ANALYSIS: Why are Covid cases in Austria rising and how worried should we be?

In the 24 hours leading to Friday, Austria reported 9,388 new Covid cases, not far off an all-time high, while the high level of Covid patients in ICUs has prompted stricter national measures. So what are the factors behind the fourth wave and how bad could it get?

Anti vax protestors Austria
People protest against Covid restrictions and vaccines in Vienna; low vaccine take-up is a likely key factor behind the current rise in cases and hospitalisations. Photo: Joe Klamar/AFP

The number of Covid-19 infections in Austria is rising quickly again – especially when compared to neighbouring European countries.

Cases in Austria are now twice as many (per capita) as in neighbouring Germany and three times as many as in Switzerland, while the number of Covid patients in ICUs has reached a high enough level to trigger the next step of Covid restrictions. 

Testing rates

First, it’s useful to make sure we’re comparing like with like. 

As the chart below from Our World in Data shows, Austria is carrying out significantly more tests relative to its population than many European countries (we have chosen to compare Austria with its neighbours and the eight other countries covered by The Local; to add other countries to the comparison, you can click the ‘Add country’ button).

This is likely due to the widespread use of 3G or 2.5G rules which mean that either proof of a negative test, vaccination or recovery is required to enter many locations ranging from restaurants to workplaces.

Some people are asymptomatic despite having Covid-19, so a higher rate of testing increases the likelihood of picking up on asymptomatic cases.

In fact, Our World in Data shows us that of these 12 countries, despite having the highest rate of positive test results, Austria has the lowest rate of test positivity except for Italy. That suggests that the other countries have a higher number of cases that aren’t reflected in the test numbers.

But that doesn’t mean Austria’s rapidly rising incidence rate is a red herring.

Because on the discrepancies in testing policy, one of the most reliable measures of how serious the pandemic situation is, is the number of patients in intensive care. This too has been rising in Austria in recent weeks and has now passed 300, which is 15 percent of total capacity and is the milestone to trigger the next stage of restrictions in Austria’s five-step plan.

Again, if we compare Austria with its European neighbours, the number of Covid patients in intensive care is very high relative to the population. This means that more people are getting seriously ill due to Covid, more people are at risk of dying from the virus, and the healthcare sector is coming under increasing strain.

The next question is what’s caused the upward trend.

Low vaccination rate and falling immunity

Vaccination rates across Austria have plateaued in recent months at just over 60 percent of the total population – far from the European Commission’s goal of 80 percent. A low rate of vaccination, combined with the fact that those vaccinated early on may now have reduced immunity (it is normal for the protective effect of vaccines to decline over time) means that the virus can spread more easily.

If we compare Austria to neighbouring Italy using the data shown above, it’s clear that Italy is also carrying out lots of tests — like Austria, it has a widespread requirement for vaccine passes or negative tests — but has a low test positivity rate, and a much lower rate of intensive care admissions.

A clear difference between the neighbours is that Italy’s vaccination rate is much higher, meaning more of the population is protected from serious illness. In Austria, around one in four of the population eligible for vaccination has chosen not to get the jab.

Currently, around 90 percent of symptomatic cases in Austria are in unvaccinated people.

The number of vaccination breakthroughs – when a fully vaccinated person becomes infected with Covid-19 – is also rising, especially in the 18 to 59 age group, but it’s still less than in unvaccinated people. The latest figures from AGES show the current seven-day incidence rate for vaccination breakthroughs in Austria is around 220.

Austria has tried several initiatives to encourage vaccination, from the government updating its own Covid dashboard to make it clear how vaccinations protect individuals, to organising drop-in vaccination centres with no need for an appointment, to more innovative ideas like a vaccination lottery in Burgenland where vaccinated residents can enter to win prizes. 

Even still, the vaccine rate lags behind its neighbours. There are several possible explanations for the apparent vaccine scepticism in Austria.

One important factor is that Austria’s far-right Freedom Party (FPÖ) has openly opposed Covid vaccination, with leader Herbert Kickl speaking at anti-vaccination rallies. Austria’s Medical Association has criticised Kickl for spreading misinformation, with its president calling the politician’s words a “slap in the face” to Austrian medical workers.

This contrasts to countries such as Denmark where governments have worked with the opposition to create and communicate Covid policy, but it is difficult to define the precise cause and effect. In a September election, anti-vaccination party MFG achieved a shock result by passing the 4 percent threshold needed to enter the local parliament. Only founded in February this year, the party’s success suggests that populist parties may be reflecting scepticism that already existed as well as fuelling it.

Austria has now approved Covid booster doses for all residents, and these are possible from six months after the second dose. In Vienna, the mayor has even announced plans to open up “off-label” vaccination for under-12s to boost the vaccination rate. This has not yet been approved by the European Medicines Agency, though the vaccine has been rolled out to under-12s in the USA.

Seasonal factors

We’ve been here before, so we know that part of the reason for the rise in cases is seasonal. Cold weather favours the spread of viruses, and people are more likely to socialise indoors than during the summer months, again creating better conditions for Covid-19 to spread.

This time last year, Austria was also recording high levels of Covid-19 cases with a seven-day incidence rate of 433 – not much more than the current rate of 430. 

However, in early November 2020, national restrictions were already in place, including a night time curfew and partial shutdown of non-essential services. Then, in mid-November, the country moved into its second national lockdown with all non-essential shops and services (including bars, cafes and hairdressers) closed. 

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Ba.4 and Ba.5 Covid variants detected in Austria: What you need to know

Austria has detected new subvariants Ba.4 and Ba.5, with cases reported in Vienna, Styria and Salzburg so far.

Ba.4 and Ba.5 Covid variants detected in Austria: What you need to know

The pandemic is not over, as we repeatedly hear the Austrian authorities saying. The news that sub-variants of the coronavirus have been found in the country has led to some concern.

Here is what we know so far about the pandemic situation in Austria.

New variants BA.4 and BA.5 in Austria

Austrian media reported that the new Covid-19 sub-variants known as BA.4 and BA.5 have been detected for the first time in the country.

The city of Vienna has reported its first cases to the Ministry of Health, and some individual cases were also identified in Styria and Salzburg. 

READ ALSO: UPDATED: The latest coronavirus restrictions in Austria

Health Minister Johannes Rauch (Greens) said that the omicron sub-variants provide slightly more infections than the currently dominant variant BA.2. There is a suspicion that they could be better at avoiding the body’s current antibody defences against Covid-19.

However, this is viewed as a sign that the current downward trend seen in the number of infections could slow down, but not that it would stop or that the infection rate would go up again. 

There is also no indication so far that the variants first identified in South Africa create a more severe disease course. 

Should we be concerned? 

Not according to specialists. Health authorities in Austria are “monitoring the situation very closely, but it doesn’t worry us at the moment”, Mario Dujakovic, spokesman for the Vienna Health City Councillor, said.

READ ALSO: Five possible winter scenarios for Covid-19 in Austria

“There is currently nothing to suggest that we should be concerned, but it certainly makes sense to keep a close eye on things. So we will continue to do this: monitor the situation closely and decide together with experts what to do if the worst comes to the worst. “, he said.

He also shared a graph showing that wastewater analyses all over Austria have come back with less viral material – a sign that the virus is less prevalent overall, new mutations or not.

Mask obligation to stay at least until July 8th

Austria currently has very few coronavirus restrictions in place. However, there are 3G (vaccinated, recovered, or tested) rules for entry in the country, some measures for visitation to hospitals and care units, and, most generally felt by the broader population, a mask mandate in some indoor areas.

READ ALSO: Austria to keep masks only in ‘essential places’ from April 16th

Those who visit or work in essential trade, such as supermarkets and pharmacies, still have to wear FFP2 masks in these establishments. In addition, the mask mandate is still in place for hospitals, care homes, public transport and their stops, taxis, and government authorities, among a few others.

These requirements have been criticised, as The Local reported. The Austrian Chamber of Commerce called for an end to the requirement and complained about the “unfair” restriction, which falls only to those dealing with essential trade. 

Since April 16th, the federal government has lifted the mask requirements for most indoor areas, including non-essential trade. 

READ ALSO: Austria extends Covid regulations as experts warn of an autumn resurgence

However, Health Minister Johannes Rauch has already rejected the demand, at least for the time being. The minister said that the uniform regulations, including the FFP2 mask obligation, should stay in place at least until July 8th. 

He mentioned that it is important to be “vigilant”, especially concerning the newly emerging omicron variants and possible development. 

Numbers are falling but expected to stabilise

Austria this Thursday reported 5,755 new infections after 157,301 PCR-Tests, according to the Health Ministry.

There are currently 1,077 people hospitalised with Covid-19, 34 fewer than in the previous 24 hours. Additionally, 84 people are in intensive care units due to the disease. 

READ ALSO: Austria recommends Covid booster shot for children aged five and over

The alpine country has recorded 18,222 deaths since the beginning of the pandemic, 22 in the last 24 hours.

Just about 68 per cent of the population has a valid vaccination certificate for Covid-19 vaccines, and 54.9 per cent have had their booster shot. 

The Ministry expects that soon the number of cases in Austria will stop falling and gradually reach a stabilisation period, Der Standard reported. Also, in a few days, less than 1,000 corona-infected people would need intensive care or regular beds because of the disease.