Public Policy Dynamics Germany #7

by RPP colleagues

Health and Politics in Germany

Total COVID-19 cases:2,893,883
14-day total COVID-19 cases per 100,000:272.53
14-day change:+77.73
Total COVID-19 deaths:77,013
14-day rise:2,299
  • German politics has been dominated by the debate on how to handle the latest Covid-19 developments. While Armin Laschet, leader of the Christian Democratic Party (CDU), proposed a “Brückenlockdown” (“bridge lockdown”) to decrease the number of cases, other high politicians plead for different measures. Meanwhile, the leading committee of the Green Party in Baden-Württemberg has decided to continue the coalition with the conservative CDU following the state elections on 14 March.
  • The German Federal Association of office-based Cardiologists has published a statement highlighting the rising number of cardiovascular diseases in Germany, even among younger people. The current pandemic intensifies these developments. Separately, the National Association of Statutory Health Insurance Funds criticises the current plan for the federal budget for 2022.
  • On 30 March, the federal and state health ministers opted to restrict the use of the AstraZeneca vaccine for citizens under 60 years of age. The decision is based on the recommendation by the Standing Committee on Vaccination (STIKO), an independent advisory group, over new concerns of unusual blood clots. Against this backdrop, doctor’s offices are now involved in the German vaccination campaign.

Politics

  • Covid-19 cases in Germany are still rising but state politicians cannot find common ground on the measures to decrease the number of new infections. After the last conference of Chancellor Merkel and the 16 Prime Ministers of the states on 22 March led to Merkel personally admitting her error in judgement and apologising to the public, political leaders seem to be paralysed regarding further decisions ever since. While federal politicians like Chancellor Merkel (CDU) and the Minister of Health Jens Spahn (CDU) push for a relatively short but strict lockdown to flatten the curve of rising case numbers, most prime ministers of the states seem to follow their own agenda. While Bavaria’s Prime Minister Markus Söder (CSU) is promoting the idea of stricter measures, many states governed by politicians from the Social Democrats (SPD) refuse to agree. However, Armin Laschet, Prime Minister of North Rhine-Westphalia and party leader of the CDU is the main figure in this discussion. Laschet pleaded for softer restrictions and a broader interpretation of the “Notbremse” (“emergency brake”) – the automatic tightening of restrictions once the seven-day incidence rises higher than 100 over a three-day period in a certain area.
  • On 28 March Chancellor Merkel joined a popular prime time talk show to express her frustration over the cooperation with several state leaders, even pointing out Laschet by name. She also expressed her thoughts on extending her own influence in further decision-making. Only days after the interview, Armin Laschet proposed a “Brückenlockdown” (“bridge lockdown”), advocating for a short but strict lockdown to massively decrease Covid-19 case numbers, without naming any concrete measures. Many observers interpret this as a change of heart as a direct reaction to Merkel’s interview. The whole dynamic is of special interest since Armin Laschet is expected to be the party’s candidate for the German chancellorship in this year’s federal elections.
  • Meanwhile, the leading committee of the Green Party in Baden-Württemberg refused to join a so called “traffic light coalition” with the Social Democrats (red party colour) and the Liberals (yellow party colour). Instead, they expressed their desire to continue a coalition with the CDU. This could have some implications for the federal election in late September this year, where the Green Party is expected to deliver a strong result. Many leftists speculate the formation of a “progressive” new government, sending the CDU into opposition after 16 years of Chancellorship.

 

Health

  • In the wake of the World Health Day on 7 April, the German Federal Association of office-based Cardiologists published a statement pointing out the rising number of cardiovascular diseases in Germany. This applies to younger people as well. Reason for this is the ever unhealthier lifestyle followed by children and teenagers. The impacts of the current pandemic seem to intensify these developments. Closed playgrounds, suspended recreational sport offerings, and home schooling have led to a massive reduction in physical activity. Several reliable studies support these statements. For example, Germany recorded about 11.6 million “Years of Life Lost” (YLL) in 2017, with about one fourth of those as a result of cardiovascular diseases. A considerable portion thereof related to younger and middle-aged groups. 
  • Furthermore, the National Association of Statutory Health Insurance Funds (GKV-SV) criticises the current plan for the federal budget for 2022. According to the federal budget plan, no additional financial resources are intended for the stabilisation of contribution rates for health care as well as for the nursing care insurances. The statutory health insurance by itself is expected to have additional financial requirements of €16-19 billion in 2022. The GKV-SV expects the Federal Government to make up for these losses in order to prevent increasing add-on fees as well as statutory service constraints for insured people. 

 

Covid-19

  • On 30 March, the Federal Minister of Health Jens Spahn and his colleagues, the 16 states’ ministers of health, decided to restrict the administration of the AstraZeneca vaccine for people under the age of 60. The ministers’ decision was based on the recommendation by the Standing Committee on Vaccination at the Robert Koch Institute (STIKO), an independent advisory group, after new cases of unusual blood clots called cerebral venous sinus thrombosis (CVST) became public. This type of blood clots mainly affected younger women. Despite the new restrictions, it was emphasised that the vaccine is highly effective against severe courses of Covid-19. The restrictions are believed to be necessary to maintain public trust in the AstraZeneca vaccine, but also in the German vaccination campaign itself.
  • The latest developments have huge implications for the German vaccination programme, especially the logistical part of it. Elderly citizens, who were previously predominantly vaccinated with the BionTech/Pfizer vaccine will, as of now, receive the AstraZeneca vaccine. Regarding younger people, who are affected by the new recommendations and were already given their first AstraZeneca shot, the STIKO announced that it would issue updated guidelines by the end of April.
  • Germany had already suspended the AstraZeneca vaccine for several days in mid-March, after similar cases were reported in several European countries. After proper investigations, the STIKO and the health ministers had assessed that the benefits of the vaccine outweigh the risks, which is why no further consequences were drawn at the time.
  • Against this background, doctor’s offices are now involved in the German vaccination campaign. During the first two weeks in April, only the vaccine from BionTech/Pfizer will be administered in the doctor’s offices while the AstraZeneca vaccine will be consigned to bigger vaccination centres. Due to relatively low initial capacities, every office is expected to receive about 20 doses per week. This number is expected to increase in the following weeks.

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