Gangelt is a small city with 12,500 inhabitants in the Heinsberg County, in the west of Germany. To be frank, neither Gangelt nor Heinsberg were the most widely known parts of Germany until the beginning of 2020. The coronavirus changed that, because Heinsberg, and in particular Gangelt, became one of the first COVID-19 hotspots in Germany.

The county was also the first region in Germany to implement measures to shutdown most social and economic activities.

Because it was one of the first affected regions, Gangelt now offers the chance to better understand the virus and its means of transmission. A team of scientists led by virologist Professor Dr Hendrik Streeck from the University Hospital Bonn conducts an in situ study and presented the first results before Easter.

Policymakers face a dilemma in the current crisis: Shutting down most social and economic activities does seem to stop the virus from spreading exponentially, helping to prevent a collapse of the health care systems.

At the same time, the negative social, economic, and long-term health effects of a shutdown are severe. Therefore, we are all looking for the right measures to change to a smart lockdown, which helps to contain the virus, while allowing more or even most normal activities.

The results of the Gangelt Study are preliminary since it is still ongoing. Nevertheless, the data can help policymakers in adjusting their response to the COVID-19.

The most important (preliminary) results are:

1. The infection rate in Gangelt according to the study lies at 15%. This means that already 15% of the inhabitants had an infection with the new coronavirus and are most likely immune for some time.
2. The case fatality rate in Gangelt is 0.37%, which is considerably lower than other studies indicated for COVID-19. The most likely explanation is that the rate of undetected infections was much lower in the Gangelt study than in other studies (see here for more information regarding COVID-19 statistics).
3. A further important detail is the scientist`s assessment that the severity of the infection could be lowered if the initial virus load causing the infection is as low as possible.

The data regarding the infection rate cannot be transferred to Germany per se. Since Gangelt was an early hotspot, the number is most likely much higher than in other areas.

However, the results show that there are considerable numbers of mild cases, which helps to spread immunity. The much lower case fatality rate compared to other studies gives hope.

In addition, the assessment, that the initial virus load is most likely an important factor for the severity of a COVID-19 disease is very important. This may mean that it will be much more important to reduce the virus load, than to prevent infections at any cost.

Wearing protective masks may be an effective way to achieve that. It may also be sufficient to reduce the number of people in closed spaces instead of closing all restaurants and cafes.