Germany Makes Rapid Virus Tests a Key to Everyday Freedoms

https://www.nytimes.com/2021/06/09/world/europe/germany-covid-rapid-antigen-tests.html

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BERLIN — Want to go out for a meal indoors in Germany? Get a test. Want to stay at a hotel as a tourist or work out at the gym? Same answer.

For the many Germans who have not yet been vaccinated, the key to Covid freedom has come from the end of a nasal swab, and rapid-test centers have multiplied at a speed usually reserved for the country’s autobahn.

Abandoned cafes and nightclubs have been converted. Wedding tents have been repurposed. Even the back seats of bicycle taxis have a new use, as tourists have been replaced by Germans being swabbed by testers in full protective gear.

Germany is one of a handful of countries betting heavily on testing — as well as vaccines — to beat the pandemic. The idea is to find potentially infectious people before they can join crowds in concert halls and restaurants and spread the virus.

The testing system is a far cry from much of the United States, where in many places, people began dining indoors or sweating together in gyms with few if any requirements. Even in Britain, where the government gives out free rapid tests and schoolchildren have taken more than 50 million since January, they are not part of everyday life for most adults.

But in Germany, people who want to participate in various types of indoor social activity or personal care need a negative rapid test that is no more than 24 hours old.

There are now 15,000 pop-up testing centers across the country — more than 1,300 in Berlin alone. The centers are funded by the government, which has spent hundreds of millions of euros on the ad hoc network. And a task force led by two cabinet ministers is ensuring that schools and day care centers have enough of these rapid antigen tests to administer to children at least twice a week.

Separately, do-it-yourself kits have been become ubiquitous at supermarket check out stands, pharmacies and even gas stations since they first came on the market earlier this year.

Experts in Germany say that they believe the testing is helping to lower virus case numbers, though proof is elusive.

“We see that the infection rate here is dropping faster than in other countries who have similar vaccination numbers,” said Prof. Ulf Dittmer, the director of virology at the university hospital in the western city of Essen. “And I think a part of that has to do with widespread testing.”

Almost 23 percent of Germans are fully vaccinated, meaning that they don’t have to present test results. Another 24 percent who have received only one dose of the vaccine and those unvaccinated still do, even though as of Tuesday, there have been only 20.8 infections per 100,000 people in a week, a number not seen since early October, before a second wave started spreading.

Throughout the pandemic, Germany has been a world leader when it comes to widespread testing. It was one of the first countries to develop a test to detect the coronavirus and relied on testing to help identify and break down chains of infection. By last summer, everyone coming home to Germany from vacation in countries with high rates of infection was being tested.

The current testing has been considered especially important because of the relatively slow start of Germany’s vaccine campaign. The country stuck with the European Union in making vaccine purchases as one unit, and found itself stymied as Brussels faltered in securing shots quickly enough. The United States has fully vaccinated almost twice as large a slice of its population.

Uwe Gottschlich, 51, is one of those who is taking tests to return to a semblance of normalcy. On a recent day, he took a seat in the comfortable rear of a bike taxi that used to pedal tourists around Berlin’s central landmarks.

Karin Schmoll, the manager of the bike taxi company, now retrained to administer tests and wearing a green full-body medical gown, gloves, a mask and a face shield, approached, explained the procedure, and then asked him to remove his mask so she could delicately probe his nostrils with a swab.

“I’m meeting some friends later,” he said. “We’re planning to sit down someplace to have a drink.” Berlin requires a test before drinking indoors, though not outdoors.

Professor Dittmer said that although antigen tests were less sensitive than the PCR tests, which take longer to process, they are good at finding people with high viral loads, who would be at greater risk of infecting others. The testing system has not been without critics. The generous government funding was meant to make it simple for people to get tested, and easy to set up a center — a political reaction to the slow and overly bureaucratic vaccine campaign.

But the boom has led to accusations of waste. Germany’s health minister, Jens Spahn, was forced to meet with state lawmakers after fraud allegations surfaced in recent weeks.

The federal government spent 576 million euros, $704 million, for its testing program in March and April. The figures for May, when the number of private testers exploded, have not yet been released.

While rapid tests are available in other countries, they are not necessarily a cornerstone of the day-to-day reopening strategy.

In the United States, antigen tests are widely available, but they are not part of any national testing strategy. In New York City, a few cultural venues, like the Park Avenue Armory, offer rapid antigen testing on site as an alternative to proving vaccination status in order to gain entry, but that is uncommon. Widespread vaccination has also limited the demand for rapid tests.

In France, showing proof of recent Covid-19 recovery, of vaccination or of a negative coronavirus test is mandatory only for events or places where more than 1,000 people attend. Italians only have to provide proof of a negative to attend weddings, christenings or other large ceremonies, or to travel outside of their home region.

The idea of testing to freedom in Germany first started in Tübingen, a university city in the southwestern state of Baden-Württemberg. In the weeks before Christmas last year, the local Red Cross set up a tent in the city center and began administering free rapid antigen tests to the public. Only those who tested negative were allowed to enter the city center to visit stores or the booths of a reduced Christmas market.

In April, the governor of the state of Saarland, in the southwest, started a statewide program allowing people to test their way to freedoms like meeting for drinks or attending a performance at the Staatstheater Saarbrücken, which thanks to the testing program was the only theater in the country open in April. As many as 400,000 people a week were getting swabbed.

Those lucky enough to attend performances — masked and with a negative test — were thrilled at the opportunity. “I have been excited to come here all day,” exclaimed Sabine Kley, as she hurried to her seat for the German premiere of “Macbeth Underworld” on April 18. “It is wonderful, and I feel safe.”

In recent weeks, German states with low case numbers have begun lifting some testing requirements, especially for such activities as eating outdoors that are considered lower risk. But some German states are keeping them in place for such activities as overnight stays for tourists, attending concerts and eating inside restaurants.

For the bike taxi company in Berlin, managed by Ms. Schmoll, setting up a testing center was a way to put idled vehicles back in use, she said, adding that business was particularly brisk toward the end of the week.

“It’s going to be a busy day today because it is the weekend and people want to go out,” said Ms. Schmoll, 53, as she looked out at the line of people waiting to take a seat on her three-wheeled cycle on a recent Friday.

And for those getting tested, like Mr. Gottschlich, the swabs are small price to pay for freedom from the pandemic rules.

“I’ll be honest,” he said. “I’ve done this every day for the last three days.”

Reporting was contributed by Emily Anthes from New York, Aurelien Breeden from Paris, Benjamin Mueller from London, Sharon Otterman from New York and Gaia Pianigiani from Italy.