1, 2, 3-G
The Rector’s Column | September 2021
In today’s Rector’s Column, I would like to touch on current events: in the past few days, there has been a lot of talk around the measures needed to restore a sense of normality to University life, complete with its personal interactions and discursive exchanges. Different scenarios were discussed and quoted in the media; including, correctly, me stating that “my personal favourite is the [so-called] 1G rule.” This means that only people who have received the vaccination against Covid are permitted to take part in University life in person. But more on this, as well as on our regulations at the PLUS, later on.
There are two important goals for teaching in this difficult situation: having as many classes held in attendance as possible and ensuring protection for our staff and students from new infections. The nationwide debate at Universities shows that the spectrum of opinions is a very broad one: Medical Universities plan to implement 1G (vaccinated), 2G (vaccinated or recovered), or 3G (vaccinated, recovered, or tested) rules. Other Universities have expressed their support for the 1G rule. It is rightly argued that Universities will not be able to avoid introducing at least a 2G rule when there are already talks of adopting it in the catering industry and a 2G option model is already being used in Germany for a wide variety of events (Hamburg). There are at least three good arguments in favour of these models: with a vaccination rate in Austria and Germany of around 60 percent, this group can hardly be expected to have their basic rights restricted; secondly, 2G is safer than 3G, because unvaccinated people can then of course no longer get infected as easily; and finally, another lockdown can be avoided. In addition, something very important: an antigen test, with which the status of the third G is checked, is highly inaccurate (and only valid for a maximum of 12-24 hours), especially if it is performed as a self-test, and thus can hardly be used as a criterion. Only the PCR test offers the certainty needed.
In short, there is a lot to be said for a stricter rule, especially given our duty of care for all students and employees. With this in mind, I (and not only I) have argued for a 1G rule. Particularly as a medical expert, I have always emphasised the following in all interviews: the convalescent status (and, by the way, all due respect is to be shown for all those who have had severe Covid symptoms) provides at least the same protection as a vaccination for a certain period of time – hence the definition of 2G. But there is one point that is not taken into account enough in the discussions about the G rules: everyone who has recovered needs a vaccination at a later stage – otherwise they lose immunity protection and increase the risk of transmission. This is the ultimate (and from my point of view correct) motive for talking about 1G – including the recovered.
Before I get to some medical statements that are important in this context, let me briefly explain why we do not use 1 to 2G across the whole University, but rather all G rules in a very differentiated way: we are obliged (even if a 1G rule would be constitutional; see the comment by Prof. Stöger from Vienna in the SN from 27 August) to enable all students, whether they are vaccinated or not, to obtain the best education possible. The response to this dialectic in anticipation is this: to do everything to ensure that all University members are vaccinated as soon as possible.
Some key medical points:
No ifs, ands or buts: we are at the beginning of a 4th wave, which, according to the current data of the Robert Koch Institute (RKI), affects mainly young adults and especially the unvaccinated. The incidence figures in Austria are currently around 125 new infections per day ( https://coronavirus.datenfakten.at/). This is mainly due to the so-called delta variant of the virus, which is significantly more infectious than the other variants and has a very high R-value of 10-12 (this means that one person infected with the virus infects about 10-12 other people who have not yet been infected; figures from the cdc, see link below).
The number of patients admitted to hospital is also on the rise; in most parts of Austria and Germany, there are about 10 times as many unvaccinated patients as vaccinated patients who have to be treated in hospital. According to the current weekly report of the RKI, only about 5 percent of the patients who required intensive medical treatment were vaccinated. Even though vaccinated people can get infected again and show symptoms (“vaccine breakthroughs”) – they are much less likely to be admitted to hospital, whilst older people vaccinated more than 6 months ago are currently most affected.
And this brings us to the big issue that concerns us all equally: how safe and, above all, how effective is the vaccine. You all know the data, which are highly reliable from a scientific point of view; the efficacy (protection against infection) of the so-called mRNA vaccines (Biontech/Pfizer, Moderna) is close to 95 per cent, that of the vector-based vaccines (Astra-Zeneca, Johnson&Johnson) is close to 75 per cent with a further increase through a heterologous second vaccination (mRNA subsequent to vector). Even if these figures vary, all active substances protect about 85 percent against severe disease progression, admission to intensive care and death. Of course, the question about side effects is very legitimate; mild side effects such as pain at the injection site, flu-like symptoms, tiredness or headaches are experienced by two-thirds of all vaccinated people and therefore most of you have also noticed them. Serious side effects such as embolisms (blood clots) in young women or myocarditis (inflammation of the heart muscle) in young men are extremely rare and out of proportion to the benefit of the vaccination.
Unfortunately, the duration of vaccine protection is not unlimited; current data show that, especially in the over-60s group (the group in which there is immune senescence, an ageing and deterioration in the immune system’s function), protection decreases after six months. Therefore, it is now also increasingly recommended that a renewed vaccination (“booster vaccination”) be carried out at least in the group of the elderly and those with other serious diseases. Our immune system also changes its response to vaccination: the so-called IgA-type antibodies formed in the short term change to the long-term IgG-type antibodies. Since the antibody measurement that is often propagated to determine the protection against infection is also inaccurate (only the responses of the so-called B cells are recorded here, not the equally important responses of the T cells), we should think about safe and effective booster vaccination at an early stage. When exactly this should take place will certainly be determined for the different age groups in the near future. One more important note: fully immunised persons (i.e. vaccinated twice) will from now on automatically be listed as K2 (category 2 contact persons) in the county of Salzburg in the event of contact – they may therefore move around just as freely as before, but should wear an FFP-2 mask outside their home environment.
For those who have recovered from the virus, there are clear guidelines as to when vaccination and thus full immunisation should be carried out; you can read in more detail about this on the Federal Centre for Health Education website (see link below). I think it is very important to emphasise this again, because in the current 1, 2 or 3G rules this recommendation is easily overseen.
There are very few medical reasons that make vaccination impossible. These are rare allergic reactions to ingredients of the vaccine or even rarer pre-existing conditions such as blood clotting or vascular disorders. Even though it is very important to record these so-called contraindications – they affect only a miniscule percentage of everyone getting the vaccine. We at the PLUS will also offer you more detailed information on this – via the prevention team, the occupational health service or, if in complex cases, via me.
Our regulations at the PLUS
We have deliberated long and hard about which measures we can use to re-establish on-site teaching and research at the PLUS; the vice rectorate of education just sent out a detailed email on this subject. As we want to achieve an optimal balance between enabling attendance and our duty of care (and the associated need for supervision), we have decided on a 3G rule with additional safety measures and a 1(to 2)G rule for selected courses where mouth and nose coverings do not provide sufficient protection. Last but not least, since wearing a mask is particularly protective against the fast and easily transmitted delta variant, we have decided on further safety measures, namely a mouth-nose covering in all common areas or spacing in all rooms with fixed seating.
A vaccination appeal
You have probably already guessed it: this Rector’s Column was ultimately written to strongly recommend vaccination to all those who have not yet been vaccinated, as this offers the best protection for yourself and everyone else around you. Every employee, every student who does not choose to be vaccinated is putting everyone around them at risk. Not only is the acute illness prevented, but also its after-effects (Long-Covid Syndrome), which – as a recent article in “The Lancet” reveals – affects half of those who fall ill and leads to significant long-term health issues. Perhaps testing is a secondary argument: but with vaccination you also save yourself the otherwise regularly required test certificates and make teaching much easier.
The scope for those who have decided not to be vaccinated is certainly diminishing; even if it is a free and autonomous decision not to be vaccinated: they are endangering others – those who cannot be vaccinated (even if they are few), children under 12, but also those who are already vaccinated. I also understand that those who are not vaccinated find it a significant intrusion on their personal rights if they are not allowed to attend events or the like. However, considering the responsibility that we all (should) feel, the facilitation of social life for those who are vaccinated should be valued at least as highly.
If you have not yet been vaccinated, take the opportunity now, as it takes several weeks for the vaccine to take effect. We, as the rectorate, will continue to rely on education and appeals; at least not on original incentives as already used elsewhere. In the USA, for example, those who are hesitating in getting vaccinated are being offered lottery tickets, and in Russia they are handing out shopping vouchers; we will not be able to afford a vaccination voucher, nor will we – as in Indonesia – impose prison sentences on those who refuse to get vaccinated.
Instead: there will be low-threshold vaccination offers, vaccination buses will be at the University at the end of September and beginning of October and we will strive to be available for anyone who is still hesitant, offering up our time for more detailed explanations.
But we have also learned much more from the Covid pandemic and I would like to conclude by sharing a few additional thoughts with you. And here, above all, the thought that the prevention of so-called lifestyle diseases would contribute significantly to reducing the catastrophic effects of Covid on morbidity and mortality. Obesity has been identified as the strongest risk factor for severe Covid disease, according to the World Health Organisation (WHO), and the problems often associated with it, such as diabetes or high blood pressure, also contribute significantly to the risk and also worsen as the disease progress. We have just reported on this interaction with a larger research group in an article that will appear in the journal “Lancet Endocrinology & Diabetes”. It is a vicious circle – as, according to a survey by the Else Kröner Centre for Nutritional Medicine, 40 percent of the respondents stated that they had gained a lot of weight over lockdown. The average weight gained was 5.6 kilograms. Of course, the negative psychosocial consequences of the lockdown are at least as significant. Perhaps it is a good lesson from the pandemic that we take care of ourselves and develop an even greater awareness of mental and physical health.
Dear staff and students, I have now taken up several minutes of your time. But I hope that these lines have conveyed that there are only two things we would like to see at the university: A return to a new, old normal, and this under conditions that alleviate our concerns about an increased risk of infection. We can only do this together by taking care of ourselves and others, by adhering to the rules formulated by our prevention team and, above all, by getting vaccinated, even again where necessary, and by talking with those who are still hesitant.
The rectorate and I personally will be happy to talk to you at any time and advise you on complex problems if necessary.
Many thanks, best regards and wishes
Rector Hendrik Lehnert
Coronavirus (ages.at) (page in German)
BZgA: Webpage (page in German)