The Heidelberg pathologist Peter Schirmacher calls for better explanations for those who died unexpectedly. In general, more autopsies have to be carried out.
Professor Peter Schirmacher is Director of the University Pathology in Heidelberg and a member of the National Academy of Sciences. Photo: zg
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Heidelberg . Prof. Peter Schirmacher (60) is Director of the University Pathology in Heidelberg and has been a member of the Leopoldina, the National Academy of Sciences, since 2012. In addition to the basics of tumor development in the digestive system, he also deals with viral diseases.
Mr. Schirmacher, to what extent can it be determined whether a person died "with" or "from" Corona?
The only way to know for sure is through an autopsy. Our extensive investigations have shown in the first three waves that the corona infection was decisive in around 80 percent of the deaths of SARS-CoV-2 positives and not in 20 percent. Since May 2021, and now especially at Omikron, we have seen that mortality from Covid has decreased significantly overall and also among those who tested positive for SARS-CoV-2.
In which area can the main damage be found in the organism?
If a patient dies of Corona, the lung damage is responsible. From the coagulation phenomena in small pulmonary vessels to the inflammatory changes in the alveoli to the connective tissue remodeling of the organ, we here in Heidelberg have been able to use our investigations to decode the sequence of changes.
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How many of the Corona dead are autopsied in Heidelberg?
Thanks to the funding from a program of the Baden-Württemberg Ministry of Science and the great support of our clinic colleagues, we have comprehensively autopsied people who died from Covid right from the start. In Heidelberg we have a Covid autopsy rate of around 70 percent.
Shouldn't we generally have to do more autopsies to get better data?
Unfortunately, we have some catching up to do in the rest of Germany. Even now we need more data on how Omikron affects deaths or why fatal outcomes can occur in individual cases despite full vaccination. It is important to know how the Covid changes in the lungs recede. So we should also autopsy deceased people who were seriously ill but later died of another cause.
Do you think the death figures that the Robert Koch Institute publishes every day are appropriate?
These numbers do not express whether people died from Corona. Based on our current data and information from other centers, we have to assume that the proportion of cases that have a positive test but have not died of Covid is now high. In this respect, these numbers give the population a false impression of the danger of the infection.
As a pathologist, how can you help decode Covid?
Even if it is not always known to the general public, we predominantly examine biopsies or surgical specimens from living patients, around 70,000 of them a year. In autopsies we deal with the 'natural', clinical causes of death. Through our systematic autopsy activity, we have reconstructed the Covid disease sequence. This has contributed to the improvement of therapy: in the prevention of coagulation, the choice of medication or the ventilation strategy. Our findings from the autopsy have also reduced suffering and saved lives.
What differences in the clinical picture do you see in young people compared to the very old?
The most recent deceased we autopsied were isolated cases in their 40's and 50's. The average age is 75 to 80 years. There are no age differences with regard to the clinical picture. In the elderly and with multiple previous illnesses, a lower severity of the disease in the lungs can lead to death. Although this cannot be determined in every individual case, because some patients have refused ventilation.
Six months ago, you warned of the high number of unreported "vaccine deaths". How did you come up with that?
In our studies, 30 percent of people who die unexpectedly and shortly after the vaccination show a direct vaccination connection. We are the only ones who have systematically taken care of these special cases. Normally, these deceased are not autopsied because they are not patients, die without contact with a doctor and there is no third-party fault. We must therefore assume that these cases are largely not recognized and investigated. Therefore, there is an important information gap here.
Where do you see the problem?
There are problems in these cases with the external post-mortem examination, the prosecutor's approach to these cases and the lack of support for a broad, qualified and systematic investigation at all levels. A question of not wanting to know. All of these cases should be investigated, but unfortunately this is not the case. We have reported and published our findings. I would have wished for a more rational response and appropriate measures.
Why should we pay much more attention to it?
In any case, it must be clarified to what extent there is a connection between death and vaccination. This helps to better diagnose, treat and prevent serious vaccine side effects. Vaccines and vaccine use can be improved. There is also a duty of care in relation to vaccination victims, which is also anchored in the Infection Protection Act. Surviving dependents are also entitled to compensation in the event of a vaccination, but only on application. Without the autopsy results, this will only happen in very few cases. Anyone who thinks about it rationally will come to the conclusion that the state must not look the other way. The same procedure must apply here as we expect and implement in the case of a Covid infection or the introduction of other drugs.
What about cerebral vein thrombosis or heart muscle inflammation?
Rare serious side effects can in principle occur with any vaccine, but depend on the preparation. We no longer see cerebral vein thrombosis because Astra-Zeneca is no longer vaccinated. At Moderna and Biontech in Heidelberg, we documented heart muscle inflammation with a fatal outcome for the first time. This is now recognized worldwide. But serious complications can also occur in the liver and kidneys, which have not led to death so far because they were treated in good time.
How do you see the discussion about a general obligation to vaccinate?
In principle, vaccination is a sensible measure that helps to protect those who are at high risk from a severe course. I do not consider a general obligation to vaccinate to be expedient, because vaccination does not prevent either an infection or its transmission. Furthermore, one cannot predict which corona variants will torment us in winter and how pathogenic they will be, and whether the available vaccines will specifically protect us from them. Anyone who wants or should be vaccinated can do so, so overall I see no medical indication for compulsory vaccination.
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