The closures of day care centers and schools during the corona pandemic were initially unavoidable – later they would have been avoidable. The responsible politicians should apologize to the children and their parents. Even if Karl Lauterbach sees it differently.
Shortly before the beginning of the Easter penitential period, Federal Health Minister Karl Lauterbach has already practiced public self-torture. In addition to the closures of the day-care centers, which he had already described as “medically inappropriate” in November, the former corona measures hardliner has also been assessing the long school closures as a “mistake” since this week. Nevertheless, he does not want to apologize because the politicians would not have known any better at the time: “At the time, however, it was recommended by the scientists who advised the federal government”. The mistakes were made because “the science wasn’t good enough”.
So are the counselors to blame for the fact that many children have been stunted in their development, socially and psychologically damaged and thrown back at school? Because families broke up during the lockdowns and an entire “Generation C” may have been traumatized for their lives? And if so, which consulting scientists might the politician Lauterbach have meant? Apparently not the epidemiologist Professor Doctor Lauterbach from the talk shows of yesteryear, because otherwise he would have to apologize for his own mistakes.
It probably couldn’t have been the Robert Koch Institute (RKI) either. Its outgoing President Lothar Wieler has just put the “Zeit” on record that his authority “always made recommendations that could have allowed schools and day-care centers to run, albeit with effort”. The Berlin chief adviser gives the buck back to politics and complains: “The available scope has not been considered with the necessary care, calm and objectivity throughout the pandemic”.
Alexander S. Kekulé (63) is a virologist, epidemiologist and former adviser to the federal government. The qualified doctor writes regularly on current scientific issues here and on Twitter at @AlexanderKekule.
Lauterbach and Wieler are not alone in trying to absolve themselves of all blame for the mistakes made in fighting the pandemic for the sake of the history books. Former Federal Health Minister Jens Spahn wrote a book in which he tirelessly explains that he and everyone else responsible didn’t know any better at the time.
His British colleague Matt Hancock, who is rightly criticized even more than Spahn, is also among the authors and in his alleged non-fiction work unabashedly presents himself as the hero of the pandemic. Christian Drosten already had the virologists in December Served and calculated that the controversial countermeasures, which were largely based on his advice, allegedly saved a million lives.
However, the collateral damage of the countermeasures cannot be glossed over so easily. The scientific data on the question of the circumstances under which day-care centers and schools are unavoidable was clearer from the start than some politicians would like to portray. There are two possible reasons for this measure: protecting children and young people from a dangerous disease and containing the wave of infections in the general population in order to protect particularly vulnerable groups.
When assessing whether the school and daycare closures were necessary, two phases of the fight against the pandemic must be distinguished.
In the early months of 2020, the closures became inevitable after failing to take more lenient countermeasures. According to reports from China at the time, one to five percent of those infected died. This made the new corona virus significantly less dangerous than the Sars virus from 2003. Due to the high level of contagion from person to person, which experts have known about since mid-January at the latest, the spread in Europe still had to be stopped by all means and as quickly as possible be fought as possible.
However, Spahn and his advisors recognized this too late. Wieler thought the disease was less dangerous than the flu and predicted that the virus “isn’t spreading very much in the world”. Drosten seconded that it was “too early to sound the alarm”.
That is why travelers from China were not checked, people with suspected respiratory infections were not systematically tested for Sars-CoV-2, chains of infection were not traced and even Bundesliga games and other mass events were not canceled. When the number of cases shot up at the beginning of March, there was no alternative to the lockdown. The federal and state governments finally decided to do so after the mayor of Halle an der Saale courageously went ahead. The delay in countermeasures has cost tens of thousands of avoidable lives, as calculation models that are now available show.
The first lockdown finally came into effect on March 22, 2020 – three weeks after the end of the Bavarian carnival holidays, four weeks after the Rhenish carnival and two months after my recommendation to take immediate countermeasures. Armin Laschet, then Prime Minister of the most severely affected state of North Rhine-Westphalia, justified the late change in policy by saying that Christian Drosten and the RKI wanted to keep schools and daycare centers open in the initial phase of the pandemic, because otherwise hospitals and other facilities would be critical infrastructure would lead to staff shortages.
Literally overnight, namely from Wednesday, March 11th, to Thursday, March 12th, 2020, Drosten then changed his mind because – according to his reasoning – a colleague had recommended that he read an older article on the Spanish flu from 1918. A participant in the chancellor’s meeting with the prime ministers on March 12 later told the “Spiegel” that some heads of government “had dropped their jaws” in view of this sudden change of heart.
Excluding the schools and daycare centers from the lockdown at the time would have been a serious mistake. It was known from the outbreaks in Wuhan and northern Italy that older people in particular are affected by severe courses. However, horror figures were reported from Lombardy, according to which more than 16 percent of all those infected died there. With an unknown virus that has not yet adapted to humans, it is impossible to even approximate the risk for children and adolescents.
Those who were familiar with the specialist literature on the Spanish flu of 1918 also knew that the timely closure of schools and kindergartens at the time could significantly slow down the spread of the disease in the general population. There was therefore no alternative to the first school closure in March 2020.
“How we live with the pandemic and what we can learn from it” by Alexander Kekulé
In the meantime, several studies have also shown for Sars-CoV-2 that school and daycare closures have a significant effect on the number of cases. A working group from the Helmholtz Institute in Braunschweig also confirmed this for the data from Germany. If the Federal Minister of Health nevertheless makes a blanket statement that schools and daycare centers should not have been closed, that is extremely dangerous: Nobody can predict whether we will need this unpleasant measure again in the next pandemic.
The second phase of the fight against the pandemic began when the lockdown was gradually ended and schools opened in May and June 2020. It was now clear that the infection mortality rate for the entire population was 0.5 percent, well below the values initially reported. Age-dependent evaluations now clearly show that children are hardly affected by severe courses and also fall ill less often than adults. Most virologists predicted that the pandemic would subside in the summer and that the number of infections would increase again significantly in the autumn.
At the end of March, I presented the SMART concept, with which the number of infections can be controlled without lockdowns: protection of risk groups, masks in everyday life, avoiding airborne transmission, rapid tracing of infection chains, quick tests for everyone. In Japan, without lockdowns, the pandemic was contained by consistent mask wearing and the “three Cs” ( avoid closed spaces, crowded places, close contacts ) rule, according to which closed spaces with poor ventilation, crowds and close contacts should be avoided. With these approaches, with appropriate preparation, further closures of daycare centers and schools could have been completely avoided from autumn 2020.
However, SMART (just like similar strategies that have been pursued in other countries) does not prevent infections as effectively as closing schools and day care centers can: For the freedom of children, limited, controlled infection outside of the risk groups is accepted . Thus, there would have been a theoretical risk that children would become infected unnoticed and then infect their grandparents or other people at home who are at high risk of severe Covid courses. The crucial question was therefore: Are children just as contagious as adults?
At the time, Christian Drosten said he had found the answer to the politically explosive question. According to a study that he announced via Twitter at the end of April 2020 and published on his institute’s server, children should “possibly” ( maybe ) be just as contagious as adults. After several experts had criticized Drosten’s methodology, he defiantly followed up in his podcast: Based on his current data, when asked whether children are just as contagious as adults, he now even has to say, “It’s probably like that.” The “New York Times At the time, he openly explained that he published the study without a previous peer review because he wanted to influence the “ongoing discussion about schools in Germany”.
In retrospect, one has to say: unfortunately, he also succeeded in this. After my comment in the Tagesspiegel and renewed criticism from scientists from two renowned research institutions (McGill University in Montreal/Canada and Erasmus Medical Center in Rotterdam/Netherlands), Drosten withdrew the original version of his study. A large number of studies have now shown that children are less contagious than adults (which is probably what prompted Lauterbach to make his current statement). In the summer of 2020, however, the supposed “virologist dispute” unsettled and divided the republic. Whether children are “drivers of the pandemic” and a danger to vulnerable groups has long remained controversial.
In the period that followed, alternative protection concepts such as SMART for schools and daycare centers were discussed, but were not implemented for a long time. Teachers were partially exempt from the mask requirement, although they pass on the virus much more frequently than children. Rapid and pool tests were only used consistently late in the pandemic. Air purifiers in classrooms are still a rarity today. Before the appearance of the omicron variant, it would also have been irresponsible to simply expose all children and young people to the virus without protection. Due to a lack of sufficient preparation, with every new corona wave there was no other choice but to close daycare centers and schools again.
The school and daycare closures were neither wrong nor medically unfounded. They would have been avoidable, however, if politicians had listened from the outset to scientists who represented positions other than those of the Berlin advisory board. After the first lockdown, alternative protection concepts were available through which a significant part of the collateral damage to children and young people could have been avoided. The fact that these were not implemented until the end of the pandemic is a failure of politics that cannot be excused by saying that “the science was not good enough”. Instead of washing their hands in innocence, the responsible people’s representatives should show a little active remorse and apologize to the children, the young people and their parents who were also afflicted. They still have some time to think about it until the beginning of the Easter penitential season on Ash Wednesday.
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