Episode 50- The Virus Is Coming Back

DISCLAIMER: I am not a doctor or a healthcare practitioner, nor do I have a master's or a PhD. I am not a native German speaker either- I only know German as a foreign language, one I learned using whatever resources I could get a hand on. If my translation conflicts with that of anyone belonging to any of the groups mentioned above, please refer to theirs instead of mine. Needless to say, if an official translation, done by a scientific translator comes out, then refer to that instead of this one. I am simply a medical student who admires the work of Dr. Drosten and colleagues, and I would like to provide unofficial translations of the podcasts so that they may be helpful to those who do not speak German.For corrections, please reach out to me on Reddit and send advice in. I apologize in advance for any errors I have made. There are some footnotes at the bottom of this translation.

Original release date: June 23, 2020
Original audio: https://mediandr-a.akamaihd.net/download/podcasts/podcast4684/AU-20200623-1437-3000.mp3
Original transcript: https://www.ndr.de/nachrichten/info/coronaskript214.pdf

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NDR Info. The Coronavirus update.

HENNIG: Now schools and kindergartens have been closed again. After an outbreak in a meat processing plant in Rheda-Wiedenbrück in North-Rhine-Westphalia, the word “Lockdown”  is coming up in the news again, at least regionally. Quo vadis (what now?), North-Rhine-Westphalia? What now, Germany? Will the infection be limited to that area? Despite this, we are in a good situation compared ot the rest of the world. In Brazil and the USA, the virus is spreading, to say the least, and Israel may be standing before a second wave. What can we in Germany learn from all this? My name is Korinna Hennig. Welcome to the 50th episode of our podcast. Today is Tuesday, the 23rd of June, 2020. We want to look at the present situation, including the so-called clusters, where there are many infections among a certain group, in a certain place, at around the same time. And we want to ask: where exactly do we stand in terms of the pandemic? What can we in the summer take as guidelines for our daily lives? To answer all of this, I am, through the app, in contact with Professor Christian Drosten in Berlin. Good day, Mr. Drosten!

DROSTEN: Hello.

HENNIG: Now we have a situation that we have already discussed in theory in the previous episode of the podcast: the R0 has risen again. Depending on the estimate and adjustments for time one uses, the R¬0 value is now around 2, according to the Robert Koch Institute. That is not because of a homogeneous spread of the virus, but because of outbreaks in particular areas. If we take a look at North-Rhine-Westphalia, on the many infections in a large meat processing plant, how controllable do you believe the outbreak is?

DROSTEN: I think that special measures are needed with this outbreak. If you look at this, you can see a few indicators that the virus has already spread to the (general) population. It’s to be expected that there is therefore a delay in noting this illness. People must first show symptoms, these symptoms have to be taken seriously enough to go to the doctor, and then people must get tested, and then must report these. You can thus see somewhat that in the population, there would be a worryingly high number of cases.

HENNIG: No more than 50 new infections per 100,000 residents—this limit is the most recent one set by politicians. If this limit is breached, more measures will have to be taken. In the district of Gütersloh there are more than 250 infections per 100,000 residents. Is this figure really a sensible limit from a scientific perspective?

DROSTEN: I think this number was a compromise, a consensus. This number was certainly not based on science. It was mostly based on considerations of capacity. I don’t know where the number comes from or who shared it. But I believe that the main consideration was up to what number the health authorities through the land could manage. Here in the outbreak we just talked about, additional help came, the Bundeswehr came. This may have been a reason to deal with things in a special way. I believe the deciding thing, what people should do now, is to prevent this whole situation from spreading outside of these areas. We have a few figures regarding hospital admissions that are related to this outbreak. These can grow even higher. However, we still haven’t breached the patient care capacity, because even if patients become seriously ill, they can be transferred elsewhere. They do not have to be treated in ICUs in the same place or facility. In this regard this isn’t a national situation, but we can see that we must prevent this from spreading unnoticed. I also have this to say: we will see (whether we are successful) when we are able to sequence the virus. The virus, which is amplifying tremendously—thus say the virologists, that it is growing explosively—when a virus so explosively grows in such a situation, then many mutations will start showing up, which may not alter its function, but by which one can deduce if it has leaked through to other places. I will say that in a few months we will be able to say: “This virus in Germany in this place, we can trace it back to an outbreak in Gütersloh.” That will probably be possible. I cannot say it with certainty, but it will very likely be so.

HENNIG: Scientists are now occupied with the question of what should be done in the field. Your laboratory in the Charité is a consultancy laboratory(1) for coronaviruses, an official advisory authority. Are you officially involved in giving advice to North-Rhine-Westphalia?

DROSTEN: No, we don’t have such a function. As far as I know, North-Rhine-Westphalia has its own advisory committee where many specialties are represented.

HENNIG:  We have already spoken about the conditions in meat processing plants in May in episode 42. You said then that it’s not only the precarious living conditions that make an infection likely, but also the fact that it is a meat processing plant. People work there in crowded conditions. Here the air is heavy, but above all, the cold plays a big role. The refrigeration temperatures in the plants—is such an outbreak like that in Tönnies a preview of what can happen in winter because of the temperature effects? A warning of how quickly this can happen?

DROSTEN: Yes, I understand this. Naturally, in the autumn and winter, where it’s around 8 degrees (Celsius) outside, in some facilities in some areas it will be the same, some meat plants, it will be as if you were outside. And wind will blow and the virus will be blown away, okay. But in winter we will have this situation of unheated rooms without ventilation. Places like waiting areas on train stations and so on, bus stops, all these areas where it’s cold and not heated. But there will be a roof above and four walls around. These areas are perhaps a more analogous situation to these meat plants. That is of course not a good analogy. I will say that I believe that this won’t be what sends us into a second wave. Either way we must be wary about the development of a second wave.


-----SIGNS THAT THE VIRUS IS COMING AGAIN-----


DROSTEN: (continued) We see in the American South that despite higher temperatures, we are headed towards a fearful situation.  The ICUs in some areas are already full. This morning I saw a report that in one state in the American South, children’s hospitals have been freed up for adults because hospital admissions have reached such a point that such action was required. And this happened in a month with higher environmental temperatures. There, the first wave was not efficiently controlled, but facilities were opened up again. That is of course something that can happen to us. We are in summer, and we surely have a few more relaxed weeks ahead of us in terms of epidemic activity. But when one considers this and compares this to other situations, then one can believe that this might not just be the effects of the summer, but that this is the détente that we have won through very efficient controls in Germany. We didn’t have a very drastic lockdown, we had one that was neither long nor very crippling. There was some freedom of movement and the duration was short. There were also Easter holidays during the time of school closures. Things were therefore very, very mild in Germany. And we have done so in order to bring some calm. We also see however that the virus is coming back. And not just the aforementioned areas—in Berlin and in other areas we have clear signs that the virus is coming back.

HENNIG: Should we then take a special look at certain housing situations? Take an apartment in Göttingen for instance. There are certain special conditions in the tight corridors and elevators there. Do these require more attention?

DROSTEN: Yes, there are details. In the same way as you would need to pay attention to whether you’re eating on the outside tables of a restaurant or on the inside, which is okay in the current weather I believe. Or if the terrace will become fuller, or maybe the inside will be fuller, or the rising alcohol level in the course of the evening…the question is always, when you have to say “This is too nitpicky!” Nobody says this, of course. Of course these will change how much the virus spreads. I don’t want to say at all that you should directly intervene. I only want to say that in the moment you have to be careful. I am not optimistic that in a month we will have such an un-stressful situation as we do now. I think that in two months we will have a problem if we don’t pay attention and if we don’t see to it that people understand that the health authorities need support and cooperation. This would be devastating to what was our great strength earlier in the year—namely, society’s togetherness and that the general population was informed.

HENNIG:  It is all the more important, then, to look at the topic of clusters, on the outbreaks we have spoken of in meat processing plants and the dense living conditions. We have already highlighted the theme of “superspreading” in this podcast. When one speaks of such a clear, massive, regional occurrence, then the question of parameters is very important—which parameters play a role in causing many people in a certain area to be infected within a short time? There is a study from Japan which studied 3,000 cases from January to April and identified around 60 clusters and in doing so were able to trace where the infection originated. The conclusion was that hospitals and care facilities play the biggest role by around 46%. Next up are restaurants, bars, workplaces and music-related facilities, such as concerts, karaoke places and so on, at around 11%. What do we say to that? What are the most important parameters that we should look at as ordinary people?

DROSTEN: Yes, it’s interesting to see that these are what caused the cluster outbreaks. I would rather not draw any direct conclusions from a study such as this one, which took place in the early stages of the epidemic. Because if we do so then we may go ahead and assume that this applies to the future. But the situation has changed in every country, including Japan and Germany. If one says for instance that hospitals and care facilities were the biggest generators of infection clusters—that may have been true in the situation at the time. Back then there weren’t so many patients. Of course this happened back then in medical situations where people weren’t really paying much attention to the pandemic. Now we are better prepared in some areas of our day to day life but do not think about the infection in others.


-----A LOOK AT THE GENERAL SITUATION-----


DROSTEN: (cont.) In this podcast, we have often said that the virus is spreading. It is spreading into other age groups and it is spreading within our society. That’s why we cannot expect things in the autumn to behave in the same way as was observed in earlier studies, and this applies to a lot of things. This applies to all these aspects of observational studies of families that we have already spoken of. This applies to schools.  This applies to these descriptions of cluster hotspots. And of course, a karaoke bar in Asia is a place where people are packed into a room and sing a lot; of course, there are aerosols there and people are also very drunk. And this is the typical situation. Only I dare to say that (transmission) happens there, because then people say “Well, in other situations this doesn’t happen.” One must say to this that in the beginning of the epidemic, maybe in some other areas this hasn’t happened. But now, when the virus is everywhere—I’m not only speaking about Germany, I’m speaking generally, we are seeing very different things in other countries— the virus appears everywhere. That’s why it is better to things about general things. Not too many people, not in a closed room. The liberation of alcohol plays a role, of course. Loud music, over which people scream loudly, where more aerosols are formed in the throat. All these things aren’t good.

HENNIG: Everything that we see now—many people have the impression that the worst is over. We can relax a little. Is the role of asymptomatic infections really greater than what we originally thought?

DROSTEN: This is relatively hard to quantify at the moment because asymptomatic and presymptomatic cases are hard to accurately separate. Asymptomatic cases, those that don’t show any symptoms over the entire course of the disease—(to judge such a case) is very subjective. One may say, “I had no symptoms, I was okay the whole time.” Another might say: “No, my nose was clogged the whole time. I found it hard to breath. I also had a sore throat.” It’s very difficult to record this properly.

HENNIG: Do we know then how high the viral load is in asymptomatic people and how long infectious viruses are spread from them?

DROSTEN: There are a few studies that currently suggest that the viral concentration is a little lower in asymptomatic people and that they spread the virus for a shorter period of time. I would rather not generalize so much, though.

HENNIG: The holidays are coming up. In this Japanese study about clusters, only one cluster was found in which there was a case of transmission in an airplane. You have, however, experience with SARS-1 research. Is it not possible for transmissions to occur when a plane is fully occupied?

DROSTEN: Yes, we have experience, even with SARS-1. We do however know more about the transmission of influenza in planes. Generally, the
ventilation conditions of airplanes are very favorable in this respect. Transmission over the long axis of planes is rare. This is because of a special type of airflow. There is a lot of knowledge about this matter, which health authorities have and can use when, say, a confirmed case gets on a plane, and they must ask: how should a contact patient be defined?

HENNIG: Estimates about how effective such ventilation systems and HEPA filters can be vary somewhat. Do you believe that if more people start flying again, these situations can become more prominent, when people sit so close to each other without any free seats between them?

DROSTEN: With regards to what I know about these environmental conditions, I’m more worried about the waiting areas before and after departures, where people are sometimes hemmed in for quite a while with so many people, than I am about the flight or period in the cabin itself.

HENNIG: We’ve talked about the topic of “other countries” already, with regards to a second wave. There is a country that, in the previous days in weeks, has come to attention, because it looked to have controlled the virus very well because it reacted early, but now the curve is going back up again—I mean Israel. Does a second wave really threaten that country? What do you suppose?

DROSTEN: Just as we have said in the past in this podcast: it all depends on what we do. And that goes the same for Israel, too. Naturally, whether a second wave is stopped depends on what we do when we know there is a second wave. This of course starts with the question: what is a second wave? How do you define that? A second wave isn’t well defined at all. I would say that when the incidence rate in Germany has gone down and doesn’t immediately go back up, one can call this the first wave. That was the case in Israel. Now everything has been opened up and relaxed—this is very comparable to the situation in Germany. And you can see that the number of cases has gone back up again. One can also see that, just as we have always somewhat anticipated, that breakouts of considerable magnitude have occurred in schools. And schools must be closed again for this to be controlled. That is something that we, simply put, must thing about. And in the discussions we must have as a society about the summer, we must recognize these issues, that things aren’t as easy as we probably thought, and remember the motto: the children have done nothing to deserve this.

HENNIG: Can we learn something from Israel about the topic of schools, what we can do, and what we have control over?

DROSTEN: If I understand this correctly—but I must say that I’m only reading the newspapers—the schools have been, relatively, largely reopened, with a strategy of symptom control among the students. Then outbreaks happened in schools. I will not say that that is a bad thing or the wrong course of action. I would rather say that this is the case of a country that handled the first wave very well and very efficiently and then perhaps opened up a bit earlier than us. That is what one can see. I know from conversations with colleagues, for instance in the Netherlands, that over there, schools too were opened rather early. Not immediately in full capacity, I believe. This leads to other problems. Over there, students with symptoms should get a PCR test done otherwise they would not be allowed to go to school. And what happened there can happen to us if we act in such a manner, namely, requiring a test from every symptomatic student. And what happens is that students will know someone in their classes who won’t come to school because they must get a PCR test. And what does that mean? Does that mean that in the last two days, someone was among us, someone who, whether symptomatic or pre-symptomatic, spread the virus? Everyone would then be afraid and talk amongst themselves. If the student in question were to come the next day and say that the PCR test was negative, people would then ask: how strong is the predictive power for such a PCR test? What would happen if the student were to be tested again? Would they be negative again? Can we allow that? And this leads to fear and discussion? A sort of stigmatization can arise, which would be totally inappropriate and discriminatory. My colleges, the ones I spoke to, have told me that this is the reasons they stopped this sort of testing. And that would be senseless, because people are in a situation where, in order to proceed safely with the opening of schools, every symptomatic student would be tested. This has happened, and now this safety net must be taken away. But that does not lead to a re-closing of schools because safety cannot be guaranteed or something. Rather, this particular safety measure is no longer there, because the schools are always open.  And then what? This question still remains. This is a social question.


-----LEARNING FROM THE EXPERIENCES OF OTHER COUNTRIES REGARDING THE TOPIC OF SCHOOLS-----


DROSTEN: (cont.) We should anticipate this, that we will also be headed towards such a situation if we do not anticipate and try to respond to this. We must do so, even in dialogues with our neighboring countries, who are experiencing similar things as well—and above all we must avoid looking for someone to blame. Not groups, not “politics”, and most of all not individual people involved elsewhere. One must, on the contrary, see things as they are. There is a saying in English football—I am not a football fan, but I know the saying—people say, “Play the ball, not the man”(2). And this is something, I believe, something very decisive, that we must, without question, take to heart in the course of these social discussions.

HENNIG: So, fight against the epidemic and not against those responsible for fighting against the epidemic.

DROSTEN: Yes, if they are at all responsible. That also means people who perhaps may simply be giving out certain information.

HENNIG: Such as yourself.

DROSTEN: Such as myself, for instance, or other scientists. Especially regarding this theme, the role of science, the great value of science for society, this is in these months clearer than ever before, and will of course be very strongly reflected, on the climate debate for instance, where there is the same underlying theme.

HENNIG: If we take a look at that question again, what can we do in schools? We have a widely agreed upon consensus that children should not be without education and should not have unequal access to education, that schools really should be opened. Should we then think about alternative testing methods? Maybe mass testing, saliva tests, stool tests? We have discussed these in the podcast, and have found that they can yield accurate results.

DROSTEN: Yes, these methods certainly bring many possibilities as to what they can inform us about. But I believe these are already being considered anyway. In federalism, we have many different approaches and many different advisory offices. I believe that in every federal state in Germany, there are virologists and other experts advising their respective politicians about these things. For these there are technical answers which we, in this podcast, have spoken about in great detail, up to the parameters concerning the performance of these tests. For instance, what is sensitivity? What are antigen tests? We have talked about these in this podcast. Saliva, sensitivity, we have talked about this, referring to literature on these matters. I will not repeat everything we said, but I will say that we must be vigilant from day to day. We must observe what is happening.


-----CURRENT OBSERVATIONS IN SCHOOLS-----


DROSTEN: (cont.) We have already said that it is clear to see that there are outbreaks in Israeli schools. We have seen in the newspapers that in Melbourne some schools have been infected following the virus’ re-entry after a period of relative calm. In Münster, in some places in the Rhineland, right now in Dortmund and Frankfurt, we have situations that we must carefully monitor in order to see whether there really are outbreaks or just isolated cases. In Berlin-Charlottenburg, there is an outbreak that really can be called an outbreak, if I am informed correctly. Was there further transmission there? Many students and school staff were infected at the same time. That is only explainable by further transmission within the school.
We have discussed many environmental parameters in this podcast, from viral load to the secondary attack rate in household studies and we have also talked a lot about why certain household studies performed during the lockdown may not always show what can happen later on. This is all because of the idea that after the lockdown, in this current, relatively relaxed period—and then in the resurgence of the virus—the virus naturally spreads in different ways in the elderly and in other social groups. We will have a different situation when we come back from summer vacations. All of this leads to a situation in which people will be very vulnerable. Then there will be contradictory information. I believe that the average citizen who does their research can understand what viral load is. We don’t have so many listeners to this podcast for no reason. They aren’t just listening because they think that these are interesting stories to read before bed, they listen because they are very much interested and understand these things. Such people will of course not believe it when they hear from other parts of the media, other areas, that children supposedly aren’t affected. They will have read elsewhere that children spread the infection. Then it will become clear to them, even if they don’t have any training in biomedicine, that there are contradictions. Something’s gotta be wrong with the information somewhere.


-----SCIENCE HAS NO OPINIONS-----


DROSTEN: (cont.) And regarding this incongruity, one might get the feeling that decisions will be made, such as opening schools again, even though everyone knows that to do so is a continuous process with so many people involved. It doesn’t help at all when certain interest groups say, “Oh, think of the children, they won’t get sick and they have a right to education.” Yes, this may be true. And naturally, people such as I should say, “Yes, I am a citizen and a father and don’t do anything crazy in normal life. However, I am also a scientist. And science in the end has an “ice-cold hand”. Science is not something which you can’t just follow along and then the next say, “Hey, we scientists, deep down we’re really the same, we want the same things, but now you’re changing your opinion a little.” Science has no opinions. Science has to do with facts. Someone with experience and background knowledge can read into things much more deeply than someone without a scientific education. We have seen in recent times that many people who don’t have a background (in epidemiology and other fields)—and because I know that that my statements will be presented in an abridged, shortened form by the media—I am stating this, I explicitly exclude pediatric authorities and others who have backgrounds.

HENNIG: So pediatricians and doctors specializing in young people?

DROSTEN: Correct. What they say is good and correct.  But there are others, who are really interest groups, who communicate over social media in a way that would be punishable in normal life. And in social media, anonymously, this is not a concern to them. They act in a defamatory way. And this serves a purpose. They are people who clearly have an agenda, sometimes multiple agendas. There are people who argue against scientific content on social media despite having no scientific training, with superficial arguments, because they want schools to stay closed no matter what. And there are others who argue superficially because they want schools to open no matter what. Their whole purpose is probably a matter of their personal situation. And I can also say that I, too, have things going on in my private life, but I will not talk about them here. We are talking about science here.

HENNIG: You have said that science has an “ice-cold hand.”  Data can only be interpreted successfully within a certain range, and since you have already spoken to our knowledgeable listeners: we have received a few questions about a study in Baden-Württemberg, which was published last week after the last episode of the podcast was published. This study was about antibodies in children. This study centered around children who weren’t at home but rather in schools and daycares past closing time. The conclusions drawn must surely be more significant in other studies which were conducted under complete lockdown conditions, in which children were at home and not at all leading regular lives. What do you think about this? Is this not more significant?

DROSTEN: I must say that this study in Baden-Württemberg, if I remember correctly, is not at all finished. I believe that statistical analysis of this study is still going on, if I understand it right. I have also heard (and I must say by the way that I haven’t been following the media portrayal of this study very closely), but I have seen a part of a press conference where the scientists who presented this have said that the informative value of this study is very limited.
I believe that all scientists involved in this sort of work, including those who have conducted this study, know that there are many factors that prevent individual studies of this sort from being representative of what we are asking about in society. The studies themselves don’t ask this. But society depends on a very broad question that the study, by itself, cannot answer. Namely: can we open schools now? What about daycares? Are the youngest children different, yes or now? This is not something a single study can answer. One can also ask: is this study’s design suitable to answer such a question? Is the situation at the moment, namely, the early stages of an epidemic, representative of a later epidemic? And we have already said some things about this in the podcast.

HENNIG: We must make a correction here to something we said in the last episode of the podcast. We were talking about antibody screening, namely in Sweden. We erroneously described a certain detail in the methodology then. What was it?

DROSTEN: Yes, I mixed something up. There was a description of an ongoing PCR study, in which it was said that patients were randomly tested. “Volunteers”, it was said, but more attention should’ve been paid to how random participants were selected. I assumed it was the same for the serological part. But I received a message telling me: “Mr. Drosten, you have overlooked or confused something. For this serological study such a process of patient randomization was not performed, but randomization was performed in other ways. Lab samples, blood samples were chosen at random and tested. That is a type of randomization. I will not say that this is of equal worth, or that this is an easier task, or that it is cheaper but leads to randomization all the same. And I see this as suitable for interpretation, namely to answer the question of seroprevalence.

HENNIG: Namely, how many antibodies.

DROSTEN: Exactly, how many antibodies. And most importantly in children vs. adults. Over the course of three weeks of research, it was discovered that the seroprevalence, especially in children, is rising. This is an observation that I felt was noteworthy enough to mention and emphasize in the podcast, because in Sweden, schools were opened up to the upper levels. For me, the interpretation of this doesn’t change at all. Even so, we should acknowledge that I simply mixed things up. I wrongly understood the methods.

HENNIG: If we open schools after summer vacation, we should also consider what measures to take. Also: we now have a chance to look at the course of the virus more precisely and see that we must worry about outbreaks in schools.

DROSTEN: However you go about this, we will be in this situation. We must therefore decide, as a society, in fair discussions, how we want to go about this. We want to open schools. We want to open daycares, otherwise society won’t function. But how do we want to do this when we know that even if we test many people, you can’t test away a virus. The virus would then be detected and there would be consequences. And what happens when we suddenly decide that we want to close schools back up again because we want virus-free schools? Then we come to the next consideration: maybe we can’t have virus-free schools. What does that mean? What does that mean for teachers? What does that mean for relatives of teachers and students who are especially at risk? What does that mean for the requirement of all parents to send their children to school? All these things are hot topics of discussion that we must clear up now, while we don’t have this problem, so that by autumn we will have had this debate and have made preliminary considerations. No matter what, we must stop saying things like: “Schools are completely unaffected so schools can be opened.” I believe this is false information. And this can come back to bite us. I think that those who keep spreading this sort of information should take another look at the situation and then actively and productively take part in another discussion. Namely: what will happen if we can’t have virus-free schools?

HENNIG: So a discussion about education which we really must have.

DROSTEN: I don’t know if this is a question of education or even medicine. It is certainly a discussion about parents being required to send their children to school. And it has so many aspects. As a virologist it is my duty to say: I talk only about my specialty, my science, not other specialties. There are other specialties besides virology which must speak out as well. But please, with a realistic, critical look at the literature and the background of the studies. You must read more into studies than the title and the abstract. You must read into the nuances and the methods.
What am I saying here? I have not read the Swedish studies properly. And in any case they are in Swedish, which is a language I am not proficient in. I must therefore get a translator. It wasn’t even a paper, it wasn’t a properly published study, but a report from a public health institute. But we are getting sidetracked. It is a discussion in which politics must be very much involved, maybe one without finger pointing, without bringing the position of others in danger. This is serious. I believe this sort of discussion cannot be permitted anymore.

HENNIG: So let’s look at what’s happening now: with the Corona-Warn app, there was a lot of hope that infections could be followed more quickly and more people pre-emptively sent into quarantine in order to prevent an outbreak. However, there are now complaints that the app doesn’t work on older smartphones and many people are locked out as a result. Do you believe that the app functions well, or does it require some work?

DROSTEN: I must say, this isn’t my specialty. I am not a computer scientist. Computer scientists exist, and it is they who must comment on this. I have no idea about this technology. I have a smartphone and the program works on it. I can say little more. I would not want to either way, because that is not part of my specialty. The only thing I can say is the same thing I have said in the past: after reading, and I dare to say understanding a number of studies, I believe that the app is decidedly useful. And that we must without question use it, and maybe a bit more convincing needs to be done in order for it to really help in the recognition of infection clusters and in following cases.

-----LEARNING FROM JAPAN: AVOID THE “THREE C’S”-----

HENNIG: Dr. Drosten, you give above all background information. Apart from social distancing and wearing masks, it is rather hard to give concrete recommendations. Nevertheless, if we take a look at the summer ahead of us, what would we do well to remember? What must we be careful of? In Japanese politics there is a saying that we should all avoid the “three C’s”—in English, closed spaces, crowded places and close contacts, the latter meaning meeting with others without proper distancing. We should avoid all three. Is this something that you would recommend during the summer? Or would you like to add anything else?

DROSTEN: Yes, I am impressed by the efficiency by which things were done in Japan, with a lot of knowledge, background knowledge, even from the time of SARS-1—I am certain this has played a role. The events there have been controlled in a very unique, relatively unintrusive way. A lockdown is not something where you aim in a specific direction, but rather, something wide-reaching. Since nobody knows what is going to happen, everything is closed down as a precaution. This has been recognized and dealt with differently in Japan. There, there is a lot of intelligence at work and a lot of security in decision making. I can only marvel at this. I don’t know what will happen in Japan in the future. But this should continue. That doesn’t mean that the Japanese have found the absolute best course of action and will forever be safe. The case statistics can change and then the Japanese would probably have to adjust. But for now, I can at least tip my hat to them.

HENNIG: Just a moment, we must mention something important. Everyone for whom the Update is part of their regular routine should take note that after this episode, we will be on summer break. You too, Dr. Drosten, will also have to take a vacation. Of course, not for weeks on end, but you do need a bit of time to devote yourself to research again. We will therefore take a break from this podcast, maybe until the end of August. What are the most important research questions for you and your team in the coming weeks?

DROSTEN: We are at a point in time where one can make big plans for the future. I cannot say precisely which areas to make plans for, but right at this moment there is talk of a concrete plan for the network of universities. We are busy with these projects, I myself don’t lead any of them. But many entities are involved with these projects, many universities and university hospitals, in order to help plan. We have interesting molecular biological, molecular virological studies, which are studying host interactions, in other words what the virus does in order to survive in cells. We still have interesting data about the MERS virus and ongoing studies about the MERS virus. We aren’t going to stop those studies, this is a completely different coronavirus, which also has the potential to cause an epidemic, and is also spreading in the Middle East and Africa. And I am generally very worried about Africa. Another group besides mine in the institute is very much engaged in South America. There are also research projects there, in order to help them, I believe.

HENNIG: They are doing studies on the current coronavirus epidemic, I assume?

DROSTEN: Yes, on the current outbreak.

HENNIG: We are continuing to hear reports about medication and vaccine development. Most recently there has been a report from Oxford about dexamethasone, which supposedly causes clear decreases in mortality rate. But this only concerns the most severely infected. Are there areas in which you can say, “Yes, these are the areas I have the highest hopes for, the areas in which research can move us forward regarding the pandemic”?

DROSTEN: I must say that vaccine research in a field that is particularly in focus. I am happy about the reports of successes. I know as well that people should of course be prudent regarding the possible conclusions one can make from these. But this is something that we researchers must focus on to control the epidemic.

HENNIG: We do not, of course, want to leave our listeners without information about the coronavirus while you are away. That is why my colleague Anja Martini will conduct two sessions with researchers from different specialties. Dr. Drosten, this is also in your best interests, in the best interest of science, that other people can also be heard?

DROSTEN: Yes, I have noted that all sorts of science are needed, not just virology, but also related fields. Of course, even in virology it shouldn’t be that only one opinion is heard, but rather, we should have many opinions being heard, hopefully in public.

HENNIG: One last, personal question. We have spoken about research, but I do believe you may also relax a little and take a break, at least in the summer. Will you really be free? Will you be able to read a novel, for instance, or will you read literature about your specialty during your free time—or will you not read at all during your vacation?

DROSTEN: I am always reading about things, as much as I can, as much as time allows me. It’s the same when I’m on vacation.

HENNIG: Dr. Drosten, we thank you for the 50 episodes of this podcast so far, this was the 50th episode. We wish you well during this summer, success for yourself as a virologist and of course, we hope that during the summer something good will happen, which we will be able to talk to you about. Many thanks for everything you have done up till now—best wishes, until next time!

DROSTEN: You’re welcome, till next time.

HENNIG: That was our episode. To reiterate, there will be no episodes from Dr. Drosten in July and August. There is  something I would like to say though about the time without the weekly podcast. Other important themes in research shouldn’t go unnoticed; our science podcast Synapses(3) will still be going the whole summer. In our latest episode, which is already online, we discuss why medicine, so to say, has been blind in one eye. This is because medicines and vaccines have been primarily tested on men and have been designed for men. And this has affected women. A new episode will come out on Friday about forests and climate change, and among other things the question of how much sense reforestation makes from a scientific sense. Our podcast is called “Synapses” and new episodes are released every Friday in the ARD Audiotheque. I would also like to take this opportunity to introduce you all to a completely different podcast, which may be especially relevant during vacation, called “Eat Read Sleep”. My wonderful colleagues Katharina Mahrenholtz and Daniel Kaiser talk about books, give reading recommendations in the podcast, sometimes in view of the coronavirus. In the first episode, which is already online, they have as a guest best-selling author Dörte Hansen—this is all in the ARD Audiotheque and other places that offer podcasts. As I have already said, during the summer break, in July and August, we will have two special episodes featuring discussions with different scientists, featuring my colleague Anja Martini. So don’t cancel your subscriptions if you have subscribed to this podcast, so you can enjoy these in the meantime. We will inform you automatically when our podcast with other scientists is online, as well as when Dr. Drosten is back. I am Korinna Hennig. I thank you very much for your time and for listening. Have a good summer, stay healthy. And continue to take an interest in science! Bye.


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1.)	Konsiliarlabor. I wasn’t able to find an appropriate, ”official” English translation for this word.
2.)	In English in the original broadcast
3.)	Synapsen in German