>> For example, there is the very first German “Corona Paper” by Max Geraedts (6), who was able to publish the results of a systematic citizen survey (n=10,037) in the specialist magazine “British Medical Journal Open” in March. And also two theses papers from a group of authors around Matthias Schrappe (H. Francois-Kettner, M. Gruhl, F. Knieps, H. Pfaff, K. Püschel) that have already been published online (7) and in print form in this issue of “Monitor Healthcare Research”. , G. Glaeske), which, among many other interesting theses, vehemently calls for improving the database in the form of population-based samples (“National Covid-19 Cohort”). The reason: "In order to clarify the important questions about prevalence and incidence, it is necessary to examine a representative sample analogous to the national cohort for HIV infection in the 1980s." According to the authors, the size must include at least 10,000 people stratify with regard to the known risk factors and make statements about high-risk groups.

The state of Bavaria carried out something similar, only on a much smaller scale, with 3,000 Munich residents who were medically monitored and analyzed for a longer period of time (8). Austria has also been active since the beginning of April with a nationwide Covid-19 prevalence study carried out twice. The results of the first study (n=1,544 random sample, Austria-wide) were published on April 10th in a scientific method report (9); those of the second – so-called “dark number study” (n=2,800 random sample, Austria-wide) – were presented at the end of April 2020 (10). According to this first study in continental Europe, which was based on nationwide representative random PCR tests, around 28,500 Austrians (0.33%) were infected at the end of April; the official number was 15,324 people.
Switzerland is also ready: The Swiss School of Public Health (SSPH+), an inter-university faculty that brings together twelve Swiss universities, has randomly selected men and women of all ages as well as children aged 5 and over across Switzerland (200 to 800 people per region). .
The first phase of the so-called Corona Immunitas study (11) has started in the canton of Geneva: Since April 6th, the University Hospitals of Geneva (HUG), in particular the Department of Population Epidemiology of the Primary Care Medicine Service, have been testing the Center for Emerging Viral Diseases and the Laboratory Medicine Service, several hundred people each week who are already being observed for another health project. Before that, however, the HUG - according to the scientists in their interim report - carried out a preliminary study to validate the performance of a high-throughput serological test platform that measures type G immunoglobulins (IgG), which are directed against SARS-CoV 2. The results of the study showed that this test reliably confirms exposure to SARS-CoV-2 20 days after the onset of symptoms. The platform was then also used for population studies. Seroprevalence studies* based on the detection of specific G-type immunoglobulins (IgG) are, according to Swiss scientists, of utmost importance to detect the proportion of the population that has already been exposed to the corona virus: The presence of immunoglobulins ( Antibodies) in the blood confirm that the person in question had been exposed to the virus.
The first interim results of the Geneva study to estimate the prevalence of anti-SARS-CoV-2 IgG antibodies in the Geneva population were published at the end of April. The first data show a seroprevalence in the Geneva population that is 3.5% (possible variability from 1.6% to 5.4%) for the first week and 5.5% (possible variability from 3.3% to 7%) for the second week ) was estimated. However, in the researchers' opinion, this sample and the period examined are too small to derive the percentage of the weekly increase with certainty, but a significant increase would have been observed between the two weeks.
However, the result suggests that around 27,000 people in the canton of Geneva were exposed to SARS-CoV-2 by April 17, 2020. However, this is a minimum estimate, which is also likely to be associated with several uncertainties. What is meant here is, on the one hand, the time required for the development of immunity and, on the other hand, the dynamics of the epidemic. The Swiss researchers also assume that population seroprevalence is likely to increase in the coming weeks, as the number of cases in the canton of Geneva has also increased recently.
However, in the Auoten's opinion, the interpretation of the seroprevalence estimates should be carried out with great caution, as the still limited number of participants, the short follow-up period and the influence of the performance of serological tests must be taken into account. Nevertheless, monitoring the evolution of seroprevalence over time is particularly important to anticipate and plan the public health response. The second phase will start in May/June with additional cantons, which will include a large sample and report on the level of immunity in the Swiss population after the first peak of the epidemic (in accordance with the recommendations of the WHO protocol) and after the first easing should deliver. In addition, the data should be used to control measures in the event of a new wave of infection and to develop a national vaccination strategy. Phase III (around September) should then enable an evaluation of the measures after the relaxation and an assessment of the completeness and duration of immunity. Furthermore, in the opinion of the federal scientists, the need for vaccination can also be evaluated based on the data.
“Covid-19 Social Monitor” (13) is the name of another project from Switzerland. Since March 2020 until summer/autumn 2020, the Winterthur Institute for Health Economics at the Zurich University of Applied Sciences (ZHAW), in collaboration with the Institute for Epidemiology, Biostatistics and Prevention at the University of Zurich, has been regularly and promptly recording the well-being of the Swiss population since the end of March the Covid-19 pandemic using a panel survey representative of the Swiss population. Continuously updated results of the “Covid-19 Social Monitor” can be found online (23). Project leaders are Dr. Marc Höglinger from the ZHAW and André Moser PhD from the Institute for Epidemiology, Biostatistics and Prevention at the University of Zurich.

Germany is not idle either. The AOK Scientific Institute (WIdO) carried out important work on the suspected high-risk populations (diseases of the cardiovascular system, diseases of the lungs, liver diseases, diabetes mellitus, cancer and patients with weakened immune systems) with its current monitor for regional distribution of previous illnesses with an increased risk of severe Covid-19 courses (14). Using an extrapolation from the AOK billing data for 2018, it was determined, for example, that a total of 21.9 million people living in Germany have at least one of the previous illnesses taken into account, meaning that they have an increased risk of severe cases of Covid-19. This means that more than a quarter (26.4%) of Germany's 83 million inhabitants have such a previous illness. According to the group of authors (G. Brückner, K. Schüssel, J. Breitkreuz, A. Schlotmann, C. Günster) around the deputy managing director of the WIdO, Helmut Schröder, there is “a significant increase with increasing age, while younger people are less affected " are. The authors also write that among residents under the age of 20, only a little more than three percent have at least one of the previous illnesses in question, the proportion of patients increases continuously with increasing age and is at least 80 percent among those over 80 years old. In addition, according to the current WIdO evaluation, almost two thirds (66.1%) of the total 21.9 million patients with at least one previous illness are 60 years old or older.
Even if it is not health care research, the clinical study centers of the German Center for Infection Research (DZIF) at the University Hospital of Cologne are currently recording all study activities on SARS-CoV-2 (15) for the first time in order to provide a Germany-wide overall overview and to effectively network researchers. The plan is for all studies planned and initiated in Germany to be embedded on the DZIF website and to form a central transparency and contact point for research activities and clinical studies on SARS-CoV-2.
But what exactly does health services research do? The German Network for Healthcare Research (DNVF) issued an initial statement on April 16th. “Overcoming the pandemic requires the active participation of health services research,” wrote the chairwoman of the DNVF, Prof. Dr. Monika Klinkhammer-Schalke (16). She promised that the DNVF would work actively to “find a way through the Corona crisis”.
The main questions from the perspective of health services research are:
• Which institutions, which equipment and which staff are available where to adequately treat all sick people with all protective measures?
• How do contextual factors (of a health policy and organizational nature as well as at the patient/practitioner level) influence the ability to adapt to the care situation and the quality of care?
• What consequences does the change in care for Covid-19 patients have for the clinics and for patients with other illnesses such as heart attacks, strokes, cancer and planned elective procedures in the short and medium term? Is there “under- or incorrect care” for patients who have to stay away from care?
• What precautions must be taken to adequately cover the prevention and care needs of non-corona patients?
• What prospective preparations must healthcare providers make for disasters (epidemics, natural events, war)?

There are a number of projects - nine in number - on important topics relating to Corona, which the DNVF lists on its portal (17).
These are, for example, projects like:
• “Protective factors and mental health during the Covid-19 pandemic” from the Department of Clinical Psychology and Psychotherapy at the Eberhard Karls University of Tübingen. The aim of the study, which was carried out using online questionnaires (18) (collection dates: April, May/June 2020), is to generate a scientific basis in order to derive recommendations for psychosocial prevention and intervention measures for those affected. The project manager is Dr. Sebastian Wolf.
• “Covid-19 and Psychiatry: A Germany-wide survey of the situation in psychiatric clinics” from the Clinic for Psychiatry and Psychotherapy at the Ludwig Maximilians University in Munich. In order to obtain the best possible overview of the contribution of psychiatry and the care situation in view of the Corona crisis, the DGPPN would like to carry out a survey among all clinics together with the clinic associations and with scientific support from the LMU Munich. A Germany-wide collection of data on care structures and established measures is planned from April to December 2020. Project leaders are Prof. Dr. Peter Falkai, Prof. Dr. Oliver Pogarell and Dr. Kristina Adorjan (19).
• “Impact of the Covid-19 pandemic on trans health and healthcare”, TransCareCovid-19 for short. In this study, the Institute for Sexual Research, Sexual Medicine and Forensic Psychiatry at the University Hospital Hamburg-Eppendorf wants to research how the Covid-19 pandemic affects the health and health care of trans and transsexual people. The results are intended to inform health professionals and support trans communities to better cope with the negative consequences. The study - launched on April 6th with a survey in English and German - consists of an online survey that is currently available in seven languages. Another ten languages (including Portuguese, Chinese, Indian) are in preparation. The project manager is Dr. Timo Nieder (20).
• “Medical child protection under social distancing conditions” is the name of another project at the University Hospital Hamburg-Eppendorf, this time supported by the Institute for Medical Psychology and Children’s Clinic. The number of cases and case severity of all medical child protection groups (n=141) in Germany are to be collected in the comparison periods of April 2019 (t0), April 2020 (t1) and June 2020 (t2). Project managers are PD Dr. Silke Pawils, Dr. Jo Ewert and Dr. Franka Metzner (21).
• “Mortality/Lethality/Pathogenesis in Covid-19” from the Institute for Forensic Medicine and many others at the UKE. All Covid-19 deaths should be recorded and analyzed within six months. However, there is no further information yet.
• “Telemedical care for patients with psychiatric illnesses” – here the Institute for Community Medicine at the University Medical Center Greifswald wants to find out what part of psychiatric care during the corona pandemic with an observation study over about three months with continuous collection of care data and regular surveys of treatment satisfaction can be replaced at short notice by telemedical care under the conditions of social distancing. The project manager is PD Dr. Neeltje van den Berg (22).
• The German Society for Rheumatology (DGRh) and the Justus Liebig University of Giessen are creating a “German Covid-19 registry for inflammatory rheumatic patients”. Since March 30, 2020, cases of patients with an underlying inflammatory rheumatic disease and a Covid-19 infection have been documented pseudonymously using an online platform. Every doctor has the opportunity to register patient cases, and patients with an underlying inflammatory rheumatic disease and evidence of a Covid-19 infection can actively register themselves. Project leaders are Dr. med. R. Hasseli, Prof. Dr. med. U. Müller-Ladner and Prof. Dr. med. C. Specker (23). The DGRh has also founded an ad hoc commission “Covid-19 Register”, whose task is to provide valid and evidence-based answers to questions about the treatment of people with inflammatory rheumatic diseases caused by Covid during the Corona crisis -19 are affected. For this purpose, information from clinics and practices should be systematically recorded and evaluated.
• “Covid-19: Dresden information and prognosis tool for the course of the disease and bed occupancy in Saxony” (DISPENSE) has been continuously creating an up-to-date and small-scale modeling of the infection and clinical events at the district and hospital level of the Covid-19 pandemic since March 2020 Saxony. The modeling is carried out using standard methods, including statistical models (including regression) of the existing data or using dynamic epidemic models of the SIR model class (see https://neherlab.org/covid19/). In the future, a model adjustment is planned based on standardized data collected from Saxon clinics and health authorities as well as new scientific findings. The development and forecast of the Covid-19 disease and the (intensive) medical care needs are presented using interactive diagrams and dashboards. Utilities and political decision-makers can interpret developments in a more differentiated manner and assess them prospectively for their own sphere of influence. The basis for this is the development of a data infrastructure that is as automated as possible, in which - starting with the minimally necessary data for the prognostic models - more data can also be communicated and aggregated for the monitoring of Covid-19 patients. In the future, the tool should also be transferable to other federal states, provided the data from regional clinics and health authorities is available. Project leaders are Prof. Dr. med. Jochen Schmitt (coordinating project manager), head of the Center for Evidence-Based Health Care (ZEGV), Prof. Dr. rer. med. Ingo Röder (institute director) and Prof. Dr. rer. nat. Martin Sedlmayr (deputy director) of the Institute for Medical Informatics and Biometrics at TU Dresden and Prof. Dr. med. D. Michael Albrecht, board member of the Carl Gustav Carus University Hospital Dresden (24).
• “The situation of people in Germany during the corona pandemic” was described by the Health Department at the FH Münster (Muenster School of Health). An online survey (n=2,641) conducted from March 26th to April 10th asked about changes in social contacts as well as loneliness and care in the health system. An initial briefing contains the most important concise results of the study (25).

The number of projects associated with Covid-19 will certainly increase enormously in the near future due to the current DFG call for proposals for interdisciplinary research into epidemics and pandemics due to the outbreak of SARS-CoV-2 (26). This interdisciplinary funding initiative is intended to support projects that deal with prevention, early detection, containment and research into the causes and effects of and how to deal with epidemics and pandemics using the example of SARS-CoV-2 and other human pathogenic microorganisms and viruses.
This includes exploration
• the challenges and impacts of an epidemic or pandemic and the measures taken on health systems;
• psychological, social and cultural factors in the emergence, spread and treatment of epidemics and pandemics as well as legal and ethical implications;
• the impact on global and regional economic development, production and value chains, logistics, transport and communication;
• biological and medical basis of a pathogen and the respective clinical picture as well as therapeutic procedures or preventive measures in combination with one or more of the previously mentioned subject areas.
In addition, projects can be applied for that initially deal with the collection and recording of basic data on the current epidemic and the current countermeasures, on the basis of which retrospective analyzes can later be carried out. Projects that are dedicated to simulating the spread and consequences of pandemics as well as the effectiveness of interventions are also possible. The declarations of intent must be sent to the DFG by July 1, 2020; However, the last date for submitting applications is September 1st.
Further funding in connection with Covid-19 is the emergency call “KLIPHA-COVID19” (27), endowed with 23 million euros, from the Austrian Federal Ministry for Climate Protection, Environment, Energy, Mobility, Innovation and Technology (BMK), with which company projects and Clinical studies should be funded.
There are also further third-party funds - which can be found at the University of Vienna (28) - through acute funding from the Austrian Fund for the Promotion of Scientific Research (FWF) for research into humanitarian crises such as epidemics and pandemics, especially for projects that deal with prevention, early detection, Containment and research into the causes and effects of humanitarian crises such as epidemics and pandemics using the example of Covid-19, or the technical, ecological, economic, political, legal, medical, cultural, psychological or ethical implications of the crisis
Deal with Covid-19 crisis.
The FWF is also building an international network to strengthen cross-border research into the current pandemic and its consequences in the area of acute support for SARS-CoV-2. In cooperation with the funding organizations from Germany (DFG), Luxembourg (FNR), Poland (NCN), Switzerland (SNF), Slovenia (ARRS) and the Czech Republic (GACR), researchers from the above-mentioned countries can now apply for international research projects more quickly . Both bilateral and trilateral projects can be submitted.
Another EU and international call on Covid issues comes from the National Institutes of Health (NIH) on “Partnerships for countermeasures against selected pathogens” (NIH: RFA-AI-20-028). Applications for this must be submitted by June 29th (29).
There was also funding from the British Department for International Development (DFID) and the Wellcome Fund founded by Sir Henry Wellcome (30). As part of a joint initiative to research the preparation and control of epidemics, the evidence base is to be strengthened in order to be able to better control corona virus epidemics and increase research and response capacities. However, the application deadlines expired at the beginning of May. However, it should be noted that while the targeted funding call for Covid-19 related research has closed, any further research inquiries relating to Covid-19 can be emailed to [email protected]. <<

from:
MVF editor-in-chief Peter Stegmaier

Editor's note (as of May 25, 2020):

In the meantime, the RKI has planned the so-called “Kupferzeller Corona Study”; according to the RKI, the first results should be available in around six weeks. A team from the Robert Koch Institute (RKI) is investigating how widespread the novel coronavirus SARS-CoV is in the community of Kupferzell -2 is on site. Around 2,000 adults from the community in Hohenlohekreis will be invited to the “CORONA MONITORING local” study in the next few days. The study program includes a throat swab, a blood sample and a survey about, among other things, clinical symptoms, previous illnesses and health behavior. An RKI team has been on site since May 18th, the investigations will begin in the following days and are expected to take place in two study centers until June 6th. Link: https://www.rki.de/DE/Content/Gesundheitsmonitoring/Studien/cml-studie/Dokumente/Studieninfo.pdf?__blob=publicationFile

Short interview:

Apfelbacher: “Deliver interdisciplinary expertise quickly and flexibly”

The early days of the corona pandemic were a time of virology and epidemiology, with at least the latter being one of the basic sciences of health services research; Quite a few health services research institutes even have this scientific discipline in their name. Why, in your opinion, is health services research only coming forward so late on the diverse topics and massive problems triggered by Corona? Or perhaps asked somewhat heretically: Does she perhaps have nothing (yet) or too little to say?
A pandemic is a health problem that affects the entire population. First of all, it was and is absolutely crucial to have a good understanding of the dynamics of the spread and to implement adequate prevention measures. In the area of care, intensive care medicine was initially required; it reacted quickly and, for example, set up the intensive care register. At the same time, forecast planning for intensive care capacities is underway. Now health services research comes onto the scene.

Who should explore what?
It is now primarily about two things: Firstly, the scientific support - from various aspects - of the care of Covid-19 patients. And secondly, research into the effects of the pandemic on other care areas and diseases. There is a risk of undersupply in some areas with unclear effects on the overall burden of disease.

In the imprint of the Public Health Covid-19 Competence Network you can read that the provider of these pages in the legal sense is the Leibniz Institute for Prevention Research and Epidemiology (BIPS), represented by the managing directors Prof. Dr. Iris Pigeot-Kübler and qualified economist Cornelia Wiedemeyer. Did BIPS also have the idea for this?
The competence network is an ad hoc association of scientific societies and was not based on a specific institute. The founding specialist societies were: DGPH, DGEpi, DGSMP, DGMS, GMDS. So professional societies with a public health focus. The competence network now includes over 20 specialist societies that represent thousands of scientists in Germany, Austria and Switzerland.

Wouldn't it have been the original task of the DNVF - which is also one of the specialist societies involved in the competence network - to initiate such an initiative? Or does it simply say: first come first serve?
As I said, they were scientific societies with a public health/prevention/population focus. From my perspective, health services research is part of public health and plays an important role in the pandemic, so the initiative could also have been initiated by the DNVF. The whole thing just happened incredibly quickly – within a few days. Five specialist societies paused briefly and then formed a coordination group of ten people. You have to be able to manage the whole thing. Then the initial focus was to bring all relevant specialist societies/networks on board, including the DNVF.

As a healthcare researcher (and also a member of the DNVF), you are part of the steering committee of the Covid-19 competence network. What is the main goal of this merger?
The aim is to quickly and flexibly provide interdisciplinary expertise on Covid-19 for current discussions and decision-making. To this end, scientific findings are compiled, processed and disseminated in a form that is as easy to understand as possible. Depending on the topic and target group, we use different formats, such as framework papers, fact sheets or policy briefs. The information is primarily aimed at authorities, institutions and political decision-makers.

And what is your personal goal within the new competence network as the new head of the Institute for Social Medicine and Health Systems Research at the Otto von Guericke University in Magdeburg?
My personal goal is to contribute as a specialist representative to evidence-based decision-making in politics. Like many colleagues who hold an academic leadership position in the areas of public health, epidemiology, social medicine, medical sociology or health services research, I feel that we all simply want and need to make a contribution now; with what we do well: systematically preparing knowledge and information! As scientists we generally have a social responsibility, and as public health scientists we have even more of a responsibility in the current situation.

The beginning activities of the Covid-19 Competence Network are currently divided into eight working groups, from modeling to health and work. Does the structure follow a stringent and consensual top-down strategy, so that one could assume that these eight topic areas are the most important that health services research will have to research in the near future? Or aren't the working group topics more research-driven?
There are now eleven working groups. But there is no top-down strategy. Rather, the competence network forms a swarm intelligence; suggestions for working groups were made, discussed and set up in the coordination and steering group. Coordinators were then appointed and important topics were determined in each working group. The working groups are open to interested parties and are not closed shops.

When will there be the first results of the Public Health Covid-19 Competence Network?
The first results of the competence network are available. Four papers have already been published in the last few days: A policy brief on “Public Health Ethics and Covid-19”, a background paper on “Indirect health consequences of the current infection protection measures in Germany”, a fact sheet on the topic “Opening of schools as part a transition strategy” and another entitled “Do older workers have to stay away from work?”

Thank you for the talk.

Citation note:

Literature:

1) https://www.welt.de/politik/deutschland/article207268921/Rechtsmediziner-Pueschel-Die-Zeit-der-Virologen-ist-vorbei.html?wtrid=kooperation.reco.taboola.free.welt.desktop
2) https://www.pnas.org/content/early/2020/04/07/2004999117
3) https://inno.uni-hohenheim.de/corona; https://inno.uni-hohenheim.de/corona-modell
4) http://rocs.hu-berlin.de/covid-19-mobility/de/mobility-monitor/
5) https://www.ukbnewsroom.de/die-landesregierung-hat-gemeinsam-mit-dem-kreis-heinsberg-und-dem-institut-fuer-virologie-an-der-universitaetsklinik-bonn-ein-besseres- corona-research-project-initiated/
6) https://bmjopen.bmj.com/content/10/2/e034617
7) MVF 03/2020, “online first”: https://www.monitor-bedarfsforschung.de/Abstracts/Abstract2020/MVF-03-20/Schrappe-etal-Covid19-Thesenpapier
8) https://www.lmu-klinikum.de/aktuelles/pressemitigungen/munchner-tropeninstitut-beginnt-stichprobeanalyse-zur-verbreitung-der-corona-pandemie-und-zur-effektigkeit-von-gegenmassnahme/6afa2c06cb6745a9
9) https://www.sora.at/nc/news-presse/news/news-einzelansicht/news/covid-19-praevalenz-1006.html
10) https://www.sora.at/fileadmin/downloads/projekte/Austria_Spread_of_SARS-CoV-2_Study_Report.pdf
11) https://www.corona-immunitas.ch/programm
12) https://www.hug-ge.ch/medias/communique-presse/seroprevalence-covid-19-premiere-estimation
13) https://www.zhaw.ch/de/sml/institute-zentren/wig/projekte/covid-19-social-monitor/
14) https://www.wido.de/fileadmin/Files/Documents/News/wido_dat_correct_paper_covid-19_2020.pdf
15) https://www.dzif.de/de/dzif-und-universitaetsmedizin-koeln-erstellen-totalueberblick-ueber-studien-zu-sars-cov-2-und
16) https://www.netzwerk-versorgungsforschung.de/uploads/1.1.0.News/Pressemitteilungen%20DNVF/Stellungnahme%20DNVF%20COVID19_2000416_final.pdf
17) https://www.netzwerk-sorgesforschung.de/index.php?page=Infobox-Covid-19
18) https://www.soscisurvey.de/psychischegesundheitcovid19/
19) https://www.med.uni-muenchen.de
20) http://www.transcarecovid-19.com
21) https://www.uke.de/kliniken-institute/institute/institut-und-poliklinik-f%C3%BCr-medizinische-psychologie/forschung/index.html – angefragt bei Pawils
22) http://www.community-medicine.de
23) https://dgrh.de/Aktuelles/Deutsches-Register-covid19-rheuma.html
24) https://www.uniklinikum-dresden.de/de/das-klinikum/universitaetscentren/zegv/news/projektstart-dispense
25) https://www.fh-muenster.de/hochschule/aktuelles/pressemitteiligen.php?pmid=8229
26) https://www.dfg.de/foerderung/info_wissen/2020/info_wissen_20_20/index.html
27) https://www.ffg.at/ausscription/emergencycall-covid-19
28) https://www.fwf.ac.at/fileadmin/files/Documents/Antragstellung/Akutfoerderung_SARS-CoV-2/FWF-urgent-funding_Joint-Projects.pdf
29) https://grants.nih.gov/grants/guide/rfa-files/RFA-AI-20-028.html
30) https://wellcome.ac.uk/grant-funding/schemes/epidemic-preparedness-covid-19