Drosten covered SK’s cases of testing of recovered patients a while ago1 in the (now twice-weekly) interview podcast. Bottom line: medical (and testing) lab/reporting culture is different compared to, in this case, Germany. From his experience in working with Asian colleagues in the public health sector, he says that they often do everything extremely thorough and by the book. This, he explained, means labs and authorities also report findings which would raise eyebrows in Germany. Quoting him, about Germany: “[Here,] results are questioned relatively quickly and rules are always seen with the possibility of an exception.”
He suggested that the virus was detected due to high sensitivity of the PCR, and compared it to “fishing for gold fish in a swimming pool” and went on to explain that when you take some samples (i.e., buckets of water) and don’t find a goldfish, you might think the pool is devoid of goldfish (and, in case of Covid-19, release the patient). However, testing again, later could lead to finding another goldfish. (I’ll add, staying in the image, that would be ok as long as the fish isn’t actually reproducing, especially not reproducing exponentially. A dead goldfish would be optimal, and this seems to be the case here. Or rather, they found some pieces of goldfish.)
There’s a broader implication in what he described.
I know this is a sensitive issue, but we have to account for different local and regional cultures and habits when comparing results, and even scientific reports. This is one reason why I argue that you can’t just copy measures taken against a virus like this. It is important to realise that even in official scientific reports a lot goes unsaid because the writers assume that everyone understands the relevant contexts. Upthread, I mentioned Amoy Gardens2. The WHO lists this as a SARS superspreading event via plumbing, and
I want to highlight different cultural, habitual and legal context in one example of a measure, again.
Germany is slowly coming to terms with community masks, and struggles to do so. This would not be a problem in most Asian countries, because people there are already used to wearing a mask.
In Germany, we e.g. have a discussion if you can wear a facemask in your own car. Even though § 23 Abs. 4 StVO basically says you can’t, but legal consensus right seems to be that you can wear a mask as long as it only covers your mouth and nose, and the rest of your face is visible. There are now discussions if an employer can force employees to wear a mask, or - especially interesting - force employees not to wear a mask. Apparently, some employers object having employees wearing masks because they have contact with customers (and “your face is the face of the company”, I presume). This will need legal clearance, soon. Culturally, seeing someones face is very highly valued around here and even already took precedent (legally!) over religious freedom. (We had interesting cases if people could wear a hijab in school, or court.) So, a wild mix of stuff to consider, but the current willingness to wear a mask is high. Social pressure in Germany is also quite a thing: the majority of people do not want to stand out, and if more people are wearing a facemask in public, many will follow.
1: Try Google Translate, it will give you a nearly understandable version.
2: Just a very speculative footnote - please don’t overinterpret my curiosity: I would be quite interested in the opinion of experienced “western” epidemiologists if the related reporting, research and publication could also be due to the described thoroughness of authorities and researchers in HK. It is quite standing out, but then, the case seems to be especially interesting for a city with such a population density and amount of high-rise communities.
