Dr. Sebastian Graefe in an interview about booster vaccinations, masks and misunderstandings

Lüneburg. More and more people in the Lüneburg district are currently falling ill with Corona again. At the same time, a relatively relaxed approach to the virus has become established in society in recent months. However, there are increasing numbers of international studies provide evidencethat Covid-19 attacks the nervous system or the heart and in the long term also in children even Autoimmune diseases can trigger or promote.

In the LZ interview, the Lüneburg infection epidemiologist Dr. Sebastian Graefe about the coming Corona winter, protection options and the German fear of booster vaccinations.

Dr. Graefe, the The pandemic is officially over. But the corona virus “SARS-CoV-2″ remains and is now considered endemic, i.e. harmless?

Not at all. Rabies was once endemic here and this infectious disease is 100 percent fatal in humans. Nobody would think of declaring that rabies was harmless just because it was endemic. And measles, for example, is still endemic…

Endemic is just an epidemiological term. Ultimately, it means nothing other than that an infection is present in a population and that more or less cases are occurring on an ongoing basis. But it says nothing about the harmlessness or danger of an infection.

Nevertheless, there seems to have been a collective relaxation or indifference in dealing with Corona. Even some family doctors only refer to Covid-19 as a “cold”, although there are always new studies about the long-term damaging effects of the virus. How do you see that?

So I think this trivialization as a cold illness is a bit dangerous: Because the corona infection is fundamentally still more serious than the viral flu and, over a certain period of time, still causes more deaths.

Corona is not a harmless cold, although with Corona, as with other viral diseases, there is a certain variability in the severity of the course of the disease: some people don’t notice it at all, some notice it a little, some people get sick, some get seriously ill and some then die from it .

This variability also exists in the population because of varying levels of immunity as a result of vaccinations or infections. And so there are harmless progressions and severe progressions. But the fact that everyone with Corona just has a cold is of course nonsense.

And then there is still this strange idea that the immune system is trained when it goes through infections. This is completely wrong! The immune system is built in such a way that millions and billions of cells exist against certain pathogens and they are never all activated in life because the pathogen in question may never appear.

The immune system is therefore preformed and does not need to be trained. It’s already in the starting blocks, and as soon as a pathogen arrives, it starts in a very specific way.

So: The immune system is not a muscle that needs to be trained, but rather a kind of memory that can be introduced to a new pathogen using vaccines without having to go through an infection.

In Austria, doctors from leading clinics recently joined one open letter turned to the Vienna Medical Association and again called for public preventive measures. The signatories also criticize the fact that the medical profession primarily obtains information about Corona through general reporting instead of in scientific specialist magazines, and therefore incorrectly assesses the risks. It is said that the unhindered infection with a neurotropic virus that affects the nervous system is irresponsible. To what extent does this description of the situation also apply to Germany?

I think that doctors generally get their information not only from radio and television or the press, but also from specialist journals or review articles, for example in the German Medical Journal. But ultimately I can’t judge it well. However, doctors are encouraged to continue their training and consult specialist information.

Sometimes it is also the case that preconceived opinions about vaccinations or infectious diseases and the like are of course difficult to change. Every doctor has their own ideas and is sometimes reluctant to deviate from them. But I think most doctors who are involved in life and see their patients every day take corona disease seriously.

Because the corona virus is not only neurotropic, but also cardiotropic, so it affects the nervous system and the heart, the endothelia (The inner cell lining of blood vessels: editor’s note) and thus on different organs. It is a virus that can replicate in many different tissues.

And the infection of the population will happen anyway. We will not be able to avoid coming into contact with such a contagious and mutation-happy virus. But the question is: How seriously will we become ill as a result and how often? It may therefore make sense to reintroduce measures such as wearing masks indoors with many people, for example in hospitals, as was recently the case at the Frankfurt University Hospital.

This awareness should be strengthened again that we are not dealing with a harmless virus and that we should not necessarily risk being infected more often. That’s why vaccinating, wearing a mask and testing if you have cold symptoms are important. Even if we cannot avoid experiencing an infection, we can perhaps reduce the danger somewhat.

If I understand you correctly, the point is not to do everything possible not to get infected, but just as rarely as possible?

Exactly, otherwise the restrictions would be far too severe. And we’re all tired of these topics: masks, Corona… it’s getting on all of our nerves. And the measures we had in some cases with lockdowns and exit restrictions were very strenuous. That’s why I don’t think we’ll go into lockdown again.

But you should protect yourself as best as possible, be it through vaccinations, masks or something else. We simply have to try to keep the infection pressure as low as possible without restricting ourselves excessively.

At the moment the infection pressure seems to be increasing rapidly again. Nevertheless, you hardly see people walking around in public with a mask. How do you assess the situation?

At the moment it’s still relatively relaxed. It is increasing, but at a relatively low level, in terms of the number of serious illnesses with patients in intensive care. That was significantly more. But winter is still coming. You should definitely keep an eye on the situation, especially if new Corona variants emerge that can strike even harder.

Like possibly the omicron variant “Pirola” (BA.2.86.), which was first detected in Germany at the end of August. Also because of Pirola’s apparently strong ability to bypass immune protection, Israel recently reintroduced mandatory PCR testing for new hospital admissions. What does the new variant mean for the corona vaccination campaign that recently started in this country?

Pirola’s numbers are still low here, so we’ll have to keep an eye on whether it will catch on. In principle, this is an omicron variant, with indeed plenty of mutations.

However, it seems to be the case that people with previous omicron disease or an adapted omicron vaccination actually develop neutralizing antibodies against Pirola. That would mean a certain level of protection against Pirola. This also applies to the brand new vaccine that has now been delivered. That would be even more reason to get a booster vaccination now.

The Stiko recommends a booster vaccination only for high-risk patients and everyone over 60 years of age. The CDC in the USA recommends corona vaccinations for everyone aged 6 months and over. What do you recommend?

In Germany we are a bit afraid again, the Germans are afraid of everything possible, including booster vaccinations. When we were still vaccinating on behalf of the Lüneburg district, we kept it relatively generous. In Lüneburg we not only vaccinated high-risk patients, but also on request.

The official recommendation also includes people who have contact with other people at high risk. I would like to see a person who has no contact with any risky people, whether older people, people with previous illnesses or pregnant women.

So you should consider a booster vaccination six to twelve months after your last vaccination or infection, even if you don’t necessarily belong to the risk group. And even if the vaccination does not reliably protect against infection, it also reduces the risk of passing on the infection.

Does this also apply to children?

Yes. And even if they have a lower risk of illness than adults, vaccination is the lesser evil for them too. This also applies to protection against long-term consequences such as Long Covid, late damage to organs or the development of autoimmune diseases, which can also be triggered by a corona infection.

Federal Health Minister Lauterbach had already called on the medical profession in the summer of 2022 Antiviral agent Paxlovid developed against Corona to prescribe more generously. But so far this has proven to be a slow seller. In the In the USA, however, pharmacies are even allowed to sell the drug without a prescription. What do you think of it?

In principle, office-based colleagues are allowed to stock the product in their practice and hand it over. The remuneration for the distribution of Paxlovid has now probably been canceled. Nevertheless, that would be possible. And perhaps many doctors are not willing or informed enough that the use of Paxlovid makes sense. The drug is really very effective.

If Paxlovid is used early, it prevents 90 percent of severe cases in people at risk who might otherwise have to go to hospital for treatment.

Selling the drug without a prescription in pharmacies would also be a consideration, especially if there is another big wave of Corona in the winter with a new variant and everyone sits together indoors without masks. I suspect that this is not possible for certain regulatory reasons.

LZ