senator reason has always been a place that welcomes a lot of people from all over the world but it's very empty at the moment right there in that the being heard so to see something like this it's very beautiful building up his message where a mass wash your hands share love. people here wait for the day when may can replace their protective masks with party masks. you're watching news don't forget you can always get the latest on our website that's steve w. dot com thanks for joining. the fight against the corona virus pandemic. has the rate of infection been developing what does the latest research say. information and context the coronavirus update 19 special. on t w. can inspire change the

people making it possible to go africa fantastic right. join them as they set out to save the environment learn from one another and work together for a better future. melancholic steal all for tuning it out for good. on d. w. . over a year after the 1st coronavirus cases some early patients are still suffering. long covert refers to symptoms that can last for months all that return up to recovery i was only in the hospital for a week and yet months later i was still can't go back to work. a new study from

woman in china has found 3 quarters of hospitalized patients still experience at least one symptom half a year later. we're yet to discover it is just how long covert can last. in the mean time doctors say get the vaccine regardless of whether you've had the virus or not survivors know all too well how damaging the sickness can be even after they get better the road to recovery can be long and difficult. peggy green is battling the long term effects of covert 19 when she became sick in march she had few sometimes but it's now devastated her life. pretty confident. i only became really ill months later and at the time i thought that everything would eventually be fine but things didn't improve i was extremely ill for many many weeks which turned into months without getting better. and. that's what

unleashed s.f. . peggy is 48 years old and suffers from long term effects after kovac. she sought treatment at a rehabilitation center on germany's baltic sea coast after the virus peggy felt. she suffered from dizzy spells and chronic pain. in some cases i also had cognitive difficulties like my head wasn't functioning properly i couldn't hear had poor vision and couldn't follow conversations well. i'm not afraid but i still wonder if i'll ever be the same again. as a covert survivor peggy has officially recovered from the illness but she says it feels

like coronavirus has stolen her healthy body and left her with a sick one in its place. peggy spent 5 weeks here her main goal is to get her life back on track. you live your life 5 days out work all week and so on my life might be more intense than it was before i would like it to be as it once was. at the moment life is dramatically different for everyone else and maybe i can still manage to get a lot done i'm sure that my recovery will allow me to i think i will be a different person than i was before but that's ok. this is leashed him. peggy green has since gone back to her normal routine but she still feels the lingering effects of illness she often feels weak and her muscles hurt but even if the road to recovery is slow she's glad to be on it. doesn't david

strain heads up the british medical association's work on the long term impact of cova that is also a survivor will get to that in a moment 1st david is there any way of speeding up recovery for long term sufferers like the woman in that report. that's a really interesting question because we don't really know what the natural history of covert itself is of the long days so i get many reports of people who for example it's a multi vitamins or it's a health supplements and swear that has made a dramatic difference for them but i also get reports from people who've done no intervention and have got dramatically better off and the apparent reason whereas in all cases we get people who don't get better so at this moment in time in the absence of randomized control trials we don't have a definitive answer as to what will or won't work well take us back to the beginning what causes long coded in the 1st place. that in

itself is a huge question that may help us identify what the treatments are but at the moment we don't fully understand there are 2 or 3 different hypotheses of being run the test and the one the reason that i'm researching into is looking at the mitochondria that is the powerhouse of the cells i mean actively if you want to think of them as the battery that powers your body basically we know covert the disease does attack that battery and what we believe is happening is that there's a many individuals who that battery just isn't recharging at the diseases it's like having the old i phone it doesn't matter how long you plug it in for it will not get the charge that it requires and we think that's what's going on and that's the theory we're working on there are others that think that this is an all too immune disease the antibodies you create so the virus then turn on the host and effectively become like rheumatoid arthritis or s.l.a.

and trigger a and also immune disease then there are some that think there are permanent scarring that take place in the lung and the blood vessels that occur as a result of the virus the bottom line is at the moment we don't know when reality is it's likely to be a combination of multiple different causes what about just how many people this actually affects but what do you make of the chinese study that shows 2 thirds of hard hit patients suffer long term effects. when you looking at the hard hit it's no surprise at all if you look at people who've been on ai to you for other reasons many of those will still have long term effects 6 or even 12 months later i think what's more interesting in long coated is a number of people like was described that only got relatively mild disease i mean for me personally i only have one day that i needed any additional therapy yeah i been left with symptoms that 12 weeks later there are actually worse than the

initial disease and these are the ones that are causing more issues from the oh and yes the office of national statistics in the u.k. they estimate that 20 percent of people who had any symptoms at all with some debilitating illness at 6 weeks and 10 percent of people even though they didn't require hospitalization or any additional care at the outset 10 percent of people who ever tested positive will have symptoms of long cohabit at 3 months and you've said this is happening to younger people more women than men those suggested to be at lower risk. exactly and that's part of the thing that we're seeing particularly in the health care setting that. the risk of dying from code it is much lower in females it's much lower in the youngsters and therefore in many health care settings these are the people that we get to work the front line because if they catch it the consequences won't be as severe but now what we're seeing is an after effect is that these are exactly the people that are more at risk of lung covidien

in all study we've identified that even though women are more likely to suffer presents itself participates in study even after we adjust for that 86 percent of the long covert that we're seeing is the myung fitter ladies and and it does appear to be very similar that all of the people who are coming presenting with symptoms of lock that were previously very fit they were very active we're not sure if that represents that they have a high a baseline and therefore they they realize that a lot more if they've been left with some weakness or it may just be that these are people who are actually noticing it because while most of us around the world are in some form of lockdown where we don't have the same freedoms that we have normally that we just don't notice how much that they set out impacts on us just briefly you've also said this isn't just a respiratory infection it's a multi-system disease other steps that can be taken to prevent long coping from

setting in. we don't really know what the cause is so it's very difficult to say assess of but one thing that we are trialing and not having a good response of with is making sure that way you've got the illness you stay with a your exercise envelope or your energy envelope we call it for many other people training if you're training for a marathon or creature running for a race you want to push yourself every single time you train with long covert what we believe is if you stay well within your energy window then the window itself will get bigger over time rather than trying to push because one of the kick key things that all of us are seeing is the hardy push yourself the longer it takes to recover after each episode so stay within your energy envelope at every available opportunity that it's right thank you very much for being honest. you're welcome.

officials are distributing madonna's coronavirus vaccine in germany it's being administered from tuesday and is the 2nd vaccine available it still people won't have a choice they'll have to take whatever comes germany is facing criticism for a slow start to its execution program code infection rates remain high despite an ongoing. time for your questions now over to our science correspondent derek williams. what's the difference between quarantine and isolation and what are the correct ways through odds are both. in the course of this pandemic these 2 terms have been used interchangeably quite often although they actually mean different things in the confusion arises because both are protective measures for stopping potential covert 19 spreaders from transmitting the disease to others so definitions 1st isolation is defined as

a measure for keeping people known to be sick with a contagious disease away from people who don't have it quarantine on the other hand is restricting the movement of people who might have been exposed to an infectious disease for a while to find out whether they've been infected or not so so those are waiting games the big difference is that if you have covert 19 you're in isolation if you only might have gotten that you're in quarantine when it comes to the right ways to observe then things get a little trickier because different health authorities in different countries regulate the 2 in different ways here in germany for example if you've tested positive for covert 19 and are recovering at home you have to isolate for at least 10 days from either the day you tested positive or the day you began to show symptoms though you can also only leave isolation if the. dr determines that your

symptoms have really improved and remain that way for at least 48 hours those who have been directly exposed to someone with the disease for example family members they're what are called category one contacts and they have to quarantine and germany's health authority says they should do so after their last contact with the sick person for 2 full weeks although they can also leave quarantine if they test negative for covert 19 after 10 days i for now. it's a constant fight for life survival the coronavirus ward at the university medical center in fribourg. since the beginning of the pandemic we've been accompanying workers in the intensive care unit to show the challenges they face on a daily basis. battling the virus doctors on the frontline

close up. next on d. w. . india. meaning god in india is leading by example. its goal is to be the 1st climate neutral town in the country. thanks to an increase its climate programme carbon emissions will be balanced out more completely eliminated. be killed before. the 60 minutes on d w. story so that people of the world over to g.w. office book and twitter up to date and in touch and follow us.

the crime fighters far back africa's most successful in radio drama series continues this season the stories focus on hate speech prevention and sustainable charcoal production. all of a sow's are available online and of course you can share and discuss on africa's facebook page and other social media platforms. crime fighters to noone else. get. thousands of covert 1000 patients are fighting for their lives in german intensive care units it outside in germany half the patients who end up on respirators die and we have to remember these are human beings with families for some of these numbers are abstract maybe coronavirus 10 iris can't put themselves in someone

else's shoes but each number stands for a person and is that size of mesh. we've been filming the work of i.c.u. teams at freiburg university medical center since the start of the pandemic. but because you can't get any more air you can't speak you realize that you might die. how can we beat this virus what are the possible long term effects in germany 2nd wave many young and healthy people have caught the coronavirus unfortunately being young and healthy is no guarantee for getting a mild case. there was a young man 45 years old with the release of a case this is a textbook case of how someone who is young and healthy and without significant breeds system conditions can almost end up dying.

the air ambulance arrives with a corona patient on board he's enclosed in a special protective box to prevent others getting infected during the journey to the hospital a little later the patient in his late forty's arrives at the intensive care unit where dr vivian saltzman works the patient is already in an artificial coma and has been into baited that means he's connected to a ventilator. manpads and the patient came from a smaller hospital he had coughing and a temperature for a few days and then his condition suddenly deteriorate at last he developed severe breathing difficulties he was in debated and there transferred here. 6 medical workers carefully turn the patient so that he's lying face down prone

positioning is proving to be one of the most important treatments to help many people severely affected by the virus. patients have to be adequately cushion to avoid pressure sores on the face for example because they spend so many hours bed bound. off their work site or their long it is adamant that if you lie on your back secretions collect and inflammation worsens the lungs can't heal properly our patients lie in bed for a while x. turning them face down allows the rear areas of the lungs to be ventilated and to heal the patients alternate between their back and the front so that all parts of the lungs can be equally ventilated that. every day the patients are turned on their stomachs and then back again it's very work intensive for the medical staff. of ventilator is not enough for many of the seriously ill covert 9000 patients they

. would die if they were not also attached to an artificial long the catheter channels the blood out of the body and then back into it with its twin tubes and i think it's something that after making a small incision the doctor pushes the catheter toward the heart using a guide wire that you know from the shot. but of. course. if. you got it right. this is the e.c.m. o. the heart lung machine. it's attached by a plastic tubing and in this instance takes over the work of the lungs. what it what blood flows into the machine the carbon dioxide is removed and the blood is in rich with oxygen then it's pumped back into the patient.

because you know of course we also use it for far too long support we use it after a heart attack after resuscitation they have a wide range of medical uses but the ones just on long support here are primarily coronavirus patients we don't have many options left for really sick patients that's the last card we have a carsley. they're going to go to the 5 we have 23 e.c.m. o's in fribourg university medical center 23 that's it and currently we only have 2 that are not in use so i hope the way won't be so severe and so disruptive because this is not just about intensive care beds as such are. tested in the 1st wave of the pandemic one in 3 patients here needed to be hooked up to an e.c.m. 0 to have a chance of survival. due to not question the therapeutic options are sobering we supply of oxygen. he had the e.c.m.

know that it just buys time the body the lungs have to heal themselves there is no medication to treat coronavirus. almost half of the patients who ended up in intensive care in fribourg during the 1st wave died at the beginning of march few people suspected what the medics would soon be facing the 1st cases were only detected in germany in late january. this is barbara she was one of germany's 1st covert 1000 patients she is a pediatric specialist at the university medical center her colleague consultant yohannes culp and has worked with her on many occasions. you. know just to put some of their visitors who are on call when the patient arrived in intensive can she had severe breathing difficulties otherwise she was very ill lunch unlike some of the patients we encounter she was feverish but not at all disorientation and that we were really struggling to get her breathing difficulties

under control so we gave her a lot of medication to try to control and we had to give her an awful lot of oxygen . then given the rapid progression of the illness we decided to anita times and into baytown this amount is to supply her with a very rich concentration of oxygen what we saw she was suffering from severe lung failure. to start. barbara spent more than a week fighting for her life. she made it her ventilation tube is gone in all likelihood she is no longer infectious today's 1st test was negative she has beat the virus but it was a close call. but the situation was frightening at that moment. you can't get any air anymore. you can't speak. you realize that you

might be going to die or. then i began giving instructions with my last remaining strength about my last wishes if i don't make it. but. i have on whatsapp. it was a nightmare. in germany's 1st wave of the covert 900 figures rose rapidly in the south of the country fribourg university medical center switched to treating only medical emergencies and patients with a new coronavirus. this is clement's the sores on his face are from the long periods of time that he has spent lying face down before contracting the virus clements was a fit man in his mid sixty's a passionate mountaineer with no preexisting conditions. vivian saltsman has been treating him for weeks his lungs were so badly affected that she's been keeping him

alive with an artificial long that supplies his blood with oxygen clemens has been attached to the machine for almost 3 weeks but the intensive care team is confident he will make it. now after 20 days they have decided that he no longer needs the e.c.m. oma she. is going to remove the tubes from here growing it's a big step forward we're all really pleased. that . the e.c.u. mo is no longer needed but he still needs ventilation via the tube inserted in his trachea. that afternoon clemons gets visitors his wife but tina and his daughter have come to see him they're still not

allowed to touch because of the danger of infection. out of. there. his eyes are half open but not focused he's only semi conscious. barbara has just received her 2nd negative test the treatment was successful the virus can no longer be detected in her body she's not infectious she has survived kovac 19. she's still weak but she's no longer getting oxygen what she doesn't realize is that the nightmare is still far from over. a little later she's back on a normal hospital ward where she gets some sobering news from a lung specialist he puts her back on oxygen she's not getting enough air this.

means i'm not independent. it's ok when i'm in the room. but it's a bit tiresome to find quite honest. shoulders if i want to go outside i have to carry this heavy bottle. it had really been hoping that i would get taken off it soon. but i think i'll just have to resign myself to my fate she stuff. is a long specialist cope at 19 has also confronted doctors in his discipline with a completely new range of challenges. the food. for the inflammation triggered by the virus has also destroyed healthy tissue in the lawn and scars have formed. and the scars are

a defect that hamper the normal functioning of the longer. they hinder the gaseous exchange and we want to restrict bad as far as possible by suppressing the inflammation that leads to these scars. and a token. with antiinflammatories like cortisone no one knows yet what the long term consequences will be of a severe case of coronavirus as a doctor barbara is only too aware of that you know. you can't but help thinking how will i cope with every day life will i be able to live and work on warmly after this. that's the $1000000.00 question. if i'm left with lung damage it wouldn't be so great of course. but i can't do anything about it.

back in intensive care clements condition has barely altered. his lungs are being ventilated via a tracheotomy he hasn't received any sedatives for some time now but he still isn't properly conscious the doctors suspect coburg 19 also attacks the brain as indicators suggest. that the excess in many cases we see the brain being severely affected many patients are agitated disoriented and the loss of sleep medication if they become so disoriented during the course of the illness the brain has to be involved in time. in the high security lab of the viral logy department they're studying the coronavirus there infecting cells with covert 19 so

that they can examine it more closely all of the light colored dots are infections that are spreading. under the microscope you can see alongside the blue cell nuclear lie that there are masses of red virus particles that are self replicating . such research is helping viral edges done yellow personally and helmet hangal to know what they're up against but sars coronavirus too which is causing the current covert $1000.00 pandemic is a much more successful and unpredictable opponent than the 1st sars virus. as a corner of your weaver all or just thought we knew about coronaviruses sauce coronavirus tune is a science virus that's much more advanced than the sars virus that we were confronted with in 20022003 which had difficulties with effective transmission about the current virus manages it. exactly that it is efficiently transmitted via the air we breathe and of course that's really bad news for us so far as if there

is a fuse in my 25 year career as a viral a just it's the nastiest virus i've come across because it's so unpredictable and it's becoming clear just how unpredictable when you get the flu you know you're going to get sick seriously ill if you're unlucky but there is a vaccine we can treat it sars c.o.v. to is quite different some people get it but don't get ill though they are infectious others die from it without it being clear why and of course it affects older people but also the odd young person it's an absolutely unfair opponent enough but once. after being unconscious for around 6 weeks clements has come around. by the. way out he took a long time to really become conscious and communicate but now he is not at all

disoriented and can join in he's mostly pretty cheerful he's a fighter have he's a cyclist he wants to do all these things again he has goals i think that's very important to know what you are fighting for to stick with it. clemens has beaten the coronavirus but he keeps getting other infections mike ammonia each one is a new threat to his life. this is hope it's a roller coaster when he got an infection again he was just lying there again i began to despair and wonder what would happen. next bad piece of news always seems to be around the corner so i'm afraid of being too optimistic you stop wanting to engage even with the positive stuff. clemens has been in intensive care for more than 2 months. his constant focus getting his own life back he has

lost more than 15 kilos and most of his muscles have wasted away. he's getting high energy nutrition via a feeding tube he is fighting to recover. files about once he is in a kind of rehabilitation face at the moment with us he's doing a lot of physiotherapy he's using the pedal exercise or school he's also able to get out of his chair already you can do that pretty well the situation with the artificial ventilation is getting better. slowly that. his wife but tina records every bit of progress that he makes. it quite in this is him going into his room he couldn't get up and sit down alone at that point out and this was the 1st time more than 4 weeks ago that you even recognised as. a

jury member that yes you can remember that i can remember. yes his gaze looked human again through reason to see a human it is a huge difference of someone has light in their eyes almost. it's really frightening when someone just looks completely blank at least i was really afraid. you wonder whether his spirit and he will be back to the way he was or not it's terrifying. barbara has been at a rehabilitation center in the black forest for almost 6 weeks now she doesn't need oxygen anymore and she's fighting her way back to normality.

amazing if you saw me on the walker. here she is 7 weeks ago on a walker at the intensive care unit in freiburg when she arrived there she was at the point of suffocation. as. it was absolutely apparent to me that i would not have survived without artificial ventilation and so in principle they've given me a new lease of life and i experienced an amazing sense of gratitude the 1st 23 days i was really over the moon. it was a feeling of happiness that i think i have never experienced before it's. not me. in summer clemons 2 was on his way to a rehabilitation center in the black forest after more than 70 days in intensive care. before he got the coronavirus he could climb 4000 meter high mountains. now the

slightest incline taxes you. know about is remote and yes i can feel that i've been active. for nuthin most of it's not my legs that are the problem it's my lungs. tell. at times i asked myself what made me so vulnerable. and that means i thought that i would definitely not be affected as badly as someone with respect. and. i don't have high blood pressure or diabetes no other chronic illnesses. who's not. i haven't found any answer to that.

it's easier if you bring up one leg next to the other. it really gets your thighs does or. the physical rehabilitation program has modest goals this isn't about climbing 4000 meter peaks but ensuring that clements can cope with daily life. a few weeks after completing her rehab barbara has a check up at the university medical center she has been training hard as a doctor she knows that your lungs don't recover on their own. take a big breath out breathe out out out out out breathe then quickly deeper deeper and quickly breathe it all out out out out out stay with it really press out early out until there's nothing left. great scott. what have the hours of training

achieved disappointment. mostly moves if only 67 really is what that would mean that my lung capacity has only approved by 10 percent in 8 weeks 5 of them spent working like a dog to improve my lungs. i'm off work tomorrow. the doctors want to take a look inside our longs because i was really in and hold your breath. are there still signs of inflammation. can mean anything. are there signs of pulmonary fibrosis scarring of the lungs to covert 19 leave lasting damage in severe cases. these cloudy areas here these very fine lines here these don't exist in normal lungs 1st so no hard data because there haven't

been any long cohort studies that would tell us whether or not these changes are likely to diminish over time well how they might develop. there are types of pulmonary fibrosis that continue to develop even when a virus has gone i can't tell from your m.r.i. at the moment. the woman. barbara performs well on the following running test but will she remain so fit. as a doctor she knows how dreadful pulmonary fibrosis can be. this is this was one of the the 2 there is what she used to call it a apathic lung fibrosis that people can get after a severe case of influenza and at some point you end up meeting a lung transplant. that's something that takes place after 10 years rather than one

. but of course its progression can come to a halt with a bit of luck that it's much too much for the call but you can also end up battling to get air. it's a horrible way to die. from school. in autumn the number of cases begins rising again. clemens has come to the medical center to thank the staff put in order the i'm glad i'm a visitor this time and not a patient. to suffer that really shook me off it. i bet it did you know all your fears come flooding back down thay. clemens continues to convalesce meanwhile more and more. virus patients start arriving at the hospital in fribourg been freed karen's

infectious diseases department is full again just like in spring and additional normal wards have already been transformed into covert 19 more it. is either going or saying that several other hospitals in the area are already full so we have to brace ourselves for even more cases and the next $7.00 to $14.00 days. early older age groups are now being affected and we know from our experience of the 1st wave that this will result in more hospital admissions. here at the normal covert ward patients often require oxygen but they don't yet need artificial ventilation about all the staff can do is give oxygen inhalations and stop patients from getting additional infections. the winter weeks will be crucial ones for the hospitals the team led by epidemiologists hio grundman is responsible for forecasting for the hospital working out how many patients will likely need to be

admitted if we don't stick to the restrictions. you have to see things from the point of view of the virus. the virus has a semi parasitic relationship to us and exploits our needs. does the iris exploits the need of people to be sociable to get together to celebrate with the family with the neighbors successful viruses take advantage of this in a perfidious way. in the 1st wave relatively few people were affected in germany now the virus is almost on the present any family can be affected. it was in the funds which. the far reaching social penetration of the virus also means that we are going to have to be more patient when it comes to fighting this virus now that it is much. more widespread. though i assume that

a short lockdown like the one that worked so well in april will not work again in that way and that we will have to come to terms with a longer lockdown of. there are more difficult times ahead for the people working in intensive care vaccination is no quick fix to be covert 19 we're going to need greater staying power. i hope that we'll have to corona virus pandemic under control in the 3 years and by then we will have successfully vaccinated the entire population and know that the immunity conferred by the vaccines well last several years and then we consider the question of when a booster vaccine might be needed in 3 years in 3 yes many intensive care units are already at or over full capacity in fribourg they still fight to save every life in the intensive care ward so working at their limit we have to say that quite clearly

we still have empty beds but every day the numbers are increasing and the patients remain in hospital for weeks for months the beds aren't frayed up in just a few days i. don't know how but we have to manage even if the numbers rise we have the beds that we have disposable. and we will do our best looking after everyone. mean we can't really do anymore is that we have to look after the severe cases we have to cut we can't say we can't cope with anymore here is the cost of point this option does not exist it gets and. we have to carry on somehow that's quite clear. and with those words philip schmidt gets to work preparing a fresh intensive care bed the next coronavirus patient is already on the way.

after. india. got it india is leading by example. this goal is to be the 1st climate neutral talent in the country. thanks to an ambitious climate program carbon emissions will be balanced out more completely eliminated. the 30 minutes following t w. sweet treats better business chocolate. the dirty side of cocoa production is especially evident in the conflict. in the gulf plantations have destroyed chroniclers adults and children work like slaves.

to sweeten the bottom line for international cocoa producers play 75 minutes on. google ideas is on its way to bring you more conservation to play how to make signals green or how can we protect habitats we can make a difference claim global ideas fundamental series against global sales or on t.w. at all mind claims her. claim. above. this is do w. news news our top stories. in the u.s. congress democrats have introduced an article of impeachment against donald trump a charge the president with inciting insurrection following the deadly riot at the u.s. capitol last week a vote is expected as early as wednesday trump could become the 1st president in u.s.

history to be impeached twice. united states has read designated cuba as a state sponsor of terrorism getting her van up with new.