One January lunch at an auto parts company, a worker turned to a colleague and asked to borrow salt.
Like salt makers, at that time, they shared a new corona virus, from which scientists concluded.
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That their exchange was documented at all was the result of close scrutiny, part of a rare success story in the global war on viruses that passed 1.5 million cases on Thursday.
The co-worker was the initial link in what became the first multi-human transmission chain documented outside of Asia COVID-19, a disease caused by coronavirus.
They are based in Stockdorf, a city in Germany with 4,000 near Munich in Bavaria, and they work at the Webasto Group auto parts supplier. The company was pushed under a global microscope after revealing that one of its employees, a Chinese woman, caught the virus and took it to Webasto headquarters. There, it was passed on to colleagues – including, scientists would study, someone had lunch in a canteen with whom Chinese patients had no contact.
The January 22 canteen scene is one of dozens of worldly incidents by which scientists have entered a medical hunt to track, test and isolate infected workers so that the Bavarian regional government can stop the spread of the virus.
The hunt has helped Germany win an important time to build its COVID-19 defense.
The time Germany bought may save lives, scientists say. The first locally transmitted COVID-19 outbreak began earlier than Italy, but Germany has fewer deaths. The first local transmission detected by Italy was on February 21. At that time Germany had begun an information ministry of health campaign and a government strategy to tackle the virus which would depend on extensive testing. In Germany so far, more than 2,100 people have died due to COVID-19. In Italy, with a smaller population, the total exceeds 17,600.
“We know that we must carefully trace the infection chain to stop it,” Clemens Wendtner, a doctor who treats Munich patients, told Reuters.
Wendtner worked with some of Germany’s top scientists to overcome what came to be known as the ‘Munich cluster,’ and they told the Bavarian government about how to respond. Bavaria leads by locking, which is carried out nationally on March 22.
Scientists including UK Chief Medical Officer Chris Whitty praised the widespread German initial tests by slowing the spread of the virus. “We all know that Germany is advancing in terms of its ability to carry out virus testing and there is much to be learned from it,” he said on TV earlier this week.
Christian Drosten, a top virologist at Berlin’s Charite hospital, said Germany was helped by having a clear initial group. “Because we had this Munich cohort from the start … it became clear that with great encouragement we could further inhibit this spread,” he said in a daily podcast for NDR radio on coronavirus.
Drosten, who refused to be interviewed for this story, was one of more than 40 scientists involved in cluster research. Their work is documented in preliminary form on a working paper at the end of last month. This paper, not yet reviewed by colleagues, is shared on the NDR website.
It was on Monday, January 27, that Holger Engelmann, CEO of Webasto, told the authorities that one of his employees had tested positive for the new corona virus. The woman, based in Shanghai, has facilitated several days of workshops and attended meetings at Webasto Headquarters.
The woman’s parents, from Wuhan, had visited her before she left on January 19 for Stockdorf, the newspaper said. While in Germany, he felt unusual chest pain and back pain during his stay. But he lowered his symptoms to jet lag.
He developed a fever on his flight back to China, tested positive after landing and was hospitalized. His parents were also later stated positive. He told his manager about the results and they sent an email to the CEO.
In Germany, Engelmann said he immediately formed a crisis team that notified medical authorities and began trying to track down staff members who had made contact with their colleagues in China.
The CEO himself is among them. “Only four or five days before I received the news, I shook hands with him,” he said.
Now known as “Case # 0” Germany, Shanghai patients are “proven employees of project management” Engelmann personally knew, he told Reuters. The company has not revealed its identity or the identity of others involved, saying anonymity has prompted staff to work together in Germany’s efforts to control the virus.
The task of finding out who made contact with him was made easy by the Webasto worker electronic calendar – for the most part, all a doctor needed was to look at staff appointments.
“That’s good luck,” said Wendtner, a doctor who treats Munich patients. “We got all the information we needed from staff to reconstruct the infection chain.”
For example, case # 1 – the first person in Germany to be infected by a Chinese woman – sat next to him at a meeting in a small room on January 20, write the scientists.
Where calendar data are incomplete, say the scientists, they can often use the whole genome sequence, which analyzes differences in the genetic code of viruses from different patients, to map their spread.
By following all these links, they found that case # 4 had been related several times with Shanghai patients. Then casket number 4 sat facing each other with a colleague in the canteen.
When the colleague turned to borrow salt, the scientists concluded, the virus moved between them. The colleague became case # 5.
Webasto said on January 28 that it was temporarily closing its Stockdorf website. Between January 27 and February 11, a total of 16 COVID-19 cases were identified in the Munich cluster. All but one is to develop symptoms.
All people who test positive are sent to the hospital so they can be observed and doctors can learn from this disease.
Bavaria closed public life in mid-March. Since then Germany has closed schools, shops, restaurants, playgrounds and sports facilities, and many companies have closed to help with this problem.
HAMMER AND DANCE
This is not to say that Germany defeated COVID-19.
The corona virus mortality rate of 1.9%, based on data collected by Reuters, is the lowest among the most affected countries and compared with 12.6% in Italy. But experts say more deaths in Germany cannot be avoided.
“The death rate will increase,” said Lothar Wieler, president of the German Robert Robert Institute for infectious diseases.
The difference between Germany and Italy is partly statistical: German figures appear to be far lower because they have been tested extensively. Germany has conducted more than 1.3 million tests, according to the Robert Koch Institute. Now do up to 500,000 tests a week, said Drosten. Italy has conducted more than 807,000 tests since February 21, according to its Civil Protection Agency. With a few local exceptions, Italy only tests people who are taken to hospital with symptoms that are clear and severe.
The German government uses weeks gained from Munich’s experience to double the number of intensive care places of around 28,000. The country already has the highest number of critical care places in Europe per head of population, according to a 2012 study.
Even so, that might not be enough. An Interior Ministry paper sent to other government departments on March 22 included the worst case scenario with more than 1 million deaths.
Another scenario sees 12,000 deaths – with more testing after partial relaxation of restrictions. The scenario was dubbed “hammer and dance,” a term coined by blogger Tomas Pueyo. This refers to a ‘hammer’ of aggressive action over several weeks, including large social distances, followed by a ‘dance’ of calibrating these steps depending on the transmission level.
German government papers argue that in the ‘hammer and dance’ scenario, the use of big data and location tracking is unavoidable. Such monitoring has proven to be controversial in Germany, where the memories of the East German Stasi secret police and its information are still fresh in the minds of many people.
The next draft action plan prepared by the government proposes a quick trace of the infection chain, the use of mandatory masks in public and limits on the meeting to help enable a gradual return to normal life after the German lockup. The government supports the development of smartphone applications to help track infections.
Germany says it will re-evaluate the lockdown after the Easter holidays; for auto parts makers at the heart of its first outbreak, the crisis is soon over. The Webasto office has been reopened.
All 16 people who captured COVID-19 there have recovered.