Where do people get infected with the coronavirus? | Science| In-depth reporting on science and technology | DW | 30.10.2020
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Science

Where do people get infected with the coronavirus?

Parts of Europe are going into lockdown again and many people are asking themselves: Why are some places closed and others allowed to stay open? Our fact check shows how much is known about the places of infection.

Germany is hotly debating the new lockdown. Owners of hotels and restaurants are afraid for their businesses. Caterers and event organizers  are holding a symbolic funeral for their industry. Artists and cultural workers  are reacting stunned. In sports, there is talk of a "catastrophe",  and German medium-sized businesses  are warning of a "deathblow" for tens of thousands of companies.

Admittedly, according to a survey in the weekly magazine Der Spiegel,  more than 62 percent of Germans consider the lockdown necessary. But many sectors of society do not see this necessity in their own field. This is also due to partly contradictory statements and information about the places of infection in recent weeks. Our fact check clarifies what we know about the sites of infection with the coronavirus and what we do not know - and it explains, why the publicly accessible data have only limited significance.

Where do people in Germany get infected?

Most people in Germany currently get infected in the private sector. The own household is the most common place of infection, according to the Robert Koch Institute  (as of October 27). Another large and currently growing area of infection is in nursing homes and homes for the elderly, followed by the workplace. The incidence of infections in the leisure sector, which is now strongly affected by the lockdown measures of the federal and state governments,  is much smaller.

Infections in the medical sector, such as in hospitals or doctors' practices, are comparatively manageable, but they have recently increased significantly. The situation is similar in educational institutions, such as schools or kindergartens, or in refugee homes. Restaurants, hotels and guesthouses account for only a very small proportion of infections in Germany, but they are among those most affected by the new measures.

The risk of getting infected in public transportation is apparently even smaller. However, this could also be due to the sharp drop in the number of passengers on buses and trains. A large proportion of infections also occur in places that the RKI does not define in detail and summarizes under "others". 

The available data, which were also processed in the following diagram, cover only about a quarter of all cases of infection in Germany. 

Infografik COVID-19 Infektionsorte Deutschland EN

Are the places of infection the same as in the first corona wave?

No, there are remarkable differences: At the peak of the first wave of the COVID 19 pandemic in Germany, old people's homes and nursing homes were even stronger drivers of the infection than private households. The medical sector — especially hospitals — and refugee shelters were also much more frequent places of infection than now.

Schools and kindergartens played no role in the pandemic in the spring - logically: unlike now, they were closed across the board. It is noticeable that the workplace played a rather minor role in spring, but is now responsible for considerably more cases. A sharp increase in workplace infections in June is mainly due to outbreaks in slaughterhouses and companies with seasonal workers.

The infection patterns in Germany have therefore changed compared to the first wave of the pandemic. This can be partly explained by other measures taken by the authorities, while other shifts will probably only become clearer when more data on the current increase in the number of infections in Germany is available. 

Schools and kindergartens remain open. Is that justified?

The governments in Germany and France  have decided to leave schools and kindergartens open despite extensive closures in public life. One of the reasons given for this is the special importance of education for society.

If one looks only at the pure numbers, the decision seems understandable. Even though schools and kindergartens play a certain role in the infection rate, this role is comparatively small.

According to RKI data, only a few outbreaks occur in educational institutions. And this is also the case in other countries: In Ireland,  schools are responsible for outbreaks of coronavirus in just under 7 percent of cases, in Spain  the figure is 6 percent. This is also due to the fact that young people are less affected by the virus than older people: The proportion of people up to 18 years of age among those infected in Europe  was less than five percent in August. 

People leaving a tram car in Germany, some wearing masks - others not.

According to the RKI, public transport is not a driver of the pandemic - most infections occur in private households

How meaningful are the data?

Unfortunately, the data of the RKI don't tell us all that much at this point. The statistics of the Berlin Institute only record so-called outbreak events. Those include documented cases with two or more infections. And the RKI admits: "Only about a quarter of the total number of reported COVID-19 cases can be assigned to an outbreak.

When asked by the DW about the remaining 75 percent of corona infections in Germany, the RKI states: "We actually do not have more data. The European Centre for Disease Prevention and Control (ECDC) is also unable to provide data on infection sites upon DW request.

Three quarters of the infections in Germany are therefore not documented with regard to the outbreak location. One reason for this is the complexity of reliably assigning a single infection to a specific location, as some people remain symptom-free for several days before they get sick. It is then hardly possible to trace back the infection.

On the other hand, this patchy data situation makes it difficult to find the right response to the pandemic - and not only in Germany. But data from other countries show at least similar trends. Studies in South Korea  also see private households at the center of the infection, where "it is six times more likely to become infected with SARS-CoV-2 than with other close contacts. And a Chinese study  puts the proportion of infections in private households at 69 percent.

This article was translated from German and updated on November 2 to emphasize the point that the data is not fully representative of all infection paterns.  

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