Coronavirus-Update #36: "Die Rolle von Kindern ist nicht geklärt" | NDR Podcast

ndr info updating the

coronavirus

Germany wears a mask and this was perhaps the most visible change in social life at the beginning of the week for many, although in reality it is only small. In addition, the tracing application for contact tracing is taking to contain the pandemic, but an application with all its buts and research is working hard to find arguments for or against the further opening of schools and daycares. I welcome all of you to a new episode of our Kroner virus

update

s this Tuesday, April 28. My name is Grüner Hennig and I am scientific editor at ndr info.

What does everything we know mean for those who have recovered? What research approaches exist when it comes to the question of medication and vaccines and, once again, what do we really know about children? I have already mentioned it. These are questions that I ask myself again today. The head of virology at the Charité Berlin wants to hire Professor Christian Drosten, who communicates with us from his office via app Hello Mr. Thorsten Hello Mr. Drosten This morning there were mind games in the news that clinics should release slowly remove the beds they have in reserve and return to normal operations.

You said last week on Charité that the intensive care unit is slowly starting to have more and more 19-cubic patients. If you now look directly at your environment, how realistic do you think those specifications are? Well, of course, it's the same in my environment here. There is a big clinic and in such a big clinic. Of course, there are doctors who want to operate and, of course, there is also a company that has to make money again at some point, so we must not forget that hospitals are also companies and, of course, in a certain way and wisely it is justified. say that we have now managed to keep the intensive care beds so free and with the reproduction rate in the low range we are so close to 1 or below 1 that it is projected to report that it has returned to 1 well, so that has to be This is the case.

Now we continue to observe, but at the moment we have a relatively large total number of patients, i.e. also in Germany a number of infectious patients, which of course has now decreased so much that initially a tolerated r 0 of 1 can be calculated for the intensive care units and under this impression we have that Yes, the logical consequence first of all is that the intensive care beds are freed up again so that normal operations and care operations can begin. It's not just about operations. It's not just about operations. There are accidents, for example, but there are also interventions that are urgently needed, for example in the area of ​​cancer and then, of course, there are internal illnesses that require intensive treatment that simply cannot be planned, that simply happen and, therefore, Of course, it has to be done.

Here there is a game of compromise and in this game of compromise it must be said that at some point there is experience and now we can have that bed capacity again. But, of course, one must be careful to go in the other direction again if the epidemiological parameters change. Now, of course, a lot has been done in hospitals, a lot has been created in terms of additional intensive capacity and organizational regulations have been adopted. It has also been practiced so that some flexibility has already been achieved in the hospitals, so I can think that they are saying that they are now freeing up so many beds for this month and but they have a return option and I still have the feeling that we have to take advantage of this possibility of relapse again in the great debate about what happens now.

That the number of infections has decreased is a big topic that many politicians, but especially families, are interested in on the topic of the children we have lately. We talk in different directions, what questions are open and in what direction they can go, do we know anything else? about the role of children in infections and transmissions that could indicate that we should reopen daycares soon? Yes, it's this week too. An important political discussion arose around this and that is a good thing and it is actually a very difficult situation that at the moment we have to discuss from a scientific point of view.

I might have to go a little further here, so maybe just to summarize the basic situation again. We have some studies where the epidemic started in China, but we looked at the basics. "Children rarely show symptoms, that doesn't mean we don't have affected children. We also looked at an estimated study in a very early episode of the

podcast

, Ingo Hahn estimated a significant number of unreported cases of infected children based on admission figures from a children's hospital and if we now mentally follow the

podcast

, we will fast forward and we will have discussed the topic of children over and over again.

There is a very good household contact study where you can examine households and see where there is an index patient , that is, who was infected first and who in the household is now infected and there is a main result which is that only about 15 percent become infected during the observation period, note, of course, in the conditions of a simultaneous intervention of scientific and epidemiological research, so where you have already said, be careful, here is an infected person, stay away from each other, so take measures very precisely and I have seen in the conditions that 15% become infected and I have also seen that if Do this now with more than many households in which the infection rate of children is exactly the same as the infection rate in all age groups in all other age groups, so it is not You can observe nothing special in children and that is, of course, an important parameter. how often a child gets infected, regardless of whether they are symptomatic or not, another important parameter that we do not know at all is how infectious a child is, so not only does one have to get the infection but also then give it away. , transmit it as a carrier exactly as a carrier and here now it is relatively difficult to determine this based on epidemiological studies in the current situation Various degrees of difficulty One point is of course if we are now in the situation of blocking contact, i.e. the schools are closed and we don't really have a chance to get infected in the outside environment, but infections actually happen mainly in the home, so the question is who now brings the infection into the home: is it the child or is it the parent? or the mother or the grandparents and there is the answer, well that is probably the age group in the population that leaves home, maybe everyone does that for one thing walking and then at the same time it is also the age group in the that infection occurs.

It was recorded more in the population and at the beginning of the epidemic in Germany and in many other countries, especially in Europe, it must be said that it was in relatively young adults where it was recorded. The age group between perhaps 30 and 45 years had quite a few pleasant incidents that normally occur among professionally active adults and now, in the special case of Germany, among adults who practice skiing, have been seen. In this situation it is also obvious that it is these people who bring the infection into the homes in the families and not in the children, and if you now analyze the chain of transmission, then of course you can make the observation, aha, interesting, Children are always at the end of said chain of transmission in homes, we can make that evaluation.

But change if, for example, as has just happened, schools reopen gradually for some classes because then there is just a lot more contact, of course, then everything will change completely, so yes, of course, and that is what we are discussing here Currently, whether the infection activity among children is the same as among adults, so we have not answered much yet and that is a basic component, an observation that is currently being discussed. Another observation that is being discussed is that you have to examine the transmission couples at all and you have to see what it looks like.

Because if you count the recipients of an infection and you count the infected people, how do you dig into the data and find out that there are relatively few children among those who transmit an infection and there is a study there? It is basically a compilation of your own data and literature. The data was compiled by the National Institute of Public Health in the Netherlands and is interesting, and Dutch colleagues in particular are in the process of collecting the evidence little by little and you can consult it. On a web page created by the institute there is, for example, a collection of data.

If the contact persons are broken down into households or into transmission pairs analyzed, it can be said who is really the contact person of a first case and who was infected by it and we know that the rate is around 15 percent, determined based on household studies. How is this distributed across age groups? There's an interesting graph that actually shows that there are infected contacts in the adult age groups and there actually aren't. So, in children, in principle, nothing in children, but the problem here is in this analysis. And that is often the case in such epidemiological studies, when you evaluate them statistically, you find that it is not significant, so it is not demonstrable, it is statistically verifiable and robust.

I mean, there are just too few kids in this study and that's the big problem we have. Actually, if we want to examine children in any aspect, in the studies that you put together, in this case, The groups that you put together always have very few children in them, why is that so? That's because, imagine yourself in the current situation. You are infected as an adult and want to get tested. You go to a text center or, optionally, to your family. Doctor, would you consider accepting your child or children? No, of course not because on the one hand children do not have symptoms and on the other hand they do not drag children to places where there are many others. suspicious patients who also want to be tested.

They want to protect their children from infection, that's why they don't take them with them and that's why we can barely put the numbers together and there is one thing we care about. That's why it's missing and that's something different, a completely different approach than the epidemiological approach, which would be asking how much virus is in your child's throat, so what is the concentration? That is initially an assumption because that is what others say. Infections know that children always have a lot of virus in their middle, so with the flu, for example, this is the case and with many other colds, too.

Children are immunologically naive, so they have nothing to do against the virus and the virus. it can spread It multiplies infinitely and that is why with influenza or other colds, when we measure the concentration of the virus in a child's throat versus the concentration of the virus in the throat of an adult, we sometimes have a difference of a factor than 10,000, so a child has 10,000 times more virus in the throat swab as an adult and with this disease it's one of those things that we basically haven't measured yet, so now a child has it, if we want to say that children are not that infectious, that's what we really want to know if we want to say: can we open daycares?

So we want to know that a child releases the virus in the same way as an adult and we can choose two paths. One is an epidemiological study in which we ask. how many actually get infected In the children it was different exactly in other children and in both in the daycare it could be measured, but the daycares were added, so it cannot be measured at the moment or it could be measured in the family, but there it is where we have the special situation at the moment, locked up and taking children that he is not coming at the moment, we cannot answer that.

The second way would be to just approach it technically and simply ask how much virus there is. in a child's throat and then you can say yes, if it really is. If you can now simply reopen daycares, then you would also have to demand that there really has to be less virus in the throat of a child than in an adult and, unfortunately, this question is very difficult to answer because in the laboratory tests that are being done also include fewer children, these are basically children who are admitted to the hospital for other reasons or because they have symptoms or the few children who are and have It was tested by the health department in household contact studies and has been tested.

At first it was done relatively strictly when the authorities still had the ability to do so. In the meantime, it was difficult and now we are out of the hole we can get out of. , the authorities can do a little more in this direction and that is still a possibility at the moment, we can start to take a look even if we have little data. For children, if we now use very large laboratories, at some point there will be more than one handful of children in the laboratory data and then you will be able to see what the concentration of the virus is in the context of the children.

We're now in the process of doing that here in our lab and I'm excited to see whatcomes out of this, so we'll make it public very quickly so that people can understand what the database is and I hope we can contribute a little to the discussion. We can probably discuss it the day after tomorrow, what came out of this on the podcast, okay and I hope you can inform the discussions a little bit with that, that would be an additional way, what role does the age of the children play, especially if you now know that some older children are in tenth grade and now go to school for various reasons, the younger ones still stay at home, so I think that with older students you have a situation like with adults, a situation that you can value a little the that we have now.

Contact measures have already learned a lot and there are certain ways to deal with things and also physically. These older school years are basically adults, while the younger ones are children. We know less, so of course we know very clearly that you cannot tell young children that they must wear a mask. Please use it and keep a distance of 1.5 meters from each other. You can say it doesn't help. , but you can't say anything exactly. Of course, there is the question of what that means, and of course now we return to the basic question. If you say you're an adult, then just say you wouldn't do it. allowing adults to do what children do in daycare, being so close to each other for hours in a room that is not well ventilated, etc.

You would have to do it if you were completely heterosexual. You have to say, let's wait for the data and if the data is like this, everything is the same as with adults, then you can't do that. But the data does not mean only what you have right now in the Charité laboratory in We have also commissioned more studies, of course, we also need data from other laboratories, but I think that in this current situation where it is relatively difficult to carry out epidemiological studies quickly because the basic situation is not there because we are locked in, technical side roads can be taken. and just looking at the data in a way that you would otherwise, so you might think it's too indirect to just look at the virus concentration here, but since we haven't even done that yet, I would already suggest that would be the next step , since the concentration of the virus in children of different age groups is good, then of course there are other considerations, so it is unfavorable for opening the daycare if the children are equally close to each other, of course, too It is unfavorable that they do not have any symptoms, then you cannot even recognize an infected child and cannot leave him at home.

Another consideration is that isolation is good because children do not have any symptoms and because they are very young. , they have a relatively small lung volume and, even when they breathe, cough or scream, they of course release less volume of air and less mobilization of the virus. On the other hand, they touch their faces and their mouths much more. the weed oh yes exactly and not only to you but also to your parents and of course that is a situation where you have to say, in principle it is very difficult and what you have to do on the side and really I am anything but So far of life, I also see that it is very important that we can somehow reopen daycares because there are certain groups of single parents or double workers in the central office and so on who simply cannot do that and then you have to think if and what It also happens from a political point of view if you allow the group size to be a little larger and thus give more groups of parents the opportunity to place children in daycare, but at the same time recognize the situation that such So, for example, parents who have children in daycare are given certain things to do, such as simply informing them that an infection they can bring home with them.

They are considered especially at risk in their family. if an adult has symptoms Come and get tested immediately Stay home Do not visit your grandparents Under no circumstances visit elderly people Not only grandparents but also other elderly people Do not combine surrogate grandmother as an in-home nanny with temporary daycare in the emergency group So I think that these requirements should be formulated in even more detail because I really believe, and this is my vision of life, minus my virological and research vision, that of course, at some point and sooner rather than later, we have to allow some larger groups of parents to have their children in emergency care again at least to give and I think we should now look at all the parameters that we know, including the concentration of the virus in children of different groups and then when let's go to elementary school, it's Of course, a different consideration again, so elementary students can do that, let's say recess now only takes place outside, there are staggered recesses, so let's just say, for example, a a quarter of the students are in the schoolyard at the same time and so on, so I think that at that age rules can be found again to have everything under control or again we have to know the concentration of the virus, key word external: if we now bring together our vision of life and that of the virologist, what role can it play? currently we are in a phase of good weather, at least you can go outside for many things relocated in kindergarten and also to go to the playground with the children, but in primary school maybe also yes, I think that really can be a solution for the near future so there are studies that we have already discussed, one came from Hong Kong and the other from Singapore where it was said that there are rosol infections anyway there is a new study that was just published in Nature from where people have observed what erosion formation is like and this study also comes to the same conclusion: yes, there is probably a part of the erosion transmission that was seen there, for example, that in certain holding areas, it is That is, in the waiting area where there are more crowds, that is, when a lot of people gather from time to time, there are measurable concentrations of rosol in the air and that is okay.

In my opinion, a rose like this is created by an infected person and then remains in the air for quite a long time. some time if the air is not moving and that is why it is so good to use this summer effect to be able to be outside like all this rosol component that then fades or dilutes, so to speak, and now returns to In life Practically, the idea is that if you want to do something for the children immediately, then I think there is one measure that you can probably have a good conscience with and that is to close the playgrounds again because they are outside and outside.

There we don't have groups of children as large as a daycare group, so we can have 20 children on a playground at peak times, that's true, but they are relatively separated from each other, which means that at the moment They are not in one. together in the room for an hour, but they are on the playground for maybe a quarter of an hour and many times they are far from each other and all this happens in the area of ​​air movements so that we are more direct, especially in Los playgrounds attack children who touch their faces, yes, maybe you can pay a little attention to it and then you would have contact transfer so that the child has something stuck to his hand and that is next to the handle of the slide, that does not it's possible.

Exclude Clearly only if we now look at all these easing measures that are now being played amid residual risk. Any kind of easing measures is a game with residual risk, so of course this playground game maybe can and should be played too. if we look at the collateral damage, in the case of families who live in a small apartment in the city and who cannot even take their children to the park when it comes to contact, transfer of residual risk, one last aspect on this issue so childish talk to teachers, they often say that we also discuss it here.

For example, students in grades 5-6 can wear respiratory masks, but if you imagine that children will, of course, quickly forget all precautionary measures and then take off the masks, they will put them on. , grab them, throw them, that is a risk factor that is too big, so it is better to keep a distance and go out of the intuition of the intuition is the distance and outside is better and more important than preventing a droplet infection and also a A small rosol infection in a closed room, so you would have a much better feeling if you imagined two situations, one situation: a school class of 20 students.

In a room where there is a certain minimum distance, maybe it depends on the spaces and everyone has a respiratory mask on, that is, a good protective nose mask, a cloth mask, for example, exactly or exactly a community mask, i.e. a common mask that can be seen everywhere right now. If this were one scenario and this were another scenario, it would be the exact same school classroom with an open window and a big fan in the window blowing out the air. The school classroom door is open, so in principle there is always a slight draft in the class.

This last scenario according to my intuition "Honey, in today's episode we are relatively close to life. I would like to talk about another topic, Mr. Drosten, which has caused demand among listeners. The WHU has just warned against the inclusion of 19 patients in the immunity committee for Cupid in recovery. as is apparently the case What is supposed to happen in Chile is a kind of personal identification to be able to travel in life without contact restrictions. We asked many listeners and they said that the professor Drosten sounded very hopeful that there is an immunity. Based on current research, how is immunity supposed to be acquired?

After recovering from the infection, one is somewhat or only temporarily immune to the virus. I still fully assume that there is an immunity that maybe after two years or So maybe a little bit longer and then it may go away. Now we are even looking at the first patients that we are monitoring. You can see that the antibodies decrease after just two months in some individual patients, but antibodies are just a correlation. , that is, only an indication of immunity, it is not that antibodies alone create and manage immunity, they are only an indicator of a recovered infection.

And that's how I would see the situation right now. I wouldn't say a silent test or an antibody test that is an immunity test. Anyone who tests positive is immune, but I prefer to say that whoever tests positive has survived the disease if, of course, a technically clean test still exists, which we have already talked about. there's a lot of room for error, but if you rule out error, it's a recovered infection and then I would go on to argue that a recovered infection provides protection, it doesn't have to be sterile immunity, it has to "So it won't be a situation where you no longer I can get infected with the virus.

That's how it will be at the beginning. After the infection, I can't get infected again, but after a period of one and a half two three years I can get infected again with the same virus, we know that this is the case for cold virus and that's why I don't think it's any different with this virus and I can't get as infected This is also important, so the virus that was previously a dangerous virus is no longer so dangerous for me. Now I will have an even more harmless cold, that maybe it will be limited to the top catering truck and it will no longer affect the lungs and I will no longer excrete as much virus.

The virus will not be in my body nor will it replicate so rampantly that I am extremely contagious, but maybe a little bit still, of course, no everything is black and white, but there are also these gray effects that are important in epidemiology, so I assume now that someone has been infected and has the infection behind them, they can be considered immune in a certain way and I don't think that's what that The World Health Organization wants to criticize. The World Health Organization is at a very high standard when it comes to its recommendations. That means they can't go into full details, they can only The directions and ways of thinking and the reason can't always be seen clearly because they are abbreviated messages, so we have to think about why the World Health Organization says caution is not immediately assumes immunity and considers those who test positive for antibodies to be immune and powerful.

There are no IDs on that and I think the real ulterior motive is that there is a small chance of error, you could be wrong, so it may be that in some cases these patients have an incorrect lab test and are not actually immune. However, they later become infected. Because they might stop taking certain protective measures, that's true, but the other thing is all the social consequences that that can have, so it can go as far as getting a job as a writer as an employer. and I have the immunity committee show it to me and I just ask people in this position thatThey are already immune that they will not be out or I am an insurance company and I know that intensive therapy for one or two infections costs a lot of money, so now we will only offer the cheap rate to people who already have an immunity card, etc.

Then, in addition, all these things, these effects that we summarize as social stigmatization up to the private sector, that people start showing their immunity card and bragging about it or excluding from the birthday party people who do not have an immunity card , all these things, of course, we have to do. Prevent that from destroying society and I think that's why the World Health Organization warns against something like this if we stay with immunity and the immune reaction and maybe expand the topic a little to include research of medications, which you and your Charité team have carried out in connection with the corona virus infection.

If we take a closer look at the mechanism of so-called autophagy, it is about the ability of cells to break down their own components, including foreign proteins, bacteria or viruses, and this process is interrupted in the case of a corona virus infection. , it is a very complex topic and we cannot discuss it in detail here, but we have done a basic study that shows an interesting result and we could start with autophagy, which is a process in the cell in which macromolecules are broken down, that is, everything type of molecules that the cell needs to be metabolized again at some point because they are no longer good and this leads to the formation of autophagosomes, which are certain degradation compartments in the cell until you have to imagine it as a small vessel in the cell with a membrane.

There is another type of vesicles around it called lysosomes, which are digestive vesicles that the cell also uses to absorb and metabolize certain food products and when this solution is digested and fuses with one of the autophagosomes of the body's own cells, it is created. another complement called lysosomes and this whole chain of components in the cell of small vesicles where there are substances in them, that is basically autophagy and it is a kind of digestive system of the cell and it is regulated, then there are the adjustment screws fines that can be turned to speed up autophagy or slow it down a little bit and there is a molecule that is at the beginning of this autophagy chain called Mclean 1 and Berlin 1 starts autophagy now you can.

But other substances are identified in the cell that break down Mclean 1 again and there is a whole chain of command and the Sars virus apparently interferes with this chain of command, as we have already seen in a previous study, published here, in the group of the Marcel Müller Institute, which collaborates at the Bonn University Hospital with Nils Gassen's working group on molecular psychiatry. This is cell metabolic research that takes place in a psychiatric clinic, so now it doesn't matter what type of patients you have in mind. This is aimed at pharmaceutical effects, this type of basic research and these working groups have already recognized this. together that there is an effect like that of the March corona virus, that is, this virus that comes from camels in the Arab region, how it disrupts autophagy and therefore has an advantage in the cell and now we have discovered in this study that the Sars virus does it too. this in the same way, so it also disrupts this complex autophagy process in the cell and therefore brings a little more balance to your side to have an advantage and now there's something interesting about it: there are certain pharmaceuticals that also interferes with autophagy there is a substance called song "it's okay" which is a tapeworm remedy, a very well known tapeworm remedy and it blocks a molecule that you call jump 2 and this gives two is a member of the cube chain above mclean 1 and there Nothing happens with that, so ultimately Berlin stabilizes one and starts increasing autophagy, so it pulls in the other direction, so the virus pulls in the opposite direction to autophagy and that doesn't again follow this chain of command in the direction of Autophagy pro gets the garbage disposal going correctly exactly to do well what the virus doesn't really want to do.

Then there are other substances. One substance is called mk 22 06, which is an act of inhibitory actuators. It is also another signal transduction skat card. element and use it as a candidate drug against breast cancer. It comes from cancer research and there is another substance that is more of a single step in its own metabolism: spermidine, a small molecule that also induces autophagy but probably in one. a concentration that pharmaceuticals cannot achieve at all and in this study we focused more on nik loser because it is actually an available medication that you can basically buy at the pharmacy.

In Germany it is no longer available on the market because there are better and more modern ones. remedies against tapeworm. I think that's the reason. I don't know what the real reason is, but it exists in many countries and there is long-standing therapeutic experience with it and such findings are of course sometimes a ray of hope if you already have one, have an approved drug and if you can say, well, actually you would have to try it on the patient because it's an approved medication so it's relatively safe, you know it doesn't have any negative side effects.

That is why we are already seriously thinking about doing it, especially because we have seen that the effective concentration here is within the achievable range. What do I mean by this? Every time we test certain candidate substances in the laboratory against such a virus. Of course, we can also visualize exactly at what concentration it is effective. We asked ourselves: can we really achieve this concentration, at least to a first approximation, in a patient's blood after oral or intravenous administration? There is always pharmacokinetic data for approved medications. medications where, in principle, you can search in studies and tables if such a thing exists.

Effective concentration can also be achieved and with song it is like that. We looked at it and came to the conclusion that the concentration that you can actually take it in tablet form as a patient leads to a concentration being reached in the blood that is in our blood. In laboratory tests, the virus plays a key role in the reproduction of the virus and that is why it gives us a good feeling and we write clinical study protocols and apply for approval soon to be able to treat patients experimentally with something like, at what stage of infection or disease would it be then?

I have often heard about other medications, the problem is that they have to be given at a very early stage, shortly after infection, when many people do not have any serious symptoms. Laboratory knowledge. there is an influence on the reproduction of the virus. The attack points are not directly on the virus. the cell, but that's actually much better for us because these antiviral substances target cells the virus can't develop resistance mutations against it as quickly. But still, even if we have a specific substance that affects replication, we want to administer it as soon as possible, that is, in a phase when the virus applies the viral phase of infection, when the virus makes this happen, in the first week and not in the phase where the immune system and the subsequent inflammation makes this happen and the virus is basically already at bay, so in the second third week, but of course it is also a compromise consideration clinically, seriously ill patients are only cared for in the later phase and they want to be helped by the experimental administration of such drugs, while in the initial phase you see in the patients the opinion that I am actually quite well, well, the patient You are not seriously ill or you are even symptomatic and you don't know anything about it or you have relatively mild symptoms. because it is still in the first week and that requires a good look, to see who has been diagnosed here, that a patient, for example, is slightly ill but has the opportunity to treat anyone, for example every day for a follow-up. follow-up exam so that you can then follow the virus concentration in this patient very precisely over time and not look at the patient's clinical improvement, but look directly at the virus and then sometimes it has completely different characteristics.

The patients do not have the characteristics of being seriously ill, that they now need to be helped very quickly, no matter what we have available, but it is a different criterion that is a patient who understands that he is interested, we believe that he is involved, although perhaps in one go. During the course of the week he sometimes gets a little sick from the medication, but he continues because he believes in it and he is mobile, he can come every day to give a sample of lung secretion, where we will then measure the virus. concentration with PCR.

He is ready every day to give a blood sample and so on, all those external criteria for a patient that are not medical at all but are just thought of from the study side. Finally, I'd like to do a quick look behind the scenes. Usually before we start recording, we talk here briefly about what kind of topics are involved, what the studio situation shows and discuss what we want to discuss here today in general terms. When I asked him about this research from his team, you were a little reserved even though it had already been published as a previous publication.

Can you explain to us why? So it's a bit like I know this podcast already has relatively high distribution and I don't actually want to influence the reviewers at the time this article is reviewed by the fact that it's already being discussed in public, that's a consideration. . That's why I reacted with a bit of restraint at first, which is why this article has been publicly available since last week. The other reason is that sometimes false hope is created when we discuss this here now I get calls from people who say I want this substance immediately and that is also a fallacy so you have to be very careful, that's why it is not said at all that this substance does something First we have to test it on a very small group of volunteers.

At the moment we don't even have permission to do that, of course we also have to inform the ethics but also the supervisory authorities and get permission. I have this permit still, that's why I can't give this substance to anyone, so it's the substance, there is stock and we have to make sure that the studios can use this stock and that someone somehow doesn't order it from the pharmacy and keep it in cupboards and never use them, and patients on whom a study could be performed will no longer receive it because the stock was purchased empty.

Of course, a very bad effect and then another effect can also occur if a patient receives or takes a study drug, then they cannot be included in another study and maybe there is another study drug somewhere that is much better. Then a patient comes in and says, I haven't noticed anything and then the study doctor says I'm sorry, but then I can't include them because that distorts the results. Unfortunately, that's how it is in clinical trials and that's why maybe I can do that here too, let's say, don't write me an email asking if you can be a loser on my part and don't do it.

Go to the pharmacy or your family doctor and ask for nick loser mied. You can only do it if there is data about it. You can't do this beforehand. Important note: We are still a long way from being a patient in research. scenery. Many of our listeners also read interviews over and over again with you and many have voted for us recently with great concern because in an interview with the British newspaper The Guardian you reported on the death threats you received about hate mail, you already talked about it in the podcast, which motivates you to continue anyway.

That is why I believe that in Germany we have gained a lot from the fact that we received the diagnosis so early and that, unlike other countries, we did not have the first deaths as an indicator, but rather the first proven diagnoses, the knowledge that has now come to our country the virus, now we are taking measures and everyone. We have played the game very well and we have also believed in this scientific evidence so that we are now in such a good situation with so few deaths in Germany and we can now do I consider these to be almost luxurious considerations.

We do not want to free up intensive care beds little by little again. Other countries have completely different concerns about other diseases and I think it is so bad and so shameful that this is not understood, that we have prevented something. Otherwise, that would have affected us as much as other countries. Here in Germany we speak the language. Maybe a bit in a bubble, many in the population don't read the news in English and maybe don't notice it that way. but in reality we are not protected from the rest of the world and, for example, today there is an interview with Jeremy in front of one of the most important infection scientistsinformed of the world, the director of the Wellcome Trust, who used to be a Professor of Infectious Diseases Medicine himself, who has a nice interview today in German and who says, for example, little by little it is becoming clear what the countries: they have to qualify the transmission rate not only in one, but reduce it well. below 1 and learn from South Korea and Germany That's what he says That's what he says as a message to the German population But of course he also said that throughout the English-speaking world Internationally in the US .USA and England That is a growing opinion that People look there with great appreciation and with a great need to learn about Germany and you wonder how the Germans did it and those are two components: the earliest availability and wide spread of diagnoses and faith in science both in politics and in the population and I see it It's not that we are going to throw this overboard now and that is the reason I continue, let's draw a line here for today, thank you until now for your time and effort in helping us get to speed and the day after tomorrow we will hear back and get to work.

I would love to provide more information. We still get tons of questions from listeners on completely different topics than what we've discussed today. We are reviewing them all and I already have topics on the list. For some time now we have wanted to discuss things with Christian Drosten, for example the debate on the origin of the virus, but sometimes the current situation overwhelms us or there are very interesting situations. There are interesting new studies that we want to discuss urgently and which then unfortunately go a bit off track . However, everything there is to know about the corona virus and its effects on our society cannot be considered only from an ecological perspective.

Tagesschau's colleagues do it in their podcasts: they think about a future scenario and then interpret it in many ways, and I think the current episode is worth listening to. This is the example of protective masks. and medications, among other things. We would start producing all these things again in the country, so no longer, especially in China for example, what would change, if it is possible and if so, how quickly the corona virus and globalization will be available for example . example on ard audi or thek and there You can also find our

update

the day after tomorrow on Thursday or on ndr.de / corona update I'm kuchener hennig thank you for listening, see you later corona virus updates a podcast from ndr info