Tuesday, 24 March 2020

Corona Virus Update with Christian Drosten: going outside, face masks, children and media troubles (part 19)

Much of the information on the new Corona virus in Germany, at least for science nerds, is spread by the Corona Virus Update Podcast with Prof. Dr. Christian Drosten. He is the head of the virology department at one of the main university hospitals in Germany and specializes on emerging viruses.

It is a podcast of the German public radio NDR. The half an hour interview number 19, on Monday the 23 of March was held by science journalist Korinna Hennig. Topics were, going out of the house, face masks, children and the media creating trouble.

Walking and jogging

Korinna Hennig:
Meanwhile, many people have come to us who are worried when they walk in the forest and joggers walk very close to them and breathe on them. Safety distance is one of the words of the hour. Is this assumption that the duration of contact plays an important role still tenable despite everything?
Christian Drosten:
Of course, it is very difficult to say anything really tenable about this now. But in principle, when you're outside, what you breathe out naturally dilutes, and the virus also dilutes. Besides, you almost always have a little bit of wind.

And so you have to concentrate more on the situation in closed rooms if you are thinking about such transmission processes.

Face masks

Too Long, Didn't read: Face mask are scarce in Europe. Medical professionals in close contact with infected people need them the most. For normal people wearing a mask outside the house does not provide any protection, the main thing they would do is protect others in case you are infective (without knowing it). However, at the moment we do not have enough masks to use that as containment method.
First of all, of course, it must be said that there is a shortage of these masks in all countries, not only in Germany, but in the whole of Europe and practically all over the world. If we now look at Europe in particular, it really is a nationwide situation in which no country has any stocks or anything like that.

I know that the German Ministry of Health began weeks ago to secure stocks and place orders. So I would think that we in Germany are very well prepared. But things like that are going on, they take time. Orders take time. Production needs a time. And right now in Germany, as in all other countries too, we have a shortage of these masks in the market.

And in fact, hospitals are still being supplied. But it's not like they're in unlimited supply now. That is why purchasing departments at large hospitals are justifiably concerned if the public were to access the same stocks now. You have to imagine that at some point there will be market competition. And supply and demand will then drive up prices. If people in the public think that they can protect themselves from infection by wearing a mask, then of course at some point there will be people who pay lunar prices for something like that, even if it has little or no effect. ...

There must be no market competition. Because in the medical sector, in professions that work close to patients - that's not just the doctor and the nurse, but also in other areas, in nursing homes and so on - it's natural to have very close contact. And different rules apply in this close contact area. And there is definitely data that shows that such respiratory tract disease transmissions are reduced by the masks. ...

For the public, there are two considerations that can be made in this way. One is self-protection: I wear a mask to keep from getting sick. The other is other-protection: I am sick, wearing a mask so that someone else does not get sick, so that the virus is not transmitted further.

And for the latter, there are, let's say mechanical good reasons for doing so. It's easy for anyone to imagine. When I sneeze, I give off tiny droplets. And when I have a piece of cloth in front of my mouth, it can either be a cellulose cloth like a mask I bought, or it can of course be a scarf or something, these big droplets are then caught. ...

The consideration is, the further away you are from this source, the more you are dealing with a finer aerosol. And this is also inhaled sideways into a mask, whether you inhale it from the front of your mouth. Or you have a mask on and you suck it in from the side. That is then simply no longer a difference. That's why: The closer to the source, the better. That's why the mask has to be at the source and not at the receiver.

And that is certainly a perfectly plausible consideration. What is not so plausible is that I cannot protect myself in public with a mask. This is just maybe a little bit difficult to convey. But there is simply either no evidence in the literature or - depending on how you want to interpret it - almost no evidence that this could help.


Do children get infected and ill?
So I think we can say that children do not get severe symptoms. There are simply no known descriptions. Well there are of course individual descriptions of severe, even unfortunately also of a few deceased children, but in view of the mass of cases it hardly seems to occur. Whereby the word hardly means: Just only in a very, very small percentage.

It is, of course, an important consideration, because now it can have two explanations: One may be that the children are not infected at all. That means that they are completely excluded. The other may be that the children are infected, become immune and at some point belong to the circle of those who have already been infected and become immune in society and then do their part to stop the epidemic. ...

Children, school children have a particular network function in society because they interact relatively intensively with several age groups. While other age groups are more in contact with their own age group. Therefore children have a very important function there. And we all want to find out in the next few weeks - by means of antibody tests, also in children - what the background infection rate is, in other words the silent infection. To ask the question: Have children perhaps, without realizing it, already contracted the infection? And may they already become immune unnoticed?
Drosten discusses a preprint (a scientific article that is not peer reviewed) about the early stage of the virus in Wuhan. In this stage all patients went to the hospital for isolation, including children because it was not known yet that they did not get ill.
One can deduce that in this early phase in Wuhan, the Authors speak of thousands to tens of thousands of unrecognized child cases that have occurred. And that, of course, gives hope in a certain way. Namely, on the one hand, if this is such a great effect, it will be possible to correct the actual infectious mortality. And what is even more important, if we know that the children are actually very actively infected, then this means that they also contribute to the [infected part of the population], in other words to this development of herd immunity. That is good news in principle, this [preprint]. What we need now is confirmation of this phenomenon through antibody tests, also in children, but not only.

About the person

Korinna Hennig:
Mr. Drosten, in conclusion, we have already mentioned here in the podcast that you are often accosted, exposed to hate mails and insults. Now we have just seen the opposite effect. Suddenly, all sorts of newspapers have begun to focus on you. You are very much in the spotlight and a hype has developed which has somehow taken on a life of its own. How do you feel about that? Are you coping with it?
Christian Drosten :
I have to admit that it makes me uneasy and I don't like it. I already have the feeling that a legend is being created. ... But of course that has very little to do with reality.

It worries me especially, when I see that that comes along with shortening of statements. For example, what has just happened this weekend is that there was a relatively differentiated interview in a large magazine, where two or three questions were asked about the topic of how can things continue now? So what do we do now? Now these measures are all in force and what does our future look like now? Can you get out of there?

And then I already said for example: Well, if you look at it, whether you fill football stadiums with people or go to school, then going to school is more important. That's why I believe that we won't have full football stadiums any time soon. But that we have to concentrate relatively soon on getting data to decide whether we can perhaps allow the whole school or just a few years of school again. Because that is really important. I was interested in this distinction, what is entertainment and what is essentially important in society? What can you focus on now if you want to get out of these contact measures again?

And then it was shortened, and that was done by the magazine itself on the Internet, of course to attract attention to this article. Basically, all they said was: "Drosten: No more football for a year." And then they wrote, which was not even mentioned in the interview, that this could probably be extended to include holding football matches without spectators. So even that, it is not true that I advised against that. That was not the content. And it wasn't directly described that way, but from the context it sounded that way. Then there is the fact that this article is also behind a paywall. That means, if you go to this internet message and want to watch the interview, then you have to pay. And that annoys me, because it was a whole afternoon of my time that I invested there. ...

It's just bad when media come and still try to make money out of this situation by such contrasts and such incentives. I think the media must stop that now. Otherwise we as scientists can no longer do the kind of things I am doing here. Some of my colleagues are much more cautious. That is of course the main reason why not many other scientists communicate in public, because these things happen all the time. It's just not bearable anymore.

This also scares me as a person because I naturally notice when something like this is announced. It went out on the servers some Sunday afternoon, I noticed it because aggressive comments suddenly appeared in my e-mail inbox that really attacked me. And where I notice, there are people I don't know, who don't know me, but who have found out my email address and who now attacking me. And that is, let's just say, the most harmless consequence. But I also find the misunderstandings that arise very serious. And we have to be clear, for what purpose? Ultimately, only for [newspaper] circulation.
This while the German language press is wonderful compared to the English language press.

Other podcasts

Part 28: Corona Virus Update: exit strategy, masks, aerosols, loss of smell and taste.

Part 27: Corona Virus Update: tracking infections by App and do go outside

Part 26: Corona Virus Update on Vaccines: clinical trials, various types, for whom and when.

Part 23: Corona Virus Update: need for speed in funding and publication, virus arrival, from pandemic to endemic

Part 22: Corona Virus Update: scientific studies on cures for COVID-19.

Part 21: Corona Virus Update: tests, tests, tests and how they work.

Part 20: Corona Virus Update: Case-tracking teams, slowdown in Germany, infectiousness.

Part 18: Leading German virologist Prof. Dr. Christian Drosten goes viral, topics: Air pollution, data quality, sequencing, immunity, seasonality & curfews.

Related reading

Corona Virus Update with Christian Drosten podcasts and transcripts (one day later).

The Robert Koch-Institut (RKI) in Germany is comparable to the US Centers for Disease Control and Prevention (CDC). The RKI publishes a daily summary of the situation: situation reports. First in German, a little later also in English. It has statistics on the number of infections and mortality and on measures take to fight the problem. Something I especially like is that they list cases by date the people got ill (if known), not just raw numbers for one day, which are total based on an unknown number of previous days. This figure (number 3) suggests that the measures work and slowed down the spread of the virus.

This weekend the RKI was looking for staff to help track infected people. They got 10,000 applications and already stopped accepting new applications. Thanks, humanity.

1 comment:

  1. Excellent resource, thank you. Just started from the beginning!


Comments are welcome, but comments without arguments may be deleted. Please try to remain on topic. (See also moderation page.)

I read every comment before publishing it. Spam comments are useless.

This comment box can be stretched for more space.