BA.5 hospitalizes more people than BA.2. That’s what Karl Lauterbach says and refers to a study from Denmark. Epidemiologist Klaus Stöhr disagrees decisively. That is a misinterpretation. What is actually in the study.

How severe are infections with the omicron variant BA.5 and how well does our immunity protect? Researchers from Denmark have investigated these questions. Because there, as in Germany, this subtype of Sars-CoV-2 has taken over the infection process. In a nationwide population study, the team examined the effects of BA.5 on people who were PCR positive between April and June 2022. On the basis of this, the researchers drew a comparison between the coronavirus variants BA.2 and BA.5. They published their results as a preprint (not yet peer-reviewed) in Preprints with The Lancet.

Health Minister Karl Lauterbach sums up the Denmark study for the Twitter user community as follows: “In Denmark there is also an increase in the number of hospitalized patients with BA5 compared to BA2. This means: autumn will be more difficult than spring was. Endemic has not been reached.”

The epidemiologist Klaus Stöhr reacted with outrage. It is “incredible” how many misinterpretations you can put into a short tweet at once. The authors of the article you cited (pre-print) come to different conclusions from their work”.

The research team writes: “We found high protection against BA.5 from previous omicron infection and similar vaccine efficacy against BA.5 infection as against BA.2 in triple vaccinated subjects. In an analysis adjusted for confounders, BA.5 infection was associated with an increased risk of hospitalization, which needs to be confirmed and verified because hospitalizations were low and stable over the study period.

This last part is the crux of the matter: Yes, it says “was BA.5 infection associated with an increased risk of hospitalization” – which Karl Lauterbach picks up on. What the Minister of Health does not mention, however, is that overall the hospitalizations during the investigation were low. This means that BA.5 is related (correlated) to a higher level of hospitalization from a statistical point of view. However, it is precisely this connection that needs to be substantiated first.

The fact that BA.5 (like BA.4) can again trigger more severe Covid-19 diseases than BA.2 did can so far neither be ruled out nor confirmed. “I think it’s possible that BA.5 could be a little more pathogenic again, but that hasn’t been finally clarified,” said Sandra Ciesek, Director of Medical Virology at the University Hospital Frankfurt am Main, in the NDR podcast in mid-June. The reason is the mutations at the key points of the spike protein, which enable the virus to penetrate and infect the lung cells more easily. BA.2, on the other hand, was better able to penetrate the mucous membranes of the upper respiratory tract.

Virologist Ulf Dittmer from the University Hospital Essen, on the other hand, recently advocated the thesis that evolution does not take place in reverse and that it is unlikely that the corona viruses would infect deeper tissue again. Because that would be a distribution disadvantage. So how does the expert rate BA.4/5?

“So far I have not seen any convincing data that BA.4/5 are more pathogenic than BA.1/2 were,” said Dittmer when asked by FOCUS Online. “Even here in Essen, there is no evidence of this in the clinic.” The current omicron subvariants could be even better at avoiding the immune system and are more infectious. Therefore, we saw another wave in many countries, including Germany. The virologist adds: “Unfortunately, with waves like this, there are always a few patients who end up back in the intensive care unit. Not infrequently with Sars-CoV-2 as an additional finding and another serious illness.”

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In any case, the current BA.5 wave is evident in many clinics. The picture of the past week has turned. While it was the normal wards that recorded strong increases, it is now the intensive care wards. However, they are still a long way from the peaks of the BA.1 and BA.2 waves. At the same time, the lack of staff in many places is exacerbating the care situation for all patients.

The German Hospital Society (DKG) provides information on how many hospital beds are occupied by Covid 19 patients. There it says: “The occupancy figures continue to rise, but the dynamic of the weekly comparison is flattening out overall. The occupancy figures in the intensive care units are increasing particularly sharply (19.8 percent), while the occupancy figures of patients who have tested positive for corona have only increased by a total of 7.9 percent in a week-to-week comparison.”

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