Text Beatrice Hamberger
Germany has long been admired abroad for the way it has handled the coronavirus crisis. Significantly more testing capacity, fewer deaths, and an efficient health care system with available intensive care beds have garnered the respect of the British, French, and Italians.
All of Europe is now facing an autumn and winter with many unknowns. But things could have been better in the first half of the year – even in Europe’s largest economic power.
Fatal misjudgements at the beginning regarding the spread and dangerousness of the novel coronavirus, SARS-COV-2, the lack of protective equipment for months, and last but not least the outbreaks in nursing homes, which continue to this day, reveal weaknesses in the crisis management.
One can argue whether the World Health Organization (WHO) was too lenient with China or whether it should have declared the coronavirus outbreak a pandemic well before March 12th. Presumably this would have made little change to the worldwide infection rates. For Germany, the factor that counts above all is how quickly and effectively politicians and authorities have responded to health threats. And here it is particularly striking that there is still room for improvement in the use of 21st-century technologies.
Pandemics of the 21st century must be combated with new technologies
Where, for example, are the antigen tests that enable uncomplicated self-testing within 30 minutes, for example after a risky contact or before visiting grandparents? Pharmacies are not allowed to sell the practical new developments, allegedly because they are less reliable with a sensitivity of about 80 to 85 percent compared to the 99.9 percent-accurate PCR test from the specialist laboratory. However, a recent paper from Harvard shows that from an epidemiological point of view many somewhat less accurate tests make more sense than fewer accurate ones.
The political resistance against the self-tests reminds one a little bit of the debate about masks. A lot of time was lost at the beginning before there was agreement on the use of this important protective measure.
Time is a very important factor in fighting infections. Even after three quarters of a year of this pandemic, the predominantly manual work carried out by the health authorities still leads to a constant backlog of reports, which is why the new infection figures for corona issued by the Robert Koch Institute (RKI) are always a little out of date. Worse still, paperwork jams often delay the timecritical notification of infected persons.
The electronic reporting and information system (DEMIS), which had been planned for seven years, entered its test phase early in August only because of the pressure exerted by the crisis. In fact, the nationwide system, which enables electronic data exchange between laboratories, health authorities, and the RKI, was not supposed to be launched until next year. The coronavirus pandemic has accelerated the process. At the moment, however, the 21st-century technology is still unusable for the majority of health authorities and laboratories.
Some lessons learned from the crisis
What can we learn from this? Digital technology is only a means to an end, but it can significantly improve infection control and healthcare. Optimists therefore see the coronavirus pandemic as boosting the digitalization of medicine. And indeed, some recent examples offer hope that people have understood this.
In just a few weeks, for example, an online register was set up that provides an overview of the available intensive care beds in the country, teleconsultations between COVID-19 clinics were set up and online consultation hours were launched. In January 2020, only around 1,400 physicians throughout Germany offered video consultations, while by the summer there were already more than 120,000.
The German government’s Corona-Warn-App should also be mentioned here. With currently 17.5 million downloads, the app was downloaded twice as often as all the other corona apps offered in Europe combined, according to the German Ministry of Health. According to statistical estimates, however, only about 5 percent of all new infections have been reported to the app to date.
In addition, the coronavirus pandemic has made a lot of research possible that was previously stuck. In Germany, patient data is guarded like a holy grail and is distributed among hospitals and doctors in private practice. The electronic patient file, which has been much talked about, won’t arrive this year. Yet it is vitally important for research and care that this data is made networkable. Especially when a pandemic is raging.
The Charité has understood this. In the middle of March, the Berlin university teaching hospital – with the support and 150 million euros of funding from the Federal Ministry of Research – initiated the National Research Network against COVID-19. In the network, more than 30 university hospitals in Germany collect and share their treatment data in order to derive strategies for the diagnosis and treatment of COVID-19 patients, which are directly incorporated into the general care. Such a state-funded research platform with a shared data pool has never existed before in this form in Germany.
Researchers from the Hasso Plattner Institute in Potsdam, however, are circumventing the German »data problem« with American data. Relatively soon after the outbreak of the coronavirus crisis, digital health experts in Potsdam, in collaboration with the Mount Sinai Hospital Institute in New York, were able to show that blood thinners can lead to a much milder course of disease in COVID-19 patients.
Artificial intelligence helped to identify certain laboratory parameters that indicated a blood clotting disorder. AI thus opened the door to a significant therapy. It has never been clearer that human lives are being put at risk when health data is not shared and processed. In this respect, digitalization (not only) in the healthcare sector is likely to be one of the winners of the pandemic.
However, in the long term it won’t work without acceptance by the people. Nobody would download an app or share their data with scientists if the benefit of the action was not obvious.
It will be exciting when the first robot systems reach the patients. Robotics expert Sami Haddadin has just invented a robot that takes throat swabs. It remains to be seen whether the solution from Munich will come before the vaccine to protect medical personnel in a high-risk situation. As Haddadin himself says, the technology of so-called embodied artificial intelligence is still in its infancy.