDR/Extra 3
Seeing dramas unfold outside their territory, national states fearing an uncontrolled spread of Corona have actually closed their borders. Their aim was to attack and solve the problem for their own people while keeping the borders open for goods and services. In fact, the latter caused increased rates of Corona infections in Germany's south and west, because the economies of Baden-Württemberg and Bavaria rely heavily on cross-border commuters.

While we can hope for improvements in the present pandemic situation over time, one sector will not recover until a vaccine against a Corona infection is available abundantly. I am referring to international tourism. Indeed, China actually claims that all "new" Corona cases seen on its territory are imported.

It is evident that in the near future, no German will risk traveling to Bella Italia. For Americans, Sinatra's "It's very nice to go trav'ling, to Paris, London, and Rome" will make way to "But it's so much nicer, yes it's so much nicer to stay home."

Even once a vaccine is available and used, the border guards will check on the validity of the vaccination certificate. Red Baron still remembers his first visit to the States in 1957 when proof of a valid vaccination against smallpox was required. The route across the Atlantic between Europe and the States used to be a racetrack. How many Boeings and Airbuses will be needed in the near and distant future?

There is life after Corona, but the world will be dramatically different.