Dissecting Germany's low coronavirus death rate

Dissecting Germany's low coronavirus death rate
Employee Philipp Hoffmann, of German biopharmaceutical company CureVac, demonstrates research workflow on a vaccine for the coronavirus (Covid-19) disease at a laboratory in Tuebingen, Germany, on March 12, 2020.
PHOTO: Reuters

As the number of confirmed coronavirus cases continues to rise across Europe, the figures in Germany have experts scratching their heads.

Despite being among the countries hardest hit by the pandemic, Germany has recorded an astonishingly low number of deaths in comparison to its European neighbours.

The latest official figures published by the disease control agency Robert Koch Institute (RKI) on Thursday showed 10,999 confirmed infections, 20 of whom had died.

That is a mortality rate of just 0.18 per cent, significantly lower than that of China (4 per cent), Britain (3.9 per cent), France (2.9 per cent) and Italy (8.3 per cent).

It's difficult to disentangle," admitted Richard Pebody of the World Health Organisation (WHO) on Tuesday.

"We don't have a true answer and it's probably a combination of different factors."

Here are some of the explanations put forward by specialists.

Better medical equipment

With 25,000 intensive care beds complete with respiratory support, Germany is well equipped compared to its European neighbours.

By contrast, France only has around 7,000 and Italy around 5,000.

In Britain, latest NHS figures show that there are just over 4,000 critical care beds across England, while health secretary Matt Hancock said Sunday that the UK has 5,000 available ventilators.

Ill patients in Germany have thus far been able to recover quickly.

To prevent hospitals from becoming overwhelmed, as they have been in Italy or eastern France, the German government has also said it planned to double intensive respiratory care beds.

Even hotels and large public halls are to be repurposed as makeshift hospitals for patients with less serious symptoms, so that hospitals can be freed up to treat those who are severely ill.

Early testing

Christian Drosten, director of the Institute of Virology at Berlin's Charite hospital, said early testing could also be a factor.

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"We recognised the disease very early in this country. We are ahead in terms of diagnosis and detection."

In January, researchers at Charite became among the first to develop a test for the virus.

Germany also has a network of independent laboratories, many of which began testing as early as January, when case numbers were still very low.

The high number of labs has increased screening capacity nationwide, and the RKI estimates that 12,000 people can be tested a day in Germany.

Getting a test is therefore easier than in some other countries. Anyone who is showing symptoms, has been in contact with a confirmed case or has recently returned from a risk zone is eligible.

Younger patients

The virus has also largely affected a younger, healthier section of the population in Germany compared to elsewhere.

"In Germany, more than 70 per cent of the people identified as having been infected until now are between 20 and 50 years old," explained RKI president Lothar Wieler.

As in Scandinavia, the first infections in Germany were identified in people who had recently returned from skiing holidays in Italy or Austria.

Yet in a country where almost a quarter of the population is over 60, there are fears that the number of deaths will skyrocket as the virus spreads further.

No post-mortem tests

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Another explanation cited by Italian experts, could be that Germany, unlike other countries, tends not to test those who have already died.

"We don't consider post-mortem tests to be a decisive factor. We work on the principle that patients are tested before they die," the RKI told AFP.

That means that if a person dies in quarantine at home and does not go to hospital, there is a high chance they will not be included in the statistics, as Giovanni Maga of Italy's National Research Council pointed out in an interview with Euronews.

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