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We have to turn the game around!

How we can present ourselves with an easier way through the Corona winter at Christmas - and what it has to do with soccer.

Authors: Melanie Brinkmann, Sandra Ciesek, Viola Priesemann

Originally published in “DIE ZEIT” Nr. 52/2020

This article can be translated and printed, if referred to the authors and the original source as follows: Wir müssen das Spiel drehen, M. Brinkmann, S. Ciesek, V. Priesemann, DIE ZEIT Nr. 52/2020

This much is clear: Christmas and New Year’s festivities this year will be very different from what we are used to. But beyond the holidays, what is a sensible strategy for the coming months? This is a question that scientists in all of Europe and the world are contemplating about. We have been in exchange with experts of various fields, from virology to sociology, from epidemiology to economics, and we all come to the same conclusion: Such a high number of cases, as we currently have, is not sustainable in the long-term, neither for the healthcare system nor for the economy and society. Therefore, we demand, together with many other scientists in Europe, to rapidly lower the number of infections, and then stabilise them on a low level. We suggest aiming for a target of 10 new infections per million people per day. This target is reachable and allows for clear leeway up to a critical limit between 35 to 50.

But this can only be sustainably accomplished if all of Europe is aiming for the same goal. The virus is taking advantage of our open borders. Without coordinated efforts, countries who have managed to lower the number of cases will repeatedly experience that the virus is reimported from neighbouring countries with a high number of cases. This European game of ping-pong has devastating consequences.

Curbing the virus spread, therefore, requires European teamwork: Every country which gets the spread under control helps its neighbouring countries in keeping the number of cases low. Thus, we urge for setting such a goal together and to make it binding. How exactly one accomplishes this goal, countries and regions will know best themselves.

But also on a regional level, fighting the pandemic requires teamwork and consideration. Many people help with the curb by reducing contacts, following safety guidelines and being careful. Of course, a large contribution is from workers in the healthcare system. Doctors, nurses and auxiliary staff are tending to infected patients in hospitals and family practices every day. Regarding the fact that some people find the pandemic exaggerated or measures too extreme, or are even denying the existence of this virus: workers in the healthcare system - also the ones in laboratories and offices - have to deal with this day by day.

To make it clearer, we want to compare it to football. No good team solely relies on the defenders and the goalkeeper to stop goals. The opponent has to be controlled on the whole field to prevent painful goals. This virus is an opponent that uses every gap in the defense and has to be taken very seriously. Therefore, our whole team has to be placed strategically and cleverly on the field. Everyone has to contribute to turning the tide. For this, we need clear rules which are understandable and most of all consistent - not only in Germany, but in the whole of Europe. Just like in football - there we also do not have different rules for different clubs or countries.

One of the best ways to sustainably strengthen our defense is the vaccine. Every day, safe and effective vaccines are coming a bit further into reach. The vaccine turns a third league team into a Champion’s league one. By now we know that there are going to be vaccines in the coming year - so it is worth it to fill the gaps in our current defense with all our might. And not only that: Until then, we have to take back the lead in this tough match.

To achieve this, we have to start with drastically reducing new infections. The benefits are clear as day:

Simulations have shown that there is a so-called tipping point at which the virus takes over. We often see such points in science. In the case of the virus, the testing capacities and the capacities of health offices are important criteria. Getting back to the football metaphor - at high case numbers, we are merely following the ball in our own penalty area instead of keeping it clear. The aim has to be not to even lose the ball to the opponent because running after the opponent costs too much strength and ressources. It is better to keep control of the ball. Thus, it holds: The earlier we act, the better it is.

To regain control of the infections and to keep it, we propose a strategy with four core elements:

  1. Drastic reduction of the number of new infections. For this purpose, the target should be to have no more than 10 new COVID-19 cases per million people per day. This target has been reached in many countries after the first wave in spring. It can be reached again. Strong and consistent interventions have proven efficient. The economy suffers significantly less from consistent but thereby short interventions than from less efficient and thereby longer ones.
  2. Stability: Keep new infections on a constant low level. When case numbers are low, easing of restrictions is possible. They should be carefully monitored, though. Targeted mitigation measures still have to be continued, such as mask wearing, hygiene, moderate contact reduction, testing, and contact tracing. Local outbreaks require a rapid and rigorous response, including travel restrictions and targeted testing to prevent exportation to stable regions.
  3. Coordinated and consistent strategy in Europe: To avoid a ping-pong effect of importing and reimporting SARS-CoV-2 infections, the reduction should be synchronized across all European countries and start as soon as possible. This synchronization will allow European borders to stay open.
  4. Develop a longer-term common vision. Develop context-sensitive regional and national action plans as well as European-level goals, depending on the COVID-19 prevalence, with a special focus on test-trace-isolate-strategy, prevention measures and vaccination strategies.

Reaching this low-incidence-strategy will take a lot from people in Europe. But it is worth it. It is much easier to stabilise the number of cases at 10 per million people per day than at 35 to 50.

In order to reach these goals, we need communication which clearly underlines the social and economical benefits for everyone. We will not persuade those who want to believe in a comprehensive conspiracy of politics, economy, science and media. But we have to make our insights, our arguments and our conclusions so easy to understand that as many people as possible are willing to see themselves as part of the team.

A part of this is also that the restrictions of our rights and freedom have a clear deadline. We are all longing for the final whistle. Looking to the future with hope, control of Sars-CoV-2 will become easier: testing methods will be expanded, contact tracing will be made more efficient through digital capabilities, vaccination will provide for increasing immunization of the population, and better understanding will be achieved through more education, information, and explanation, even for lay people.

So what does this mean for the upcoming holiday season? So far, the Christmas season has been described as a pandemic horror scenario, since it is considered a major risk. But it is actually an opportunity, a chance to bring infection numbers down to low levels. Companies have company vacations, schools and daycare centers are closed, and currently also restaurants, leisure and cultural facilities.

The risk is called proximity: We are moving closer together within our own four walls, possibly with people from the most diverse parts of the republic. But that's exactly where we need to be particularly vigilant - even before we meet, but especially when we're together.

By protecting our loved ones, slowing the spread of infection, and easing the burden on our healthcare system, we can take advantage of the holiday season and the deceleration it brings. We can give ourselves presents: After all, then, if we succeed in reducing the number of cases now, we can move more easily through the upcoming winter months, then we can visit restaurants, meet friends, and enjoy our so many cultural offerings. All of this is possible if infection numbers are kept at a low and stable level.

We don't want to sugarcoat anything: It will remain exhausting even then. But only if we put the virus in its place will we be able to lead a largely normal life again.