The number of respiratory infections is currently high in Frankfurt. Doctors observe a catch-up effect due to corona.
Frankfurt -The nose is dripping, the throat hurts and the cough torments: a war for a year and a half, now rarely occurs again. The cases are also increasing with general practitioner Jürgen Burdenski in the north of Frankfurt, around 50 per week. Does that worry him? “No,” answers the family doctor from Eckenheim on the phone. “The number of patients with colds is high, but that is the first nothing unusual at this time of the year,” says Burdenski. “And secondly, the numbers are higher than in 2020, but not higher than about two years ago.”
The former should not come as a surprise, given that Germany was still mostly facing lockdown during the cold season last year. The contacts were reduced to a minimum, and the immune system hardly came into contact with pathogens.
Nothing to feel of a wave yet – so far
Because of the return to more normalcy, including in schools and daycare centers, doctors like Burdenski are already observing catch-up effects in respiratory diseases. But the general practitioners have nothing to do with a particularly violent cold and flu epidemic that general practitioners have employed, for example. At least not yet.
The Frankfurt physician’s experience is consistent with the current figures from the Robert Koch Institute (RKI). Respiratory infections are not among the reportable diseases, which is why there are no precise figures. The agency nonetheless breaks down at least the estimated rate of acute respiratory disease (ARE) every week.
The basis is the online reports from around 6,800 participants who provide the RKI with weekly information on whether they are suffering from a respiratory infection. In addition to colds, this also includes sore throat or tonsillitis that die from viruses or bacteria. In the 44th calendar week (1st to 7th November) the total ARE rate was 5.5 percent or based on 100,000 inhabitants, with 5500 ARE cases well above the value of the previous year when the country was in lockdown. It is worthwhile to compare the current figures with the rates of autumn and winter 2018/2019, i.e. before the pandemic.
Number of illnesses at the same level as before Corona
The figures over the past few weeks make it clear: Overall, the ARE rate has now adjusted to that of the years before the pandemic. Also in the 2018/2019 season there has been a steady and sometimes strong increase in autumn since the 32nd calendar week. The number of cases is rising even more slowly this year, and the rates did not increase in the 44th calendar week, but have been abandoned. Extrapolated to the population in Germany, around 4.6 million had a new acute respiratory disease (with or without fever) in the 44th calendar week. All in all, a wave of colds that goes beyond the usual level cannot yet be spoken of.
At times, however, the number of infections among small children rose sharply and was well above the pre-crisis level. There were still significant differences between the age groups up to calendar week 40. The ARE rate among adults is always in the same range as it was before the Covid 19 pandemic at this time of year. However, the RKI cold curve for children (0 to 14 years) in the previous weeks was still consistently above the values for the 2018/19 season, in some cases significantly.
This was mainly due to the high number of cases among small children (0 to 4 years of age). In calendar week 39, the ARE rate among 0 to 4-year-olds was still 22.2 percent compared to 8.6 percent in the same period in 2019.
According to the RKI, there has been a downward trend for four weeks
According to the RKI, however, a downward trend has been noticeable for four weeks. According to the latest weekly report, the rate among small children in calendar 44 has now largely adjusted to the pre-pandemic level at that time, at 15.3 percent week.
The temporary increase in children is mainly due to the fact that the respiratory syncytial virus (RS) is currently rampant and children’s clinics and pediatric practices have even reported to the limit nationwide in the last few weeks (we reported). The situation in Frankfurt is still tense. RS is a pathogen that is the most common cause of acute respiratory infections in babies and young children around the world.
The rising numbers are also related to the pandemic – and the functioning of the immune system. It has to be trained continuously. This is why contact with viruses and bacteria is so important, explains Wiebke Remann from the Frankfurt Health Department. The defense only learns how to react through contact with pathogens. This information is then stored in the immunological memory. As a result, the children’s immune system, which is still very inexperienced, can react faster and more effectively when they come into contact with pathogens that are already in place, explains physician Burdenski. In lockdown, however, the defense was hardly confronted with viruses and bacteria, immune reactions only rarely took place – and now have to be relearned.
Restaurant, cinema, school: the immune system is challenged again
Since restaurants, cinemas, schools and daycare centers have reopened, the defense system has come into contact with pathogens again after a long break and is strongly challenged. The result: often run more often than usual.
Family doctor Burdenski does not believe that this effect will be significantly more colds and severe courses in adults this year than during the Corona period. However, one could not judge in advance how severe the cold waves are, says Reimann from the health department. “In any case, the medical mask protects against all droplet infections to a certain extent.” Burdenski is more concerned about the significant increase in corona cases. Covid-19 can also hardly be distinguished from a cold. He therefore appeals to all those affected: “Everyone with cold symptoms should isolate themselves and do a corona test.” (Julian Dorn)