COVID-19 has lost much of its fearsome reputation. Most people in Germany are vaccinated or have otherwise built up a baseline immunity. Still, general practitioners like Lars Rettstadt are busy.

"It's typical infection season again. There's a lot of sniffling and coughing," said the doctor in Dortmund, a city in western Germany. "When we open the door on Monday morning, there are 70 people without an appointment: men, women, young and old."

By his estimate, 80% of them have viral infections of some kind. Half of those are COVID-19.

Only few severe cases

Without a mask mandate, most patients don't wear one. Rettstadt's practice offers them for 50 cents. He has set aside an hour just for infection appointments, and patients can also reach him by video. PCR tests are reserved for those in particularly bad shape.

"We no longer see severe cases," he said, adding just one patient, aged 94, had to be hospitalized due to COVID-19. 

Otherwise, symptoms reflect the regular wintry kind that keep people out of work to recover in bed at home. Yet sick days can go for as long as two weeks.

10% of country suffering respiratory infections

While the illness might not be fatal, it is causing massive disruptions. As much as 10% of the country sick, according to Germany's Robert Koch Institute for public health, and offices and services are struggling to stay open. And with the mix-and-mingle Christmas season coming up, Health Minister Karl Lauterbach has urged people to get their vaccinations topped up.

The official, seven-day incidence is at 38, which seems low in comparison to 2,000 during the omicron wave in early 2022. Yet with testing sporadic, that number may be deceiving. A recent test of wastewater has shown more COVID-19 in the water since this form of testing was first started in June 2022.

Other forms of PCR testing suggest a seven-day incidence of almost 3,900 in the western German state of Rhineland-Palatinate, said the Frankfurt-based virologist Martin Stürmer. That's up from 2,600 one week ago.

"We are in a phase where the coronavirus figures are increasing massively," he added.

Pirola variants on the rise 

The coronavirus figures are in addition to the usual cases of flu and respiratory illnesses. Yet these haven't translated into a higher burden on hospitals and ICU wards, said Stürmer. The death rate has also remained stable.

Of the many variants out there now, the "JN.1 subvariant, another successor variant of pirola, is now responsible for almost a third of cases," he added. 

While the risk to the general population is low, Stürmer called on at-risk groups, including people over the age of 60, to get booster shots. These add a layer of defense against so-called long COVID, the long-term effects of COVID-19. Masks could be sensible, too, he added, although there is little public desire to go back to them.

"The willingness to be vaccinated is also certainly at a low level," said Stürmer. "I think these are all factors that we could significantly improve with positive and meaningful communication."

This article was originally written in German.

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