[Challenges in infectious disease control and the current pandemic by skewed distributions].

Background: The pandemic phase 3-mitigation-by the SARS-Coronavirus‑2 is currently taking on speed in Germany. Skewed distributions of key epidemiological parameters of the virus and patient care are a challenge for the control of the outbreak as well as keeping the system functional. Methods: The skewed parameters-pre-patency period, incubation period, duration of viral shedding and time to admission to hospital-are analyzed in regard to their impact and possible countermeasures. Results: The skewed distributions are exclusively time related variables. They are a handicap for outbreak control as well patient management. Optimization between residual open flanks and the efforts to close them is difficult. The main stakeholders are the local health departments, the diagnostic laboratories, the health care infrastructure and finally the citizens in regard to the burden due to non-pharmaceutical interventions including quarantine and isolation. The duration of quarantine and isolation should urgently be shortened for health care workers (HCW) as well as people in critical infrastructure by ready (re-) testing. Calculated risks have to be taken within a phase 3 of a pandemic to keep a system going. Conclusions: The skewed distributions are a special challenge for infectious disease control. In the case of ending quarantine and isolation in phase 3 of the pandemic, they should be judged specifically in regard to the client/patient. Cumulative distribution functions are very helpful in this regard.