World Medical Director Frank Ulrich Montgomery calls for a Europe-wide PCR test requirement when entering the country from China. Epidemiologists have a very clear opinion on this: It is not necessary for travelers from the People’s Republic to be tested.

A Europe-wide PCR test should be mandatory for all travelers from China. In view of the massive wave of corona infections there, the Chairman of the World Medical Association, Frank Ulrich Montgomery, spoke out in favor of this.

“We don’t know what’s happening in China right now. The infections run completely uncontrolled. I therefore think it makes sense to make a PCR test mandatory upon entry,” Montgomery told the Rheinische Post. The Federal Association of Doctors in the Public Health Service had previously advocated a uniform obligation to carry out rapid tests in the European Union.

Several European countries have already issued entry restrictions or have promised to do so, including France, Italy and Spain. The EU had not yet decided on a common line during consultations on the corona situation in China on Thursday. On Tuesday, a spokesman for the European Commission said after a meeting of representatives of the national health ministries: “The overwhelming majority of countries are in favor of tests before departure.” In principle, a “coordinated approach” was agreed. The discussion is to be continued this Wednesday at a meeting of the EU states at expert level.

Montgomery also called for sequencing of those who tested positive in order to be able to identify corona variants that have not yet been registered in Germany: “It cannot be ruled out that new variants from China will find their way to Germany. We should be prepared for the worst case and practice prevention.”

The Federal Association of Doctors in the Public Health Service is also calling for an EU-wide test requirement for travelers from China. “We now need a uniform protection concept across Europe,” said Johannes Nießen, chairman of the federal association, to the newspapers of the Funke media group: “Every traveler from China should be tested using a quick test when entering the EU.” The rule must apply to business travelers, tourists and other visitors apply. If the test result is positive, a PCR test must follow and the sample must be sequenced. Anyone who has been infected should definitely have to go into isolation, said Nießen.

Background: After almost three years of lockdowns, mass tests and forced quarantine, China abruptly announced the end of its zero-Covid policy on December 7th. The most populous country is currently experiencing a huge corona wave, which particularly affects people who are old or have previous illnesses. Hospitals are overwhelmed, crematoria can’t cremate the corpses fast enough. It is estimated that tens of thousands may have died.

After international pressure, China has now started storing larger numbers of Sars-CoV-2 sequences in the GISAID EpiCoV genome database. From December 1 to December 30, 2022, China registered 592 virus sequences there. These mainly belonged to known virus lines such as BA.5.2 (35 percent), BF.7 (24 percent), BQ.1 (18), BA.2.75 (5), XBB (4), and BA.2 (2). Due to travel, the variants BA.5.6, BA.4.6, BM.4.1.1 and BA.2.3.20 were also detected in China. A new variant has not yet been discovered.

So do we have to be afraid when new variants or the super variant come to us from China? “The answer is no,” is virologist Alexander Kekulé’s clear judgment in the current podcast. “So if you assume that it’s only ‘normal’ omicron variants that come from there, then we don’t have to protect ourselves from that, we have enough of them ourselves.” very good immunity in the population. This means that there is no danger from the variants currently circulating.

There will be new mutations. There is no doubt about that. However, the virologist has long considered it unlikely that there is a super mutant or killer variant among them, as he has already explained several times in the podcast. In any case, the question is whether such a variant could prevail at all against the other immunological background that we have in Germany.

In his opinion, it is therefore “not necessary to have special control measures for Chinese travelers to Europe now”. On the one hand, not so many tourists come. On the other hand, it is difficult to control the situation properly with PCR tests. In addition, “in my view, it is not justified due to the low risk of a particularly dangerous variant”. However, he is surprised that Mr. Lauterbach, who, as is well known, belongs to the group that fears a killer variant, has not been calling for border closures for a long time.

Gérard Krause, Head of the Epidemiology Department at the Helmholtz Center for Infection Research (HZI), Braunschweig, agrees with Kekulé: “Personally, I do not think it is appropriate to introduce entry controls for travelers from China or elsewhere to Covid-19 in the current situation .” With regard to Covid-19, we have long been in the phase of targeted mitigation or we should finally be aware of it and act accordingly. And further: “Containment measures such as entry restrictions or controls make sense for a short initial phase of an epidemic or pandemic, but not now. The identification of new molecular variants does not change this per se either.”

Isabella Eckerle, head of the Emerging Viruses research group in the Department of Infectious Diseases, University of Geneva, finds the sequencing of travelers from China to be very useful. Because there is hardly any information about the variants circulating there from China itself. However, the expert is not worried: “With the sequences of this kind that are available so far, nothing unusual or surprising has been discovered so far. And the sequences that are detected in China are also found in other places in the world.”

Eckerle, like her colleagues, therefore considers entry restrictions, quarantine or isolation of infected travelers returning from China “not appropriate”. “However, the discussion makes it clear how important it is to have reliable sequencing data over the long term – not just from China, but from every country,” emphasizes the scientist and demands: “Instead of short-term, isolated efforts for a single country, it would make much more sense here to invest in permanent structures. One possibility, for example, could be the sequencing of aircraft waste water. If several countries set up such programs and coordinate them well, then you can get a good overview of the global virus circulation with relatively little investment.”