Germany’s Ground Zero A District Is Paralyzed by Coronavirus
The entrance to the hospital in Heinsberg.
Foto: MATTHIAS JUNG / DER SPIEGELWhen Stephan Pusch, the district administrator of Heinsberg, a region in the far west of Germany, thinks of the coronavirus , the book that comes to mind is "Lord of the Flies.” He’s not trying to say Germans have gone wild and civilization is crumbling.
Pusch is just trying to say that the human, the social being, can take on antisocial characteristics when placed under considerable pressure. In other words, you need to tread lightly with people experiencing the kind of crisis seen in Heinsberg right now, in the state of North-Rhine Westphalia. There are some moments when people just lose it.
It’s 9:20 a.m. on Tuesday morning and the district administrator glances at his watch. At this moment, there are 84 registered cases of coronavirus in his district. By Thursday, that figure will grow to 197.
The first infected people were registered a week ago, on Fat Tuesday. They had been celebrating carnival festivities for the past 10 days in the town of Gangelt, which is part of the Heinsberg district. The married couple became the first registered cases of COVID-19 in the state. When Germany’s federal health minister called Pusch directly, the administrator knew the situation was going to be a big deal.
Heinsberg has become a case study for Germany of how a district can respond to a health crisis like this.
When the district administrator meets a reporter, he doesn’t shake hands, and instead bumps elbows. The crisis team is about to meet in what will be the first of two or three meetings on this day. They will, once again, focus on medical care, which isn’t going very well. Pusch sits in a conference room in the district offices, a massive administrative building. Confused local residents stand outside the administrative offices, which have been closed to the public.
Anything But Business as Usual
The situation in the district is anything but business as usual. Heinsberg is a flat region containing villages lined with brick rowhouses, single-family homes with gravel front gardens. About 250,000 people live here.
The streets are devoid of cars. Many people are staying at home in voluntary quarantine. The Dutch, who live just across the border and often shop here are also keeping away. Even healthy residents are staying indoors out of fear of the invisible threat.
A cafe that is usually open until 6 p.m. closes at 2 p.m. One gym remains shut, and there are few customers at local book and shoe stores. A pharmacist wearing gloves passes cough drops and medication through the pharmacy’s night-service window.
At the Heinsberg hospital, even fathers and mothers who want to see their newborn babies are stopped and asked about whom they have had contact with and whether they have a fever. In any instances of doubt, their temperature is taken.
The local jail isn’t allowing any visits at all. A flea market for children’s goods has been cancelled, as has a meetup for local senior citizens and all soccer matches in the district this weekend.
Sitting in his office, Pusch, a man who is used to public life, talks about the first crisis meeting on Feb. 25 and his visit to the state health minister the next day.
Coronavirus testing site in Gangelt: What's worse? The virus or the panic?
Foto: MATTHIAS JUNG / DER SPIEGELThe meeting was held to discuss the case of a man who had attended a large party with his wife hosted by a local carnival association on Feb. 15. The man had danced a comedic ballet performance at the party and is now in serious condition at a hospital in Düsseldorf.
Pusch says he also wants to share bad news with the people in his district because he believes in transparency and communication. He regularly addresses residents in videos posted on the district administration’s website and on Facebook. By Tuesday, he had published 11 videos since the beginning of the coronavirus crisis. He calls them the "The Pusch Report.”
The most impactful video is probably the sixth, a response to false information spread on social media claiming that people weren’t complying with the quarantine and that restricted areas would be set up.
Pusch told residents: "As long as I'm in charge, nothing will be sealed off here.”
When asked why he wouldn’t, given that entire cities and villages had been sealed off in Italy, he responded, "That’s not the kind of approach you can convey to the people of Germany. Besides, you can’t control it.”
Measures from the Middle Ages
COVID-19 is a virus of the globalized era, but the containment measures being used, including quarantines and restricted areas, originated in the Middle Ages. Back then, homes of people suffering from the plague were marked with a cross on the door. Pusch doesn’t think much of the idea of placing police watches in front of every home. He says he spent time thinking about his own own capacities and the feelings of local residents.
Pusch says people "grew very alarmed by the false report.” If there hadn’t been a response to it, he says, "people would have broken out in panic” and attempted to flee - the infected and the non-infected alike. The district shares a 78-kilometer long border with the Netherlands, and Pusch says sealing off an area that big would have required the deployment of the German military.
"Again: You can’t do that here. Crises like these can only be solved together, with the residents and through trust.”
Supermarket shelves in Heinsberg: "I won’t take the risk of endangering my children."
Foto: SASCHA STEINBACH / EPA-EFE / REXThe question now is how bad the crisis actually is. Experts say that there are only mild symptoms or none at all in 80 percent of the people infected, and the mortality rate is between 0.3 and 0.7 percent. Is that low or high, reassuring or disturbing?
The big questions now being asked over the cancellation of trade fairs, stock-market crashes, travel cancellations and panic buying around the world, have already arrive here in Heinsberg. The biggest: What’s worse – the virus or the panic it is fueling?
A Risk of Paralysis
If the regulations are too lax, the district administrator could be putting local lives at risk. If they’re too strict, he could paralyze public life and the economy.
Pusch ordered the closure of local schools and daycare centers until the end of the first week of March, but he doesn’t want to have everyone and everything tested. Pusch and his crisis team, for instance, determined that it wasn’t necessary to test every single person who had been to the carnival party in Gangelt. They felt that telling people they should stay home for 14 days went far enough.
But some even had trouble with that.
One woman who was at the party and is still awaiting her test results at home is having difficulty grappling with what is going on. Reached by phone, she explains how she contacted the local public-health authorities, who directed her to get in touch with her family doctor. The doctor then told her to contact the public-health authorities. She says she hasn’t heard anything else from the health office since. She then waited for days and decided to have her doctor test her for the illness. The woman says she can’t understand why tests aren’t being given to each of the 300 people who attended the party. Although her husband works at home, she can’t do the same. She recalls that when she recently cleaned her bathroom and her husband asked if he should help her, she said: "Don’t, so that I’ll still have something to do tomorrow.”
Crises Bring Out the Best and the Worst
She says that the social surveillance feels very real and that she doesn’t even dare to go to the mailbox out of fear that people will start talking about it, that they might accuse her of acting irresponsibly. One passerby, she recalls, drew a cross with his fingers when he saw her standing in the window.
But people can also act differently.
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The article you are reading originally appeared in German in issue 11/2020 (March 7th, 2020) of DER SPIEGEL.
Marion Böhm is from Gangelt. She has two dogs, a part-time job, a Facebook group that she administers and a caring nature. When she heard about the quarantine – at one point it affected around 1,000 people in the Heinsberg district – she thought to herself, what do these people need? Someone to do their shopping. Someone to walk the dog.
The offer from her and a few others was posted in a Facebook group called "You’re a Gangelt Resident If You ...,” which has been transformed since the virus arrived in the Heinsberg district.
"My Children Will Be Staying Home”
Before the crisis, the group addressed questions like: Does anyone know a good glazier? People posted about trash had been left in the forest, a sheep that had been caught in a fence or a highland cow that had given birth to a pretty calf.
Now its members ask whether the district administrator will reopen schools and daycare centers. One person writes: "Personally, I think it's too dangerous." Another mother agrees: "My children will be staying home! I will teach them until everything is contained. I won’t take the risk of endangering my children. I’ll get a sick note for them and all will be good.”
There are also numerous posts about medical care. "It took me almost three hours to get through to my family doctor on the phone,” one laments. Or, "I’ve been trying for about an hour and I have already dialed the number over 150 times.”
Some medical offices had to close after coming into contact with patients infected with the coronavirus, and now the remaining doctor’s offices are overloaded, as are the backup emergency telephone numbers. These concerns are also being registered with a local district hotline for the public. A central emergency center for coronavirus tests has been set up in the gymnasium of a school in Gangelt and a second clinic is open for testing in the nearby town of Erkelenz, but patients and even doctors remain confused about the procedures.
Calls for Outside Help
Pusch is calling for help from the Association of Statutory Health Insurance Physicians. He also says it’s impossible to adhere to the rules set out by the Robert Koch Institute, Germany's center for disease control, ordering that any doctor who has come into contact with infected patients to stop working with patients. He says the district needs doctors. Pusch also believes that doctors who aren’t showing any symptoms should be allowed to work.
But is that prudent or even necessary?
The wife of one general practitioner, who herself works in the medical field, says she’s worried about her husband and her children. His office is still open, but he can’t keep substituting for other doctors at his clinic indefinitely. She says there’s no protective gear available and her husband can’t protect himself or even their children.
After pleas for help from the state, some protective gear has since been delivered. Pusch says that the real price of cost cuts is now being felt in the corona crisis, which he describes as a "test of resilience.” He asks, "How crisis proof is this country?”
And how crisis proof is his district?
In the eighth video, Pusch describes an idea that contradicts previous crisis-management efforts. He says that anyone who has come in contact with an infected person should monitor whether they have any symptoms of the illness. And that if they don’t, they should go on with their everyday lives. Otherwise, he adds, "I’d have to place the entire district under quarantine.” Pusch also says he is acting pragmatically and that the situation is "dynamic.”
Luckily, the current pathogen isn’t Ebola or the earlier SARS virus and most of the cases seen so far have been mild. Indeed, it has been something of a dress rehearsal for Germany, a production most are hoping will never make it to the stage.
