"Everything gurgles!" : What the Viennese test strategy can achieve
Anyone who has passed by a gas station in Vienna on a Sunday lunchtime in recent months has observed something strange: People flock there in droves, by car, on foot, on bicycles. You ignore the gas pumps, enter the store directly, drop a small blue box into a large collection box and leave again.
The little blue box that is Vienna’s corona testing strategy. The strategy because of which all the discussions going on in Germany and elsewhere about the limited informative value of Corona rapid tests, the reports about queues in front of test centers and a lack of laboratory capacity for PCR tests, seem like a glimpse into a parallel world for people living in Vienna. Because of which a city of two million people alone sometimes carries out as many PCR tests per day as the whole of Germany put together, as many media have recently noted with excitement – an average of 188,000 per day in January, according to the laboratory responsible, and 356,000 on the strongest day so far at the end of the month. How good is this strategy really? Should Germany adopt it?
There is always a stack of little blue boxes on my desk, too. Two or three times a week, I open one of them and let a tiny plastic bottle of saline solution and a tube with a barcode tumble onto the table. I log on to a website, rinse my mouth with the saline solution, spit the solution into the tube, put the tube back in the box, walk to the nearest supermarket or gas station and throw the box into a drop-off box there.
At most 24 hours later, but usually after ten or twelve hours, I have the link to my PCR result on my cell phone. I don’t have to pay anything for it, the result, when I turn on my webcam while flushing, also counts as official test proof; I haven’t had a stick up my nose for months.
Why does Germany not use the strategy?
For many people in Vienna, it has long been a matter of course to throw in a PCR test before meeting friends, before family gatherings, before training at the sports club. 1.3 million Viennese – two-thirds of the population – use the "Alles gurgelt" project!" at least once a fortnight, says Mario Dujakovic, spokesman for Vienna’s city health department.
For them – for us – is "Everything gurgles!" enormously practical and convenient. Why hasn’t a program like this been in place in Germany for a long time, at least in the big cities? Are there plans there in this direction?
The Federal Ministry of Health and the Berlin Senate Department of Health left inquiries about this unanswered. The Munich health department says they are aware of the project, but are not planning anything similar "because the PCR capacities in Munich were still sufficient" and because "in our opinion, such projects should fit into the testing and reporting strategy as well as into the strategies for contact person management of the federal and state governments".
Hamburg’s social services department responds that because laboratory capacity has been exhausted, the main priority now, "in the short term," is to "focus available capacity on vulnerable groups of people and those in the area of critical (health) infrastructure". Therefore, "a detailed evaluation of further strategies of other cities cannot be made at present". "In the short term", "at present" – this reads as if the city of Hamburg had been asleep for the last year. Because the project "Everything gurgles!"The pandemic vaccine has been running since March 2021, and the laboratory capacity for it first had to be built up in Vienna.
It’s not quite that simple
The laboratory company Lifebrain first rented one and then several additional buildings, set up dozens of pipetting robots and PCR analyzers, and hired hundreds of employees. It evaluates the samples in a pooled way, always ten at a time, and only in the case of positive pools is each sample examined again individually. For "Everything gurgles!", the city is also cooperating with Lead Horizon, which is providing test kits and IT infrastructure, with the Rewe Group, whose stores serve as drop-off points, and with the postal service, which is bringing the samples to the lab.
A city of milk and honey, Vienna, a snoring Germany? With this tenor, German media recently reported on "Everything gurgles!" reports.
But it’s not quite that simple again. If you ask Austrian experts whether the benefit for society as a whole justifies the financial expense, a more differentiated picture emerges. "The cost-benefit analysis is very difficult," says Peter Klimek, for example, a complexity researcher at the Medical University of Vienna and a member of the Austrian Covid prognosis consortium.
The problem starts with the interpretation of the infection figures. In the fourth wave in the fall, Vienna consistently had the lowest incidence among all Austrian states. At present, however, more cases are registered here per day than in almost all other German states, and more than in Berlin or Hamburg, for example. But the bare figures give a false picture: the number of unreported cases in Vienna, and thus in Austria as a whole, is probably much lower than elsewhere. The idea behind extensive testing is to find many infected people who either don’t have any symptoms yet – or who remain asymptomatic and would therefore remain under the radar without a screening strategy.
No miracle cure for the pandemic
Niki Popper, a simulation researcher at the Centre for Computational Complex Systems at the Vienna University of Technology and a member of the Austrian Covid crisis coordination team, believes it is plausible that the real incidence in Austria could even be lower than in Germany. A comparative value to calculate – for example, about the positivity rate, which is currently 32 percent in Germany, in Vienna only 2.5 percent – can not, however, be.
However, it is possible to calculate how much a well-functioning PCR screening program can reduce the effective reproduction rate: by about 15 percent. "This is not a magic pill, I’m not going to end the epidemic with this," says Popper. However, this is true for practically all measures. 15 percent, which is about the same as the benefit of banning large-scale events.