German health minister steps up COVID-19 crisis management

It is not the beginning Germany's new Health Minister Karl Lauterbach would have hoped for. A week after taking office, he admitted on Thursday that Germany has a shortage of both BioNTech/Pfizer and Moderna vaccine doses and that he is negotiating to buy more vaccines, mainly from Eastern European countries.

"We want to buy BioNTech from other countries — Romania, Bulgaria, Poland and Portugal," he confirmed. He also suggested some of the BioNTech vaccine doses ordered for the second quarter of 2022 could be obtained earlier.

Lauterbach confirmed that 35 million additional doses of Moderna had been ordered directly from the manufacturer with EU approval. On Wednesday, Lauterbach and Finance Minister Christian Lindner announced that Germany would shell out an extra €2.2 billion ($2.48 billion) for vaccine purchases.

The third "booster shot" will be the "central building block" in the fight against the omicron variant, the health minister told the Thursday press conference, adding, "We need to be very quick." 

As things stand, 50 million vaccine doses are expected in the first quarter of 2022, but 70 million are needed.

Lauterbach said he is especially concerned after examining current data from the UK, where cases of the omicron coronavirus variant are believed to be doubling on a near daily basis. He stressed that an "offensive booster strategy" is Germany's best tool in fighting the pandemic.

Smaller Christmas?

Lothar Wieler, head of Germany's Robert Koch Institute (RKI) disease control agency, stressed that omicron was likely to become the dominant variant in Germany very soon.

"We need to make sure Christmas is not a kick-start for omicron. Please spend Christmas only with a small group of people," he said, suggesting that even vaccinated people should consider getting tested before they meet up with elderly relatives for the holidays.

Germany's vaccination rate is hovering at around 70%. Recently, severe restrictions have been placed on the unvaccinated, barring them, for example, access to cultural and sporting events.

This has led to an increase in the number of vaccines administered to over one million per day in December. Now vaccination is available for children from the age of 5. But that will not be enough, says Lauterbach. Unlike his predecessor, Jens Spahn, Lauterbach is in favor of a general vaccination mandate.

But if demand for vaccines cannot be met, it will be difficult to implement the mandatory vaccination of hospital and nursing home staff by March as the government intends, let alone carry out a general vaccine mandate — which is currently under discussion.

New COVID-19 teams

The new health minister has promised to involve scientists more closely in political decision-making. Again, unlike Spahn, who had no medical background, Lauterbach is a physician and epidemiologist. Throughout the pandemic, his predictions for the spread of the virus and proposals to combat it with harsh measures proved to be accurate.

On Tuesday, a newly established panel of scientific experts in the Chancellery held its first meeting designed to bring scientists and politicians together. Its 19 members are experts in the fields of virology and immunology and medicine in general, but also ethics and psychology. The group includes the heads of two central organizations: The Robert Koch Institute, the federal agency responsible for disease control and prevention; and the Permanent Vaccination Commission, or STIKO.

Further meetings are to be held weekly, with the goal of establishing "a broader debate, more acceptance, and transparency." What exactly that means could come into focus before Christmas. Because by then there should be more clarity on the impact of the omicron variant.

Lauterbach took pains to stress that political decisions, however, will be made by politicians — and not the council.

The new German government seems to be following President Frank-Walter Steinmeier's lead. He recently cited the need to learn lessons from the pandemic, calling on politicians to make decisions, to justify them, and to ensure they are democratically legitimate. At a panel discussion in November, he stressed that it was "important for politicians to disclose which experts they involve in decision-making, which facts and value judgments they take into account and what uncertainties and insecurities there are."

The new advisory panel may not find it easy to speak with one voice, though: Members Hendrik Streeck and Christian Drosten, for instance, are two of the most popular virologists in Germany and have often expressed conflicting opinions on pandemic control. It remains to be seen whether the panel will be able to reach unanimous conclusions.

In addition to the expert panel, there will also be a new crisis team in the Chancellery. It brings together federal and state government representatives and will coordinate concerted action. One of its goals is to improve the organization of vaccination campaigns: The head of the crisis team, Major General Carsten Breuer, has already urged keeping vaccination sites open across the country during the Christmas holidays.

In the new year, however, Germany's vaccination drive may be headed for a snag. As he alluded to Thursday, earlier this week Lauterbach announced that an inventory inspection revealed an insufficient amount of vaccine doses had been ordered for the first three months of 2022. According to media reports, the country could be short as many as 60 million doses. Beyond purchases from other EU nations, Lauterbach promised he would immediately negotiate with manufacturers to secure extra supplies.

Structural challenges

Lauterbach has big plans but the federal health minister has limited powers. Like the US, and in stark contrast to France, lawmaking rests with the states and the list of regional powers is long: Health policy is part of it, just like education, policing and cultural policy.

Germany's 16 states continue to impose and extend their own regional rules and restrictions, as well as organizing vaccinations.

The fact that many hospitals have been struggling to cope with the increased number of patients during the current fourth wave of the pandemic has also highlighted wider structural problems. For years, health services have seen cuts in funding. Now the new government wants to reverse the trend. This is a "hopeful sign that there will be an end to the painful structural changes," said Gerald Gass, head of the German Hospital Association (DKG), which represents over 1,900 hospitals nationwide.

Germany's governing coalition has vowed to introduce "binding staffing levels in hospitals" for inpatient care in the short term in order to improve working conditions "quickly and noticeably."

Furthermore, they see a need to strengthen outpatient care facilities and create "integrated emergency centers" that make sure only serious cases end up in hospital emergency rooms.

This story was originally written in German.