RKI Evaluation: Decline in COVID-19 Cases, Yet Higher Than 2023 Levels

Following a period of heightened coronavirus transmission in Germany, indications now suggest a deceleration in the momentum. The Robert Koch Institute (RKI) experts, in their latest weekly report on acute respiratory diseases released on Wednesday evening, highlight a growing sign of reduced Covid-19 activity.

This trend is evident in various aspects, such as a decline in the viral load observed in wastewater. Additionally, the number of laboratory-confirmed cases reported to the RKI has decreased, although the institute notes that this reduction may be influenced by the Christmas holiday period, characterized by reduced testing.

The RKI estimates a total of approximately 4.6 million cases of acute respiratory illnesses last week, irrespective of doctor visits. This figure is notably lower than the pre-Christmas period, where it occasionally approached nine million cases. However, it still surpasses the levels observed at the beginning of 2023.

The elevated number of cases is attributed not only to COVID-19 but also to influenza and the respiratory syncytial virus (RSV). According to the report, RSV has led to hospitalizations, particularly among children under two years of age.

Greater clarity on the ongoing flu wave is expected after the conclusion of the school holidays. The RKI underscores that the assessment of the situation can be more accurate in the following weeks, as many federal states have recently been on school break. The report notes that influenza has predominantly affected school-age children and young adults.

The prevailing strain of influenza is Influenza A(H1N1)pdm09, commonly identified in random virological examinations. This subtype, originating from the 2009 flu pandemic, has been circulating seasonally in Germany, with significant activity noted in the 2018/19 season.

Turning to COVID-19, the dominant variant in Germany is JN.1, a descendant of the Omicron variant. According to the latest RKI figures from mid-December, JN.1 accounted for 59 percent of examined samples. Distinguished from the parent line BA.2.86 (Pirola), JN.1 carries an additional mutation in the spike protein, crucial for the virus's invasion of human cells.

The World Health Organization (WHO) has separately classified JN.1 as a "variant of interest" for several weeks. Previously considered part of the parent line, BA.2.86, JN.1's distinct WHO classification arose due to its rapid international spread. In the preliminary assessment, the WHO categorized the risk to public health as low, based on the limited available data. While an increase in cases is anticipated, especially in winter-afflicted countries, the WHO does not anticipate failure in the effectiveness of population immunity and current booster vaccines against severe disease.

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