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Coronavirus Disease (COVID-19)

We are witnessing a substantial increase in the number of infections in Germany. As a result, the authorities have imposed drastic restrictions on everyday life, in a move to slow down any further spread of the virus. On 11 March 2020, the Director-General of WHO declared the spate of infections caused by SARS-CoV-2 ( COVID-19 ) a pandemic.

Current Figures Official, confirmed figures on cases of SARS-CoV-2 infection in Germany, China and worldwide, can be found on the website of the Robert Koch Institute.

Frequently asked questions

What citizens should know and what action they should take

How can I protect myself from the coronavirus? You should behave in the same way you do to protect yourself from a flu virus: regular and thorough hand washing, proper coughing and sneezing as well as keeping your distance from sick persons – these are the most effective protective measures in everyday life. You should also refrain from shaking hands.

Available downloads How can I protect myself from infection? Download in German | English | Turkish (accessible PDF -Files)

If possible, avoid going on trips, using public transport and instead work from home. Generally, all contact with others should be reduced to the bare minimum and the attendance of events with crowds of people should be avoided. Citizens who are older than 70 years of age should obtain a vaccine against pneumococcal infection.

What should be done if a coronavirus infection is suspected? What are the symptoms? Persons who have had personal contact with someone confirmed as carrying SARS-CoV-2 should immediately, and irrespective of symptoms, contact their competent health office, get in touch with the doctor or call 116117 – and stay at home. A coronavirus infection causes flu-like symptoms such as dry cough, fever, a runny nose and fatigue. There have also been reports of difficulties breathing, an itchy throat, headaches, joint pains, nausea, diarrhoea and shivering.

If I have a mild respiratory disease, do I need to go to my doctor's practice to pick up a sick leave certificate? Starting immediately, patients with mild respiratory diseases of the upper respiratory tract can have a certificate a certificate of unfitness for work issued for a maximum of seven days, after consulting with their doctor by phone. There is no need to go to your doctor’s practice for this purpose. This agreement has been in force since 9 March 2020, for an initial period of four weeks.

What should I do after returning from a trip abroad? People who have spent time in a risk area as identified by the Robert Koch Institute, or in regions where COVID-19 cases have occurred, should avoid unnecessary contact with others and stay at home, if possible. Should you develop symptoms within 14 days, you should visit a doctor after calling in advance to announce your visit. Persons arriving in Germany from Iran, Italy, Japan or South Korea must provide information on where they can be reached for the 30 days after arrival. Passengers arriving in Germany from China must provide additional information.

WHO has declared a pandemic. What does it mean for Germany? On 11 March 2020, the Director-General of WHO declared the spate of infections cuased by SARS-CoV-2 (COVID-19) a pandemic. This declaration of a pandemic by WHO has no direct impact on the preparation and measures being conducted in Germany. Germany has taken the situation very seriously from the outset and also conducted the same measures that WHO is now emphasising once again. These are: Inform the population on the risks posed by the disease

Inform the population on how each individual can protect him/herself and appeal to everyone to do so

Do everything to find, isolate, test and treat every case, as well as locate every contact person, so as to prevent further spread of the disease

Prepare hospitals and clinics for the emergency situation that is to be expected

Prepare medical personnel and protect them from infection

Help each other and take care of one another. On 30 January 2020, WHO had already declared the situation to be a “Public Health Emergency of International Concern, (PHEIC)” and issued recommendations to contain and control the outbreak.

Additional frequently asked questions

What do SARS-CoV-2 and Covid-19 stand for ? On 11 February, the novel coronavirus that had provisionally been known as 2019-nCoV, was given a new name: SARS- CoV -2. The acronym SARS stands for severe acute respiratory syndrome. The name denotes its close relationship to the SARS coronavirus that caused an epidemic in 2002/2003. The respiratory disease that can be caused by SARS-CoV-2 has also been given a new name. It is now called Covid-19 (Corona Virus Disease 2019).

How does the novel virus spread? The novel coronavirus SARS-CoV-2 spreads from person to person. Droplet infection is the main mode of transmission. Transmission can take place directly, from person-to-person, or indirectly through contact between hands and the mucous membranes of the mouth, the nose or the conjunctiva of the eyes. There have been reports of persons who were infected by individuals who had only shown slight or non-specific symptoms of disease. The percentage of asymptomatic cases is unclear; according to data from WHO and China, however, such cases do not play a significant role in the spread of SARS-CoV-2.

How long does it take from infection to the onset of disease? It is currently thought that an infected person can go up to 14 days before noticing any symptoms. According to WHO, the incubation period is, on average, five to six days.

How dangerous is an infection with SARS-CoV-2? Among the cases reported to date, in four out of five cases infection was mild. In some patients, the virus can lead to severe illness, including difficult breathing, and to pneumonia. Deaths have mainly occurred among patients who were elderly and/or had prior underlying chronic illnesses.

Who decides whether a test for SARS-CoV-2 will be conducted? Currently, hospitals and family physicians decide who will be tested. They base their decision on the recommendations of the Robert Koch Institute. According to these recommendations, symptoms such as fever, a sore throat and respiratory complaints, on their own, are not sufficient. The person must additionally have had contact with an infected person, or have spent time in a region in which the virus was proven to exist over large areas. Testing should be done only if disease symptoms are present. If you are healthy, a test will not be able to tell you whether or not you will fall ill in the coming days. At the same time, this puts an unnecessary strain on our testing capacities.

Does the health insurance pay for the SARS-CoV-2 test? By and large, health insurance funds have been covering the cost of coronavirus testing since 28 February 2020. The prerequisite is that the attending physician decides whether the patient should be tested.

Is there a quick test for SARS-CoV-2 for home use? A quick test, similar to a pregnancy test, by means of which you can verify an infection with the novel coronavirus SARS-CoV-2 on your own, does not exist. Persons who suspect that they might be infected with SARS-CoV-2, should (after announcing your visit by phone) visit their doctor who will have a laboratory diagnosis conducted.

Is there a vaccine? Efforts to develop a vaccine are already underway. As yet, there is no vaccine available, however.

What are the treatment options? Not all diseases that follow a SARS-CoV-2 infection take a serious course and require treatment. Even in most of the cases reported from China, disease progression was mild. Treatment of the infection depends on the severity of the disease presentation (e.g administering oxygen, maintaining fluid balance, if necessary administering antibiotics to combat bacterial co-infections) and also includes the treatment of relevant underlying chronic illnesses. A specific treatment, in other words, one that is directed at the new coronavirus itself, is currently not yet available.

How prepared is Germany? Germany is as prepared as it can possibly be. Above all, our network of centres of expertise and special clinics is unmatched by international standards. We have a very good disease warning and notification system, as well as excellent pandemic preparedness plans. In addition, regular emergency training exercises are conducted at airports in Germany. The Robert Koch Institute is responsible for coordination and information.

What does it mean for Germany if the SARS-CoV-2 coronavirus continues to spread throughout the country? We do not know how many people in total will be infected with the SARS-CoV-2 coronavirus in Germany. Estimates speak of up to 70% of the population; however it is unclear over what period of time this will take place. We cannot anticipate the impact this will have on Germany. It could be more severe than a serious wave of influenza; progression could, however, also be much milder. There is no way to predict this. In Germany, we have also seen cases of severe disease progression and have recorded our first deaths.

Which areas are to be considered risk areas? The Robert Koch Institute updates the international risk areas and especially affected areas in Germany on its website, constantly, based on the current situation.

What are the recommendations for persons travelling to areas in which transmission is occurring? The Federal Foreign Office warns against all non-essential tourist trips abroad, as strict and increasingly more drastic restrictions in international air and other travel, worldwide restrictions on admission, quarantine measures and restrictions on public life in many countries are to be expected. The current travel and safety recommendations can be found on the web page of the Federal Foreign Office (AA). In addition, general information on COVID-19 for travellers has been prepared also by the AA.

What arrangements have been put in place for travellers coming into Germany on flights from risk areas? Carriers of passengers, who arrive in Germany by plane, ship, train or bus from China, Iran, Italy, Japan, or South Korea, must distribute the following instructions on recommended behaviour to prevent the disease or in case of symptoms: www.rki.de/ncov-handzettel The same applies to all operators of airports, ports, passenger train stations and coach stations. Before landing in Germany, pilots on flights from Iran, Italy, Japan, South Korea or China must transmit the Aircraft Declaration of Health to the authorities. Before disembarking from the aircraft or ship, passengers arriving in Germany from Iran, Italy, Japan or South Korea by plane or ship, must provide information on their flight/trip and on where they can be reached for the 30 days after arrival. This is done with the disembarkation card: Aircraft disembarkation card Ship disembarkation card Passengers from China to Germany must provide additional information on where they were staying in China, persons with whom they were in contact and their state of health. In this case, this disembarkation card must be used. Airlines, ship-owners, charterers and all other persons and all other persons responsible for operating ships must keep the data on flights and trips to Germany from Iran, Italy, Japan, South Korea and China available for a period of 30 days after arrival.

Are there measures for train passengers? In addition to the measures for passengers arriving from especially affected countries (see above), the following general order by the Federal Police applies: Railway companies operating public passenger long-distance and regional trains are required to notify the command and location service of the Federal Police of suspected COVID-19 cases immediately. Contact data and information on how the notification must be phrased are to be found in the General order.

Should a suspected case arise, travellers on said train must fill out the "Train disembarkation card". These forms will be handed out to passengers if necessary. The Federal Ministry of Transport and Digital Infrastructure (BMVi) has made additional information on rail transport available on its website.

What other arrangements have been put in place to protect the German public from the novel coronavirus SARS-CoV-2? The Robert Koch Institute has been granted wider powers in coordinating response measures with the Federal Laender. Regular coordination meetings are being held among the EU Health Ministers so as to guarantee as unified an approach as possible. To ensure that suspected cases are detected as early as possible, doctors, hospitals and laboratories have also been required to report any cases where there are reasonable grounds for suspicion (CoronaVMeldeV). Additional, possible measures will continually be under scrutiny depending on the risk assessment for Germany. Non-budgeted expenditure of up to 23 million euros are earmarked to fund, inter alia, measures related to repatriation and outbreak control, measures taken by the RKI , as well as research promotion and risk communication measures.

What is the purpose of quarantine? The aim is to slow down, as far as possible, any further spread of SARS-CoV-2 in Germany. To do this, it is necessary to identify the contacts of persons with a confirmed case of infection and – depending on their individual infection risk – monitor their state of health for the maximum duration of the incubation period (14 days), if necessary while under quarantine at home. The public health office specifies the procedure for contact persons. The recommendations of the public health office can include: staying at home, keeping a certain distance from others, washing your hands regularly, as well as airing living rooms and bedrooms properly and not sharing household objects (dishes, clothes, etc. ) with third parties, without washing these as usual beforehand. If possible, you should not share your bathroom. Hygienic articles should not be shared and clothing should be washed regularly and thoroughly (with the usual washing methods). It is important to observe the rules for coughing and sneezing. We advise you to use disposable paper handkerchiefs. Relatives can assist contact persons in coping with everyday life, for example by doing their shopping. However, close physical contact should be avoided. Relatives can also help by ensuring that living rooms and bedrooms are well aired and pay close attention to regular hand-washing. Contact surfaces, such as tables or door handles, should be cleaned regularly with household cleaners.

When does a person need to be quarantined? If there is a high risk that you have become infected: If within the last two weeks you have had close contact with a person who has contracted COVID-19. Close contact means either that you spoke with the sick person for at least 15 minutes or you were coughed or sneezed on at a time when this person was infectious. Whenever the public health office places you under quarantine. You do not have to be quarantined, if: In the past two weeks, you were in the same room as a person with COVID-19 but had no close contact.

You were in an area with rising rates of COVID-19 because, then, the risk that you might have become infected is slight. However, persons working with people who have pre-existing diseases (hospital, elderly care, etc.) should by all means inform their company medical officer. What applies for every person is, however: daily self-inspection for symptoms of disease. Any person who is perfectly healthy but has had contact with a family member, friend or acquaintance who, in turn, had contact with a laboratory-confirmed COVID-19 patient, does not have to be quarantined. In this case, you are not a contact person, have no increased risk of contracting COVID-19 and cannot infect anyone else either. If, however, you are showing symptoms of respiratory disease, you should have yourself tested.

Will I continue to get my salary if I have been placed under quarantine? Yes, your employer will continue to pay your salary. Your employer will then be entitled to reimbursement, from the Federal Land, of the sums used for the continued payment of wages. Should, contrary to expectations, your employer not pay, you are entitled to compensation from the competent authority (according to Section 56 of the Protection against Infection Act ( IfSG )). In the first six weeks, this compensation will correspond to your net salary. After this period, you will receive the amount you would receive as sick pay.

Will self-employed persons receive financial compensation if they are no longer able to work as a result of the virus? Yes, self-employed persons and freelancers will receive compensation for loss of earnings according to the Act on the Prevention and Control of Infectious Diseases. The competent authority will base compensation on the profit established in the tax declaration of the previous calendar year.

What precautions must be taken at large-scale events? The cancellation of events and the closure of schools and kindergartens fall within the responsibility of the Federal Laender and/or the local authorities. In the meantime, all the Federal Laender have cancelled events and closed schools and kindergartens. Only in a very few exceptional cases may an event be allowed. The Robert Koch Institute has published “General Principles of Risk Assessment and Recommendations for Action with respect to Large-Scale Events” (PDF-File) to support local authorities in deciding on whether to cancel an event.

Is there a danger that a person can become infected with the novel coronavirus (SARS-CoV-2) through foodstuffs or objects? According to the Federal Institute for Risk Assessment, no proven case has been reported to date of a person being infected by consuming contaminated foodstuffs or through contact with objects contaminated with the SARS-CoV-2 virus. Nor have there been any reports of other coronaviruses causing infection through foodstuffs or contact with dry surfaces. However, virus transmission by way of smear infection is considered possible from surfaces contaminated shortly before contact. Owing to the relatively poor stability demonstrated by coronaviruses in the environment, it is likely that the window of contamination only exists for a short period. The risk assessment of foods or objects falls within the remit of the Federal Institute for Risk Assessment ( BfR ); the Federal Institute for Occupational Safety and Health ( BAuA ) is responsible for occupational safety and health.

Is water a possible source of infection in the transmission of SARS-CoV-2? SARS-CoV-2 is similar to other coronaviruses for which water does not constitute a relevant route of transmission. The direct transmission of coronaviruses via the stools of infected persons also appears negligible; to date, no case of a faecal-oral transmission of the virus has been reported. The German Environment Agency has published a detailed statement on coronavirus and drinking water.

Where can doctors and clinics obtain additional information? The Robert Koch Institute posts information for professionals (in German) online. Here you can find, among other things, a flowchart for doctors (in German) to assist them in clarifying suspected cases and deciding on the measures to be taken as well as Recommendations on hygienic measures when treating patients with a SARS-CoV-2 infection.

When was the first information about the outbreak received? On 31 December 2019, China’s WHO country office was informed of a cluster of patients with pneumonia of unknown cause in Wuhan, a city of 90 million inhabitants in the province of Hubei, China.

Where did the outbreak start? According to information from the Chinese authorities in Wuhan, some patients worked as traders or vendors at the Huanan Seafood Market in Wuhan. It is the largest seafood market in Wuhan with over 600 stalls and 1,500 workers. It has been reported that wild animals and/or organs of other animals and reptiles were also offered for sale at the market. It is currently assumed that SARS-CoV-2 was spread to human beings from bats.

Have there been similar outbreaks in the past? This new virus is a pathogen belonging to the coronavirus family, which is the same family as SARS (severe acute respiratory syndrome) and MERS -CoV (Middle East respiratory syndrome coronavirus). In 2003, Germany recorded a small number of SARS cases. The disease did not spread further within Germany.

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