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Vital Protective Mechanism Discovered: Dying Cells Protect Their Neighbors To Maintain Tissue Integrity

Artistic rendering of dying cells protecting their neighbors to maintain tissue integrity. Holes in epithelium created by uncoordinated cell death are shown in purple. Credit: © Institut Pasteur / Léo Valon et Romain Levayer

Cells undergoing cell death protect their neighbors to maintain tissue integrity.

To enable tissue renewal, human tissues constantly eliminate millions of cells, without jeopardizing tissue integrity, form, and connectivity. The mechanisms involved in maintaining this integrity remain unknown. Scientists from the Institut Pasteur and the CNRS recently revealed a new process that allows eliminated cells to temporarily protect their neighbors from cell death, thereby maintaining tissue integrity. This protective mechanism is vital, and if disrupted can lead to a temporary loss of connectivity. The scientists observed that when the mechanism is deactivated, the simultaneous elimination of several neighboring cells compromises tissue integrity. This lack of integrity could be responsible for chronic inflammation. The results of the research were published in the journal Developmental Cell on June 2, 2021.

Human epithelia are tissues found in several parts of the body (such as the epidermis and internal mucosa). They are composed of layers of contiguous cells that serve as a physical and chemical barrier. This role is constantly being put to the test by both the outside environment and their own renewal. Tissue renewal involves the formation of new cells by cell division and the elimination of dead cells. The mechanisms that regulate the ability of epithelia to maintain their integrity in contexts involving large numbers of eliminated cells remain poorly understood, despite the fact that this situation occurs regularly during embryogenesis or the maintenance of adult tissues. For example, more than ten billion cells can be eliminated every day in an adult intestine. How are these eliminations orchestrated to maintain tissue integrity and connectivity?

Scientists from the Institut Pasteur and the CNRS set out to identify the mechanisms involved in epithelial integrity and the conditions that can affect epithelial connectivity by using Drosophila (or vinegar flies), an organism studied in the laboratory with a similar epithelial architecture to humans.

Using protein-sensitive fluorescent markers, the research team revealed that when a cell dies, the EGFR-ERK pathway – a cell activation signaling pathway known for its involvement in the regulation of cell survival – is temporarily activated in the neighboring cells. The scientists observed that the activation of the EGFR-ERK pathway protected neighboring cells from cell death for approximately one hour, thereby preventing the simultaneous elimination of a group of cells. “We already knew that this pathway plays a key role in regulating cell survival in epithelial tissue, but we were surprised to observe such protective dynamics between cells,” comments Romain Levayer, Head of the Cell Death and Epithelial Homeostasis Unit at the Institut Pasteur and last author of the study.

Drosophila Pupa Epithelium

A Drosophila pupa epithelium showing cell contours (gray) and the reporter of the EGFR-ERK pathway (yellow/purple gradient). Credit: © Institut Pasteur / Romain Levayer et Léo Valon

The scientists’ research also shows that inhibiting this protective mechanism has a drastic effect on epithelial tissue: cell elimination becomes random and neighboring cells can be eliminated simultaneously, leading to repeated losses of connectivity. The elimination of groups of neighboring cells is never observed in epithelial tissue in normal conditions, when the EGFR-ERK pathway is not deliberately inhibited, even if a large number of cells are eliminated.

By using a new optogenetic tool that can control cell death in time and space and bypass the protective mechanism, the scientists confirmed that epithelial integrity was compromised when neighboring cells were eliminated simultaneously. “Surprisingly, epithelial tissue is highly sensitive to the spatial distribution of eliminated cells. Although it can withstand the elimination of a large number of cells, epithelial integrity is affected if just three neighboring cells are eliminated simultaneously,” explains Léo Valon, a scientist in the Cell Death and Epithelial Homeostasis Unit at the Institut Pasteur and first author of the study.

The scientists’ observations confirm that tissues need to develop mechanisms preventing the elimination of neighboring groups of cells. “These observations are important as they illustrate the incredible self-organizing ability of biological tissues, a property that enables them to withstand stressful conditions. So there is no need for a conductor to orchestrate where and when the cells should die; everything is based on highly local communications between neighboring cells,” adds Romain Levayer.

This process seems to have been conserved during evolution. The same protective mechanism based on local EGFR-ERK activation was discovered independently in human cell lines by the research group led by Olivier Pertz at the University of Bern in Switzerland (the results are published in the same journal2). The results of the other study suggest that the protective mechanism is conserved between species separated by hundreds of millions of years, indicating that it is a relatively universal mechanism.

Future research will reveal whether disruption to this cell death coordination mechanism and repeated loss of connectivity in epithelial tissue could be one of the roots of chronic inflammation, a phenomenon responsible for various diseases that are currently among the leading causes of death worldwide.

Distribution of cell deaths in a Drosophila epithelium:

[embedded content]

Development of the Drosophila pupa epithelium showing the location of all cell deaths (colored dots). The cell contours are shown in gray. Credit: © Institut Pasteur / Léo Valon et Romain Levayer

Activation of the EGFR-ERK pathway in neighboring cells:

[embedded content]

Activation of the EGFR-ERK pathway in the neighbors of a cell extruded from the tissue. The reporter on the left is excluded from the nucleus when the pathway is activated (the eliminated cell is circled in green). Activation can also be viewed by other pathway sensors (the FRET sensor – red for strong activation. Credit: © Institut Pasteur / Romain Levayer et Léo Valon


  1. “Robustness of epithelial sealing is an emerging property of local ERK feedback driven by cell elimination” by Léo Valon, Anđela Davidović, Florence Levillayer, Alexis Villars, Mathilde Chouly, Fabiana Cerqueira-Campos and Romain Levayer, 2 June 2021, Developmental Cell.
    DOI: 10.1016/j.devcel.2021.05.006
  2. “Collective ERK/Akt activity waves orchestrate epithelial homeostasis by driving apoptosis-induced survival” by Paolo Armando Gagliardi, Maciej Dobrzyński, Marc-Antoine Jacques, Coralie Dessauges, Pascal Ender, Yannick Blum, Robert M. Hughes, Andrew R. Cohen and Olivier Pertz, 2 June 2021, Developmental Cell.
    DOI: 10.1016/j.devcel.2021.05.007

This research project was supported by the European Research Council (ERC), a Marie Skłodowska-Curie post-doctoral fellowship, the Fondation pour la Recherche Médicale (FRM) et the Cercle Fondation Schlumberger pour l’Education et la Recherche (FSER), R.Levayer 2019 laureate.

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This post originally posted here The European Times News

Spain to maintain coronavirus restrictions into holiday season – 'Covid has not gone away'

Spain to maintain coronavirus restrictions into holiday season - 'Covid has not gone away'
Spain‘s minister for tourism has said the nation is pushing to welcome back tourists in June. However, officials have said key coronavirus restrictions will remain in place, with many impacting tourists.
Though the nation is set to lift its State of Emergency on May 9, Spain’s holiday hotspots are likely to continue coronavirus safety regulations.

The Balearics, Canary Islands and the Costa del Sol have all indicated that restrictions, including strict checks at airports, mask-wearing, curfews and even partial closure of the hotel industry, might continue after this Sunday.

The Balearic government has also gone to court to ask for special permission as leaders say they would need the backing of the law which the State of Emergency currently gives but which would disappear from May 9.

The Balearics, which include Majorca, Menorca and Ibiza, want the power to continue to impose and even strengthen if necessary coronavirus restrictions to avoid new outbreaks.

READ MORE: ‘Good god why do that!’ Britons hesitant to travel in blow to tourism

The islands’ government says it might want to increase its curfew orders, currently from 11pm to 6pm, and is asking for special permission to be allowed to impose the hours of 10pm to 7am if necessary.

The courts are also being asked to approve the need for all travellers into the Balearics to prove a negative PCR coronavirus test and to be able to close borders if needed.

The Balearics want to continue to limit social groups to six if necessary and capacity restrictions at places of worship.

And Balearic president, Francina Armengol is asking for legal permission for the partial closure of the hotel industry should coronavirus cases soar again.

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The government of the Canary Islands has further indicated that some restrictions will remain once Spain lifts the State of Emergency. This will include checks at airports and ports.

The Andalusian government, which covers the Costa del Sol, intends to announce details of measures that will be continued after May 9 and is seeking the backing of the courts.

The region wants the power to maintain perimeter closures in municipalities with incidence rates above 500 cases per 100,000 inhabitants.

President, Juanma Moreno said there are still localities above 500 and 1,000 cases of coronavirus and “we must prevent them from increasing infections in the neighbouring municipalities.

“Therefore, once the state of alarm subsides on May 9, Andalusia will request judicial endorsement to maintain the perimeter closures when necessary, something that we will do in a timely manner, safeguarding the powers of the community.”

He added: “If there is an outbreak, I will use all the instruments at our disposal and I will not hesitate to take measures no matter how harsh they may be to preserve people’s health.”

However, he has ruled out reimposing any curfews and will phase in increased hours for pubs and restaurants as more people get vaccinated.

“Covid has not gone away and people continue to die every day in Spain and Andalusia, they continue to be infected and suffer,” he said today.

“Therefore, despite starting to see the light at the end of the tunnel, we must vaccinate and meet the vaccination objectives. ”

UK citizens are currently waiting to find out when they will be able to visit the nation on holiday.

Though international travel is due to resume from May 17, this will depend on the UK Government’s “green list”.

Furthermore, Fernando Valdes Verelst, Spain’s tourism minister, has said Spain is not set to welcome back tourists until June when a COVID-19 travel certificate has been established by the EU.

“June will be the start of the recovery of tourism in Spain,” he said.

“By then, we will have a digital vaccination certificate in place and we will be able to reopen our borders.”

Additional reporting by Rita Sobot.

This post originally appeared on Daily Express :: Travel Feed

Emerging COVID-19 success story: Germany’s push to maintain progress

Emerging COVID-19 success story: Germany’s push to maintain progress
  • Institutional affiliations:
    (i) Robert Koch Institute
    (ii) Health Protection Authority, City of Frankfurt, Frankfurt am Main
  • World Bank. GDP (current US$ ) – Germany [data set]. World Bank Data. Washington, DC: World Bank. https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=DE&view=chart.[1] Accessed June 1, 2020.

    Tikkanen R, Osborn R, Mossialos E, Djordjevic A, Wharton GA. International Health Care System Profiles – Germany. The Commonwealth Fund. June 5, 2020. https://international.commonwealthfund.org/countries/germany/.[2] Accessed June 6, 2020.

  • World Bank. Hospital beds (per 1,000 people) – Germany [data set]. World Bank Data. Washington, DC: World Bank. https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?locations=DE&most_recent_value_desc=true.[3] Accessed June 5, 2020.
  • Germany excels among its European peers. The Economist. April 25, 2020. https://www.economist.com/europe/2020/04/25/germany-excels-among-its-european-peers.[4] Accessed June 1, 2020.
  • World Bank. Physicians (per 1,000 people) – Germany [data set]. World Bank Data. Washington, DC: World Bank. https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=DE&most_recent_value_desc=true.[5] Accessed June 1, 2020.
  • Björnberg A. Euro Health Consumer Index 2018. Marseillan, France: Health Consumer Powerhouse; 2018. https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf.[6] Accessed June 1, 2020.
  • The Commonwealth Fund. 2010 Commonwealth Fund International Health Policy Survey. New York: The Commonwealth Fund; 2010. https://www.commonwealthfund.org/publications/surveys/2010/nov/2010-commonwealth-fund-international-health-policy-survey[7]. Accessed March 4, 2021.
  • World Bank. Life expectancy at birth, total (years) – Germany [data set]. World Bank Data. Washington, DC: World Bank. https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=DE&name_desc=true.[8] Accessed June 2, 2020.
  • United Nations Maternal Mortality Estimation Inter-Agency Group. Maternal Mortality in 2000-2017: Internationally Comparable MMR Estimates—Germany. Geneva: World Health Organization; 2019. https://www.who.int/gho/maternal_health/countries/deu.pdf?ua=1.[9] Accessed June 1, 2020.
  • Empfehlungen des Robert Koch-Instituts zur Meldung von Verdachtsfällen von COVID-19 [Recommendations from the Robert Koch Institute for reporting suspected cases of COVID-19]. Robert Koch Institute website. Last updated May 29, 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Empfehlung_Meldung.html.[10] Accessed June 5, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[11] Accessed June 5, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[12] Accessed June 5, 2020.
  • Coronavirus disease 2019 (COVID-19) daily situation report of the Robert Koch Institute. April 3, 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-03-04-en.pdf?__blob=publicationFile.[13] Accessed June 2, 2020.
  • Hollingsworth J, Marsh J, Picheta R, Alfonso III F, Vera A. March 22 coronavirus news. CNN. March 3, 2020. https://edition.cnn.com/world/live-news/coronavirus-outbreak-03-22-20/h_0ff44fe3fd52f6ea7471206d0b7ff501[14]. Accessed June 5, 2020.
  • Flare-up in virus cases sets back Germany’s efforts to reopen. New York Times. June 25, 2020. Updated July 16, 2020. https://www.nytimes.com/2020/06/25/world/europe/germany-coronavirus-reopening.html[15]. Accessed November 23, 2020.

    Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Updated daily. https://ourworldindata.org/coronavirus/country/germany?country=~DEU[16].

  • Flare-up in virus cases sets back Germany’s efforts to reopen. New York Times. June 25, 2020. Updated July 16, 2020. https://www.nytimes.com/2020/06/25/world/europe/germany-coronavirus-reopening.html[17]. Accessed November 23, 2020.
  • France, Germany see surge in coronavirus cases as holidaymakers return home. France 24. August 20, 2020. https://www.france24.com/en/20200820-france-and-germany-see-surge-in-infections-as-holidaymakers-return-home[18]. Accessed November 23, 2020.
  • Situation report – 15 November 2020. Robert Koch Institute website. Last updated November 15, 2020. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html[19]. Accessed November 22, 2020.
  • Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Updated daily. https://ourworldindata.org/coronavirus/country/germany?country=~DEU[20].
  • Robert Koch Institute. Ergänzung zum Nationalen Pandemieplan – COVID-19 – neuartige Coronaviruserkrankung [Supplement to the National Pandemic Plan – COVID-19 – Novel Coronavirus Disease]. Berlin: Robert Koch Institute; 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Ergaenzung_Pandemieplan_Covid.html.[21] Accessed June 8, 2020.
  • Eckner C. How Germany has managed to perform so many Covid-19 tests. The Spectator. April 6, 2020. https://www.spectator.co.uk/article/how-germany-has-managed-to-perform-so-many-covid-19-tests.[22] Accessed June 1, 2020.
  • What we do – Departments and units at the Robert Koch Institute. Robert Koch Institute website. https://www.rki.de/EN/Content/Institute/DepartmentsUnits/DepartmentsUnits_node.html.[23] Accessed June 5, 2020.
  • Researchers develop first diagnostic test for novel coronavirus in China. [Press release]. Charite. January 16, 2020. https://www.charite.de/en/service/press_reports/artikel/detail/researchers_develop_first_diagnostic_test_for_novel_coronavirus_in_china/.[24] Accessed June 1, 2020.
  • Information on testing. Zusammen gegen Corona website. https://www.zusammengegencorona.de/en/inform/information-on-testing/.[25] Accessed June 5, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[26] Accessed June 5, 2020.
  • Germany’s “bottom-up” testing keeps coronavirus at bay. Financial Times. November 23, 2020. https://www.ft.com/content/0a7bc361-6fcc-406d-89a0-96c684912e46[27]. Accessed November 23, 2020.
  • Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Updated daily. https://ourworldindata.org/coronavirus/country/germany?country=~DEU[28].
  • Carrel P, Poltz J. It was the saltshaker: how Germany meticulously traced its coronavirus outbreak. The World Economic Forum COVID Action Platform. April 12, 2020. https://www.weforum.org/agenda/2020/04/it-was-the-saltshaker-how-germany-meticulously-traced-its-coronavirus-outbreak.[29] Accessed June 1, 2020.
  • Böhmer MM, Buchholz U, Corman VM, et al. Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series. Lancet Infectious Disease. 2020;S1473-3099(20)30314-5. http://doi.org/10.1016/S1473-3099(20)30314-5.[30] Accessed June 5, 2020.
  • Böhmer MM, Buchholz U, Corman VM, et al. Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series. Lancet Infectious Disease. 2020;S1473-3099(20)30314-5. http://doi.org/10.1016/S1473-3099(20)30314-5.[31] Accessed June 5, 2020.
  • Einblicke in die Analysen der Corona-Datenspende [Insights into the analysis of corona data donation]. Corona-Datenspende website. https://corona-datenspende.de/.[32] Accessed June 5, 2020.
  • Busvine D, Rinke A. Germany flips to Apple-Google approach on smartphone contact tracing. Reuters. April 26, 2020. https://www.reuters.com/article/us-health-coronavirus-europe-tech/germany-flips-on-smartphone-contact-tracing-backs-apple-and-google-idUSKCN22807J.[33] Accessed June 1, 2020.
  • Robert Koch Institute. Coronavirus SARS-CoV-2 Handreichung für niedergelassene Ärztinnen und Ärzte [Coronavirus SARS-CoV-2 handout for general practitioners]. Last updated June 24, 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/WarnApp/Handreichung-Arzt.html[34]. Accessed November 23, 2020.
  • So funktioniert die #CoronaWarnApp [This is how the #CoronaWarnApp works]. YouTube. German Federal Ministry of Health. https://www.youtube.com/watch?v=shoM2G-yecA&feature=emb_logo[35]. Accessed November 23, 2020.
  • 100 days of the Corona-Warn-App. German Federal Government. https://www.bundesregierung.de/breg-de/themen/coronavirus/corona-warn-app-1790632[36]. Accessed November 23, 2020.
  • Rosenbach M, Schmergal C. Germans disappointed by coronavirus tracking app: lots of work but little utility. Der Spiegel. September 24, 2020. https://www.spiegel.de/international/germany/lots-of-work-but-little-utility-germans-disappointed-by-coronavirus-tracking-app-a-7c30191e-b225-4c37-917d-41dc2a6078a1[37]. Accessed November 23, 2020.
  • Beaumont P, Connolly K. Covid-19 track and trace: what can UK learn from countries that got it right? The Guardian. May 21, 2020. https://www.theguardian.com/world/2020/may/21/covid-19-track-and-trace-what-can-uk-learn-from-countries-got-it-right.[38] Accessed June 1, 2020.
  • McKeever V. Why Germany’s coronavirus strategy doesn’t appear to be working. CNBC. https://www.cnbc.com/2020/11/06/why-germanys-coronavirus-strategy-doesnt-appear-to-be-working.html[39]. Accessed November 23, 2020.
  • Regalado A. Blood tests show 14% of people are now immune to covid-19 in one town in Germany. MIT Technology Review. April 9, 2020. https://www.technologyreview.com/2020/04/09/999015/blood-tests-show-15-of-people-are-now-immune-to-covid-19-in-one-town-in-germany/.[40] Accessed June 2, 2020.
  • Wie viele Menschen sind immun gegen das neue Coronavirus? Robert Koch-Institut startet bundesweite Antikörper-Studien. [How many people are immune to the new coronavirus? Robert Koch Institute starts nationwide antibody studies]. Press release. April 9, 2020. Robert Koch Institute website. https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2020/05_2020.html.[41] Accessed June 5, 2020.
  • Robert Koch Institute. Serologische Untersuchungen von Blutspenden auf Antikörper gegen SARS-CoV-2 (SeBluCo-Studie) [Serological testing of blood donations to identify antibodies against SARS-CoV-2 (SeBluCo study)]. Last updated November 26, 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Projekte_RKI/SeBluCo_Zwischenbericht.html[42]. Accessed February 10, 2021.
  • Robert Koch Institute. Studie corona-monitoring lokal [Local coronavirus monitoring study]. https://www.rki.de/DE/Content/Gesundheitsmonitoring/Studien/cml-studie/cml-studie_node.html[43]. Accessed February 10, 2021.
  • Seroepidemiological studies in the general population. Robert Koch Institute website. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/AK-Studien-english/Sero_General.html[44]. Accessed February 12, 2021.
  • France and Germany announce new restrictions as cases surge in Europe. New York Times. Last updated October 29, 2020. https://www.nytimes.com/live/2020/10/28/world/covid-19-coronavirus-updates[45]. Accessed November 23, 2020.
  • McKeever V. Why Germany’s coronavirus strategy doesn’t appear to be working. CNBC. https://www.cnbc.com/2020/11/06/why-germanys-coronavirus-strategy-doesnt-appear-to-be-working.html[46]. Accessed November 23, 2020.
  • Bund und Länder: Kontakte auf ein Minimum beschränken [Federal and state governments: Keep contacts to a minimum]. German Federal Government. November 16, 2020. https://www.bundesregierung.de/breg-de/aktuelles/bund-laender-beschluss-1811744[47]. Accessed November 23, 2020.
  • Covid-19: Germany introduces new restrictions amid rise in cases. BBC News. December 16, 2020. https://www.bbc.com/news/world-europe-55324422[48]. Accessed January 19, 2021.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[49] Accessed June 5, 2020.
  • Aktuelle Informationen für Reisende [Current information for travelers]. German Ministry of Health. https://www.bundesgesundheitsministerium.de/coronavirus-infos-reisende.html[50]. Accessed November 23, 2020.
  • Loxton R. Travel: what to know about Germany’s new two test strategy for arrivals from foreign “risk zones.” The Local. January 7, 2021. Updated January 11, 2021. https://www.thelocal.de/20210107/explained-germanys-new-two-test-strategy-for-travellers-from-foreign-risk-zones[51]. Accessed February 10, 2021.
  • Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Updated daily. https://ourworldindata.org/coronavirus/country/germany?country=~DEU[52].
  • Doty P, Blanco M. Long-Term Care and the Impact of Covid-19: A First Look at Comparative Cross-National Statistics. Research Brief. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services; 2020. https://aspe.hhs.gov/basic-report/long-term-care-and-impact-covid-19-first-look-comparative-cross-national-statistics[53]. Accessed February 12, 2021.
  • Situation report – 15 December 2020. Robert Koch Institute website. Last updated December 15, 2020. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html[54]. Accessed February 22, 202.
  • COVID-19 (Coronavirus SARS-CoV-2). Robert Koch Institute website. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/nCoV.html.[55] Accessed June 5, 2020.
  • COVID-19: Kriterien zur Entlassung aus dem Krankenhaus bzw. aus der häuslichen Isolierung [COVID-19: Criteria for discharge from hospital or from home isolation]. Robert Koch Institute website. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Entlassmanagement.html[56]. Accessed June 5, 2020.
  • Robert Koch Institute. Prävention und Management von COVID-19 in Altenund Pflegeeinrichtungen und Einrichtungen für Menschen mit Beeinträchtigungen und Behinderungen [Prevention and management of COVID-19 in elder care facilities and facilities for people with impairments and disabilities]. Berlin: Robert Koch Institute; 2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Alten_Pflegeeinrichtung_Empfehlung.pdf[57]. Accessed June 5, 2020.
  • Situation report – 16 November 2020. Robert Koch Institute website. Last updated November 16, 2020. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html[58]. Accessed November 22, 2020.
  • Situation report – 17 November 2020. Robert Koch Institute website. Last updated November 17, 2020. https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html[59]. Accessed November 22, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[60] Accessed June 5, 2020.
  • Ellyatt H. Germany’s vaccine rollout: challenges and problems in vaccine strategy. CNBC. January 20, 2021. https://www.cnbc.com/2021/01/19/germanys-vaccine-rollout-challenges-and-problems-in-vaccine-strategy.html[61]. Accessed February 10, 2021.

    Von Der Burchard H. Germans vexed as coronavirus vaccine rollout lags. Politico. January 12, 2021. https://www.politico.eu/article/coronavirus-story-kiel/[62]. Accessed February 12, 2021.

  • Morris L, Weber-Steinhaus F. Schools have seen no coronavirus outbreaks since reopening a month ago in Germany. Washington Post. September 11, 2020. https://www.washingtonpost.com/world/europe/covid-schools-germany/2020/09/10/309648a4-eedf-11ea-bd08-1b10132b458f_story.html[63]. Accessed November 23, 2020.
  • Coronavirus: Germany improves ventilation to chase away Covid. BBC News. October 19, 2020. https://www.bbc.com/news/world-europe-54599593[64]. Accessed November 23, 2020.
  • Nierenberg A, Pasick A. Schools will close in Germany as cases surge. New York Times. December 14, 2020. https://www.nytimes.com/2020/12/14/us/german-school-close-coronavirus-lockdown.html[65]. Accessed February 10, 2021.
  • Marcus I. Germany: Merkel and federal states to prolong lockdown. Berlin Spectator. February 10, 2021. https://berlinspectator.com/2021/02/10/germany-merkel-and-federal-states-to-prolong-lockdown/[66]. Accessed February 10, 2021.
  • DIVI-Intensivregister website. https://www.intensivregister.de[67]. Accessed June 5, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[68] Accessed June 5, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[69] Accessed June 5, 2020.
  • Connolly K. German doctors pose naked in protest at PPE shortages. The Guardian. April 27, 2020. https://www.theguardian.com/world/2020/apr/27/german-doctors-pose-naked-in-protest-at-ppe-shortages.[70] Accessed June 2, 2020.
  • Martin N. Coronavirus: German ICUs see 40% more patients than in April. Deutsche Welle. December 6, 2020. https://www.dw.com/en/coronavirus-german-icus-see-40-more-patients-than-in-april/a-55836491[71]. Accessed February 3, 2021.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[72] Accessed June 5, 2020.
  • Netherlands airlifts coronavirus patients to Germany. Los Angeles Times. October 23, 2020. https://www.latimes.com/world-nation/story/2020-10-23/dutch-hospital-airlifts-patients-to-germany-amid-virus-surge[73]. Accessed November 24, 2020.
  • Bartsch M, Dahlkamp J, Thimm K, Weber N, Weinzierl A, Winter S. German ICUs are struggling to keep up with corona. Der Spiegel. November 12, 2020. https://www.spiegel.de/international/germany/the-second-wave-hits-the-hospitals-german-icus-are-struggling-to-keep-up-with-corona-a-c096f95a-781c-4703-889b-08b523341551[74]. Accessed November 23, 2020.
  • Coronavirus SARS-CoV-2: Chronik der bisherigen Maßnahmen [Coronavirus SARS-CoV-2: chronology of measures taken]. German Federal Ministry of Health. https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html.[75] Accessed June 5, 2020.
  • Organisation for Economic Co-operation and Development (OECD). OECD Economic Outlook, Interim Report September 2020. Paris: OECD; 2020. https://doi.org/10.1787/16097408[76].
  • Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Updated daily. https://ourworldindata.org/coronavirus/country/germany?country=~DEU[77].
  • The Editorial Board. Germany’s new coronavirus thinking. Wall Street Journal. May 14, 2020. https://www.wsj.com/articles/germanys-new-coronavirus-thinking-11589498695.[78] Accessed June 2, 2020.
  • Lu G, Razum O, Jahn A, et al. COVID-19 in Germany and China: mitigation versus elimination strategy. Global Health Action. 2021;14(1):1875601. https://doi.org/10.1080/16549716.2021.1875601[79]
  • All visualizations, data, and code produced by Our World in Data are completely open access under the Creative Commons BY license[80]. You have the permission to use, distribute, and reproduce these in any medium, provided the source and authors are credited.

    The data produced by third parties and made available by Our World in Data is subject to the license terms from the original third-party authors. We will always indicate the original source of the data in our documentation, so you should always check the license of any such third-party data before use and redistribution.


    1. ^ https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=DE&view=chart. (data.worldbank.org)
    2. ^ https://international.commonwealthfund.org/countries/germany/. (international.commonwealthfund.org)
    3. ^ https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?locations=DE&most_recent_value_desc=true. (data.worldbank.org)
    4. ^ https://www.economist.com/europe/2020/04/25/germany-excels-among-its-european-peers. (www.economist.com)
    5. ^ https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=DE&most_recent_value_desc=true. (data.worldbank.org)
    6. ^ https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf. (healthpowerhouse.com)
    7. ^ https://www.commonwealthfund.org/publications/surveys/2010/nov/2010-commonwealth-fund-international-health-policy-survey (www.commonwealthfund.org)
    8. ^ https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=DE&name_desc=true. (data.worldbank.org)
    9. ^ https://www.who.int/gho/maternal_health/countries/deu.pdf?ua=1. (www.who.int)
    10. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Empfehlung_Meldung.html. (www.rki.de)
    11. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    12. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    13. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-03-04-en.pdf?__blob=publicationFile. (www.rki.de)
    14. ^ https://edition.cnn.com/world/live-news/coronavirus-outbreak-03-22-20/h_0ff44fe3fd52f6ea7471206d0b7ff501 (edition.cnn.com)
    15. ^ https://www.nytimes.com/2020/06/25/world/europe/germany-coronavirus-reopening.html (www.nytimes.com)
    16. ^ https://ourworldindata.org/coronavirus/country/germany?country=~DEU (ourworldindata.org)
    17. ^ https://www.nytimes.com/2020/06/25/world/europe/germany-coronavirus-reopening.html (www.nytimes.com)
    18. ^ https://www.france24.com/en/20200820-france-and-germany-see-surge-in-infections-as-holidaymakers-return-home (www.france24.com)
    19. ^ https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html (www.rki.de)
    20. ^ https://ourworldindata.org/coronavirus/country/germany?country=~DEU (ourworldindata.org)
    21. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Ergaenzung_Pandemieplan_Covid.html. (www.rki.de)
    22. ^ https://www.spectator.co.uk/article/how-germany-has-managed-to-perform-so-many-covid-19-tests. (www.spectator.co.uk)
    23. ^ https://www.rki.de/EN/Content/Institute/DepartmentsUnits/DepartmentsUnits_node.html. (www.rki.de)
    24. ^ https://www.charite.de/en/service/press_reports/artikel/detail/researchers_develop_first_diagnostic_test_for_novel_coronavirus_in_china/. (www.charite.de)
    25. ^ https://www.zusammengegencorona.de/en/inform/information-on-testing/. (www.zusammengegencorona.de)
    26. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    27. ^ https://www.ft.com/content/0a7bc361-6fcc-406d-89a0-96c684912e46 (www.ft.com)
    28. ^ https://ourworldindata.org/coronavirus/country/germany?country=~DEU (ourworldindata.org)
    29. ^ https://www.weforum.org/agenda/2020/04/it-was-the-saltshaker-how-germany-meticulously-traced-its-coronavirus-outbreak. (www.weforum.org)
    30. ^ http://doi.org/10.1016/S1473-3099(20)30314-5. (doi.org)
    31. ^ http://doi.org/10.1016/S1473-3099(20)30314-5. (doi.org)
    32. ^ https://corona-datenspende.de/. (corona-datenspende.de)
    33. ^ https://www.reuters.com/article/us-health-coronavirus-europe-tech/germany-flips-on-smartphone-contact-tracing-backs-apple-and-google-idUSKCN22807J. (www.reuters.com)
    34. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/WarnApp/Handreichung-Arzt.html (www.rki.de)
    35. ^ https://www.youtube.com/watch?v=shoM2G-yecA&feature=emb_logo (www.youtube.com)
    36. ^ https://www.bundesregierung.de/breg-de/themen/coronavirus/corona-warn-app-1790632 (www.bundesregierung.de)
    37. ^ https://www.spiegel.de/international/germany/lots-of-work-but-little-utility-germans-disappointed-by-coronavirus-tracking-app-a-7c30191e-b225-4c37-917d-41dc2a6078a1 (www.spiegel.de)
    38. ^ https://www.theguardian.com/world/2020/may/21/covid-19-track-and-trace-what-can-uk-learn-from-countries-got-it-right. (www.theguardian.com)
    39. ^ https://www.cnbc.com/2020/11/06/why-germanys-coronavirus-strategy-doesnt-appear-to-be-working.html (www.cnbc.com)
    40. ^ https://www.technologyreview.com/2020/04/09/999015/blood-tests-show-15-of-people-are-now-immune-to-covid-19-in-one-town-in-germany/. (www.technologyreview.com)
    41. ^ https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2020/05_2020.html. (www.rki.de)
    42. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Projekte_RKI/SeBluCo_Zwischenbericht.html (www.rki.de)
    43. ^ https://www.rki.de/DE/Content/Gesundheitsmonitoring/Studien/cml-studie/cml-studie_node.html (www.rki.de)
    44. ^ https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/AK-Studien-english/Sero_General.html (www.rki.de)
    45. ^ https://www.nytimes.com/live/2020/10/28/world/covid-19-coronavirus-updates (www.nytimes.com)
    46. ^ https://www.cnbc.com/2020/11/06/why-germanys-coronavirus-strategy-doesnt-appear-to-be-working.html (www.cnbc.com)
    47. ^ https://www.bundesregierung.de/breg-de/aktuelles/bund-laender-beschluss-1811744 (www.bundesregierung.de)
    48. ^ https://www.bbc.com/news/world-europe-55324422 (www.bbc.com)
    49. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    50. ^ https://www.bundesgesundheitsministerium.de/coronavirus-infos-reisende.html (www.bundesgesundheitsministerium.de)
    51. ^ https://www.thelocal.de/20210107/explained-germanys-new-two-test-strategy-for-travellers-from-foreign-risk-zones (www.thelocal.de)
    52. ^ https://ourworldindata.org/coronavirus/country/germany?country=~DEU (ourworldindata.org)
    53. ^ https://aspe.hhs.gov/basic-report/long-term-care-and-impact-covid-19-first-look-comparative-cross-national-statistics (aspe.hhs.gov)
    54. ^ https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html (www.rki.de)
    55. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/nCoV.html. (www.rki.de)
    56. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Entlassmanagement.html (www.rki.de)
    57. ^ https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Alten_Pflegeeinrichtung_Empfehlung.pdf (www.rki.de)
    58. ^ https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html (www.rki.de)
    59. ^ https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html (www.rki.de)
    60. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    61. ^ https://www.cnbc.com/2021/01/19/germanys-vaccine-rollout-challenges-and-problems-in-vaccine-strategy.html (www.cnbc.com)
    62. ^ https://www.politico.eu/article/coronavirus-story-kiel/ (www.politico.eu)
    63. ^ https://www.washingtonpost.com/world/europe/covid-schools-germany/2020/09/10/309648a4-eedf-11ea-bd08-1b10132b458f_story.html (www.washingtonpost.com)
    64. ^ https://www.bbc.com/news/world-europe-54599593 (www.bbc.com)
    65. ^ https://www.nytimes.com/2020/12/14/us/german-school-close-coronavirus-lockdown.html (www.nytimes.com)
    66. ^ https://berlinspectator.com/2021/02/10/germany-merkel-and-federal-states-to-prolong-lockdown/ (berlinspectator.com)
    67. ^ https://www.intensivregister.de (www.intensivregister.de)
    68. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    69. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    70. ^ https://www.theguardian.com/world/2020/apr/27/german-doctors-pose-naked-in-protest-at-ppe-shortages. (www.theguardian.com)
    71. ^ https://www.dw.com/en/coronavirus-german-icus-see-40-more-patients-than-in-april/a-55836491 (www.dw.com)
    72. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    73. ^ https://www.latimes.com/world-nation/story/2020-10-23/dutch-hospital-airlifts-patients-to-germany-amid-virus-surge (www.latimes.com)
    74. ^ https://www.spiegel.de/international/germany/the-second-wave-hits-the-hospitals-german-icus-are-struggling-to-keep-up-with-corona-a-c096f95a-781c-4703-889b-08b523341551 (www.spiegel.de)
    75. ^ https://www.bundesgesundheitsministerium.de/en/coronavirus/chronologie-coronavirus.html. (www.bundesgesundheitsministerium.de)
    76. ^ https://doi.org/10.1787/16097408 (doi.org)
    77. ^ https://ourworldindata.org/coronavirus/country/germany?country=~DEU (ourworldindata.org)
    78. ^ https://www.wsj.com/articles/germanys-new-coronavirus-thinking-11589498695. (www.wsj.com)
    79. ^ https://doi.org/10.1080/16549716.2021.1875601 (doi.org)
    80. ^ Creative Commons BY license (creativecommons.org)

    Guest Authors

    Liverpool maintain Mohamed Salah transfer stance as Kylian Mbappe priority comes to light

    Liverpool maintain Mohamed Salah transfer stance as Kylian Mbappe priority comes to light
    Liverpool are reportedly confident Mohamed Salah will stay at the club ahead of the summer transfer window, amid speculation linking the Egyptian star with a move to Real Madrid. Meanwhile, there’s an update on Kylian Mbappe’s future, and Thomas Muller has suggested he could follow in Thiago Alcantara’s footsteps, as Express Sport brings you the latest transfer news on Jurgen Klopp’s side.

    Liverpool’s Mohamed Salah stance

    Liverpool remain convinced that Mohamed Salah won’t be leaving Anfield any time soon.

    Salah has frequently been linked with interest from Real Madrid, and transfer speculation was ramped up earlier this season when former Egypt striker Mohamed Aboutrika claimed his compatriot was not happy at the club.

    But the Premier League club are confident Salah will see out his contract, which expires in 2023 – and are optimistic he will stay longer, according to journalist Fabrizio Romano.

    “Liverpool are convinced that they can keep Mohamed Salah,” Romano wrote in his column for Benchwarmers.

    “Soon they will have to talk about his contract expiring in June 2023, but there is no problem with the club.”

    THINK YOU KNOW SPORT? Test your sporting knowledge with our tricky quiz

    Mbappe priority amid Reds transfer talk

    One player Liverpool have freuquently been linked with in recent times is PSG star Kylian Mbappe.

    The 22-year-old World Cup winner has long been expected to join Real Madrid if and when he leaves the Parc des Princes.

    But he has also spoken of his admiration for Liverpool – and the feeling is mutual, with Klopp a confirmed fan of the forward.

    However, Mbappe has not held talks with the Reds, despite rumours to the contrary.

    That’s again according to Romano, who said Mbappe’s current focus is on extending his Paris-Saint Germain contract, which is due to expire at the end of next season.


    “Kylian Mbappe has not started any negotiations with Liverpool so far despite the rumours,” wrote Romanon in his Benchwarmers column.

    “To date, the priority is to negotiate with Paris Saint-Germain for the renewal of his contract.”

    Muller hints at following in Thiago’s footsteps

    Thomas Muller has suggested he could follow in the footsteps of Thiago Alcantara, who joined Liverpool last summer.

    Muller broke into Bayern Munich’s first team in 2008, and has become synonymous with Bundesliga giants’ success ever since.