Germany has a low coronavirus mortality rate: Here’s why

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Workers wheel a deceased person outside of Brooklyn Hospital Center during the coronavirus disease (COVID-19) outbreak in the Brooklyn borough of New York City, New York, U.S., March 30, 2020.

Brendan McDermid | Reuters

The world is reeling from the coronavirus pandemic, and some countries are reeling more than others.

But Germany seems to be taking the epidemic in its stride with a high number of cases but a low number of deaths, thanks to a number of factors.

In Europe, while Italy and Spain are the worst hit countries with over 100,000 cases each, as of Friday, Germany has recorded 84,794 confirmed cases but has witnessed just 1,107 deaths, according to data from Johns Hopkins University.

The low mortality rate in Germany, at just over 1%, is far below its neighboring European countries, and this has been put down to Germany’s decision to implement widespread testing of people suspected of having the virus, as opposed to Italy or the U.K.’s decision to only test symptomatic cases.

Karl Lauterbach, a professor of health economics and epidemiology at the University of Cologne, and a politician in the Social Democratic Party (SPD) of Germany, told CNBC that Germany’s less severe experience of the pandemic so far was down to a handful of factors.

“I think so far we’ve been lucky because we were hit by the wave of new infections later than many other European countries, for example Italy, Spain and France,” he told CNBC Thursday.

“So we had a minor but important delay in the wave of infections coming to Germany. Secondly, the first people that got infected in Germany tended to be younger than the average of the population … so we were hit later and with younger patients initially.”

Lauterbach noted that a third factor that helped Germany was a slow increase in the number of infections, allowing those patients to be treated at the country’s top medical institutions, including some of the country’s best university hospitals (including those in Bonn, Dusseldorf, Aachen and Cologne) in the Heinsberg region where there was a cluster of infections at the start of the outbreak.

“Number four, all things considered, the German health-care system and hospital system has been modernized by the Social Democrats and Christian Democrats over the last 20 years … this meant we had more hospital beds, more ventilators, more ICU (Intensive Care Units) beds and more hospital doctors, roughly speaking, than any other comparable country in Europe … So our system is in a reasonable shape for such an epidemic.”

Suppression strategy

While almost all European countries have introduced lockdowns to prevent the spread of the coronavirus, fatality rates have differed wildly.

The mortality rate in Italy around the end of March stood at 11%, for example. Germany’s rate is comparable with South Korea, a country that has also attracted plaudits for its management of the coronavirus crisis with extensive testing, contact tracing and digital surveillance of its citizens. Germany’s lockdown, alongside a rigorous testing regime, has also helped, Lauterbach said.

While countries like the U.K. now have to build a diagnostics industry from scratch, Germany already had one built around the multinational might of Roche. The country reportedly has the capacity to carry out up to 500,000 tests a week, whereas the U.K. can currently only manage just over 10,000 a day.

Asked about the possible trajectory Germany’s coronavirus rate could take, Lauterbach said his worst-case scenario was that 10% of Germany’s 83 million population contract the virus, and with a 1% fatality rate, then 80,000 people would die.

“It must be lower than that, it would be a tragedy if 10% of the population get infected, that’s my personal worst-case scenario.”

He said the lockdown would continue until at least April 20 and then the government would review how the lockdown is working.

“The strategy that we’re following is a suppression strategy,” he said. “Once the suppression has worked and we are down to, let’s say, a couple of hundred cases per day or even better, less than a hundred cases, we will try to follow up on every case and get in touch with everyone who has been in touch with those new cases, quarantine and test them, and we will also likely require masks to be worn on public transport and in some work places.”

He said the government’s plan was to keep the virus suppressed as long as possible, with a partial lifting of the lockdown expected at the end of April, though he said it would not be able to be completely lifted for a long period of time and that would be data dependent.

Lauterbach is also a politician in Germany’s center-left SPD party that is in a coalition government with Chancellor Angela Merkel’s Christian Democratic Union (CDU) and its Bavarian sister party, the Christian Social Union (CSU). Tensions between the CDU and SPD have been high over the last year, with the SPD agonizing over whether to leave the coalition. 

“We have to work together now and there’s an understanding that this is clearly not the time for disagreements between the two coalition partners … This is crisis management, this is not about party politics.”

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