we refer to 2G as Geimpft or Genesen (Vaccinated or has recovered from the isease) and 3G ( additionally or Tested negative) RKI= German center of disease control, RobertKoch Institute Berlin.

BOOSTER TOPIC ( updated Nov.12,2021):
Our colleague A. Soltani opened his general practice on 1 October. This makes it possible for us to fulfil your wishes for COVID IMPACTS better than before. This applies to BUSINESSES as well as individuals or family members. Because of the supply problem, vaccinations can only be given by appointment only.

Please contact us as a business or individual/family via the email address soltani@klingerplatz.de ,

Mr Soltani will then take care of the rest.

For BOOSTER vaccinations, please state when the FIRST covid vaccination took place or, for companies, when the first vaccination date took place on the premises.

Please note that vaccinations are currently NOT carried out at the examination centre Klingerplatz 5 / 1st floor, but all individual vaccinations are carried out at the Soltani practice (Hinrichsring 10 – Tel.: 0511 695071 ) or by arrangement in the company.

on Covid  Oct 24,2021

The general population in germany  is getting lost in the jumble of information about Covid right now.
Even the question of whether I have to wear a mask at the weekly street market is only known by half of them, because everything seems to change every week.

Everything could be so simple if everyone added up 1 and 1 and we had more and more meaningful data for political and individual decisions.

In this context, I will quote and interpret from the following data treasures: BILD Zeitung, Frankfurter Allgemeine Sonntagszeitung (especially the constant interviews with lung doctor Cihan Celik, who runs an intensive care unit) and the bulletins of the government, the RKI and announcements of the Israeli Ministry of Health. Whoever distrusts my following statements should google the item, where there is no „maybe“ in the sentence, it is a matter of scientifically proven facts.

The vaccination ist for YOU, not for the others:
1. vaccinated as well as unvaccinated people can get infected again and excrete viruses in almost the same quantity. The probability of a vaccinated person becoming reinfected and a spreader is only about 10% of the probability of an unvaccinated person becoming infected.
In this respect, it is not „safe“ if many people come together in a confined space under 2 G rules to do something that is classified as risky, e.g. singing, dancing, playing sports and similar activities that involve heavy breathing…. A successful vaccination therefore only leads to a certain risk reduction, depending on the mask question, i.e. whether the 2G circle is allowed to wear masks and how many people come together.

So mathematically it is a considerable difference in risk whether 4 friends (all 2G) spend an evening together but otherwise alone in a living room playing cards or whether these same people spent Saturday evening together with 10,000 others (also all 2G) crowded together and dancing to pop songs in the Westfalenhalle without masks.

Julian Nagelsmann, the Bayern coach who, according to reports, has been vaccinated twice, is one of the examples this weekend that even young, trained, healthy people will experience a so-called „breakthrough infection“, which in his case is even symptomatic.  In this respect, a differentiation into vaccinated= safe and unvaccinated= unsafe is not tenable. Correct would be Vaccinated= not really safe Unvaccinated= not at all safe. Unfortunately, I have not found anything in the Basic Law on this.

How safe you are is a matter of -are you vaccined and –which vaccine you got
2. vaccination is not equal to vaccination, and here an enormous loss of knowledge has been allowed by data protection. The RKI constantly blurts out a vaccination rate that says NOTHING about which vaccine was used. It is precisely the combination of the data VACCINE/breakthrough infection that could have given a very good classification of the actual protective effect.

Dr. Celik gives us an idea of what this means: 92% of the severe cases in his intensive care unit were UNvaccinated and 4% were people who had been vaccinated with Johnson&Johnson, although 95% of those vaccinated in Hesse had received the Biontec or Moderna vaccine.

(A little excursion into mathematics: out of 1000 persons with Corona in intensive care, 920 are Unvaccinated and if all vaccines were the same, less than 1 intensive care patient out of 1000 should have been vaccinated with Johnson&Johnson (mathematically 4% out of 8% = 0.3), but in fact there are 40, i.e. an over-disease rate of 120 times).

Conclusion: Johnson&Johnson is better than nothing but not good, those who have been vaccinated with it should undergo a 3rd vaccination with Biontech as soon as possible.

Speaking of vaccination rates, company doctors are currently being blamed for the fact that the RKI publishes figures that are too low. From my point of view the figures are useless because:

ERROR 1: The billing of the services was completely separate from the reporting of the vaccination to the RKI. What does the vaccinator / vaccination centre / company doctor care about more? He will always do the billing scrupulously first. It would have been easy to combine billing via the Association of Statutory Health Insurance Physicians (KV) with the KV passing on the figures to the RKI. In addition, not all company doctors are the same. The vaccination and reporting procedure was completely different in the large companies, e.g. in the automotive industry, with salaried doctors (who were NOT allowed to do ANY BILLING, which certainly did not promote their interest in additional paperwork) and freelance company doctors, who had to document and bill for every vaccination, but were also supposed to report to the RKI every working day.

Anyone who has seen the sweaty work of us company doctors and the mobile vaccination teams when we finally received vaccine would not believe that there was still time and energy for additional paperwork at the end of the shift.

Anyone who wants to understand this now can work out the figures for the freelancers through the quarterly accounts that have been prepared in the meantime. In the case of company doctors in large companies, one can only determine how much vaccine they have received (someone will have the number) and calculate the half/half for first and second vaccinations, then one would have a „well-educated guess“.

ERROR 2: And what about the numerous vaccination tourists who have been vaccinated with Sputnik or Sinovac in Russia or the Balkans, who counts them?

I have asked around in my circle of acquaintances. I know NO ONE who is unvaccinated, so here in the microcosm the rate of vaccination is 100%.

There was NO documentation of which vaccine was used. This is now taking revenge, because there is a grey area with people who believe they have protection, but which ( at least with Sputnik and Sinovac) is objectively obviously worse than in the Biontech/Moderna group, i.e. largely based on HOPE. And some of the vaccines approved here have been used so little that statements about their effectiveness are simply a misnomer.

 4. VACCINATION STRATEGY

Learning from Israel means learning to win: Israel was the first country to be vaccinated with Biontec at an early stage, and it was very well sealed off from the outside world. 6 months after the first vaccination, an increasing number of „vaccination breakthroughs“ were observed and first the old and sick, then the over 50s and now EVERYONE was prescribed a third vaccination from the 6th month after the first. That is, in fact the same regime as we have been using against HepatitisB for ages.

From this I derive my personal recommendation (which only does not come from the vaccination commission because they lack official figures, although empirical medicine (I speak as a general practitioner) has long since shown the way:

1. BIONTEC/MODERNA VACCINATED ? EVERYONE should get a 3rd (booster) vaccination with Biontec after the 6th month after the first Biontec vaccination if possible. (We have been following this vaccination strategy for decades, e.g. for hepatitis B, and it has proven successful).

2nd Johnson&Johnson vaccination ? Everyone should immediately (from the 4th week after vaccination with J&J) receive a Biontec booster vaccination.

3. vaccinated with other vaccines? Even if there is no data, it is obvious that a booster with Biontech makes sense and is indicated. Only time will tell if and when a second Biontech will be necessary. If vaccinated with non-approved vaccines such as Sinovac or Sputnik, at least one booster vaccination is required, actually 2 to be considered vaccinated in the sense of 2G. According to the disease figures in England, it can be assumed that it was a good thing for US that they did not export their Oxford vaccine, as here too the protective effect seems to be low and to continue to decline sharply after 6 months. I am strongly in favour of a 3rd vaccination after Oxford with either Biontec or Moderna

4. healty again after an COVID19-infection? You MUST have a booster vaccination with Biontec from the 6th month after recovery, only then will you have full and apparently long-lasting protection.
If you have long Covid, it must be clarified with your family doctor in each individual case when a booster vaccination can take place.

5. SOCIAL CONTACTS

The virus is there and will not go away. A vaccination protects quite well against severe courses of the virus, but not against infection and further spread by you. Vaccination is a measure of SELF-protection. Youth does NOT protect against severe courses, even if statistically less likely. But this also means that RISKY behaviour quickly uses up the statistical advantage of younger people.  Anyone who puts themselves in danger (be it in the gym, the subway, in a club, on an aeroplane or anywhere else where people come together closely and for longer than a few minutes) should wear an ffp2 mask and ALWAYS and ALWAYS over their mouth and nose. And this advice certainly applies until spring.  Exercising in poorly ventilated indoor spaces, whether in a club or studio, without a mask is high risk and will remain so. The same applies to air travel, especially for longer journeys because you can’t always wear a mask (e.g. when eating/drinking). For your own information and to protect those around you, you should take at least two quick tests in the five days afterwards to increase safety for yourself and your family.

And always remember: A rapid test gives you the certainty that you are not a superspreader for the next 12 hours. It makes sense to attend an event in the sense of 3G but only for the 12 hours after the test, AFTER the risk event a test makes sense at least 48 hours later and a second one 2 days later.

And again for the record: being vaccinated does not mean no danger, it means  less danger.

Stay healthy!
written by

Mathias Bieberbach, MD

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