Scientific Consideration of the Misinterpretations of Test Results During the Corona Pandemic

Author(s): Lars Homagk

SARS-CoV-2 in 2019 a coronavirus started circulating. Nevertheless, in 2021 there was a significant decrease in respiratory infections with a simultaneous significant increase in pandemic-related SARS-CoV-2 infections found. The end of the 2019/2020 influenza season was already registered in early summer 2020, and in the following season. There was an nearly complete absence of influenza. The further processing of this influenza gap showed multifactorial reasons also the lack of registration of influenza cases This study looks for further reaseons and from several perspectives in order to develop strategies for a representative recording of acute respiratory diseases (ARI). For Evaluation the data of GrippeWeb, the RKI’s Survstat® tool and the RKI’s reporting data on the new coronavirus were used. In addition, an evaluation of several billing numbers (32006, 32816, 32841) in the outpatient system from 2017 to 2022. Furthermore an evaluation of data on sick leave and illness statistics from 2019 to 2021. The data shows an average of 300,000 annual reports for ARI per year. In 2019 it increased to 1,985,985 reports, in 2020 (5,453,017) and in 2021 to 29,681,158. There is also a correlation between the SARS-CoV-2 test frequency and the positive results, as well as an increase in the previously 6% positive rate for SARS-CoV-2 to over 50% in 2022. At the same time decreases the medical burden due to acute respiratory diseases (ARI) contrary to the increase of the acute respiratory diseases reported. In contrast to influenza A/B, the other viral respiratory pathogens (adenovirus, parainfluenza virus and RS virus) do not show any significant reduction. From 2020, the number of reports of respiratory infections to the RKI increased from an average of 300,000 annual reports by 2019 to 1,985,985 reports in 2020, over 5,453,017 reports in 2021 and to 29,681,158 in 2022. On the other hand cases of incapacity to work due to respiratory infections fell from 31.0% in 2019 to 15.3% in 2021. The reduction in influenza A and B from 2020 as a result of the comprehensive Covid-19 control measures, including the obligation to wear masks, cannot be considered a major reason; rather, the aspect of underreporting of influenza cases plays a significant role. Therefore, the reporting quantity of the sentinal practices should be considered and the recording of incapacity diagnoses should be taken into account. Furthermore, an infection positive rate should not be used as a criterion for infection avoidance strategies and the recording of test results should always be validated and controlled. Only the testing of symptomatic persons should be remunerated and only these validated test results should be considered in the registration.