With countries all over the world struggling to come to terms with the impact of COVID-19, Germany has managed to not only limit the total number of cases but also register a lower total and relative death rate. For this reason Germany has attracted a lot of attention and praise for their handling of the crisis. Although the battle to flatten the curve continues, their response has attracted international commendation, and other countries have envied the speed with which their healthcare system was able to adapt. So what has Germany done differently, and why were they so much more prepared than many others in Europe?
As of April 6, Germany had the fourth-highest number of cases worldwide, exceeding 100,000, with Russia‘s coronavirus cases coming in third. Despite the high number of confirmed cases though, Germany’s death rate remains between 0.8% and 1.5%, and the country’s recovery has been rapid.
When compared even to countries with a similar amount of infections, facing similar demands on hospitals and the healthcare system as a whole, this is low. It is notably significantly lower than in countries who have applied no restrictions.
There are some mitigating factors. Germany has a young population, which in turn means that the average age of infected patients has been lower in Germany. As coronavirus disproportionately affects those over 65, this means the survival rate is higher.
Germany also has much higher testing figures. By making testing available to those not admitted to hospitals, a truer picture of the total cases and actual mortality rates emerges. It is also generally accepted though that it is this testing program which has seen Germany fare so well relative to their neighbours in Europe.
All of this was made possible because of forward planning. Germany had a robust national pandemic plan, thanks to the Robert Koch Institute (RKI), who monitor public health across Germany. The RKI is responsible for planning for all scenarios related to infectious disease, which of course includes pandemic planning.
As a result, Germany was the only country in Europe to initially have adequate stockpiles of vital PPE such as surgical masks, face masks, IR temperature scanners, medical gloves and medical protective clothing. Germany was able to provide neighbouring countries with specialised N95 masks, KN95 masks and FFP2 masks, such was the level of preparedness.
They moved earlier than most, imposing conditions akin to lockdown on March 22, whilst the total number of deaths across the nation stood at only 94. Spain had waited until 196 had died, the UK 422, and Italy 463, before lockdown conditions were imposed, for perspective.
Boasting the largest number of critical care beds per 1000 people in Europe, Germany’s robust health care system was perhaps the only in Europe with anything like the capacity to cope with the numbers that might reasonably be expected during the pandemic. The government has now pledged an additional €3 billion to double this to 56,000.
They were also the only country in Europe with the capacity to carry out mass testing right from the beginning of the pandemic, giving them a much clearer picture as events unfolded. With the capacity to conduct around 500,000 tests each week already in place, and a well-structured pandemic plan, Germany had far fewer problems rolling out their program.
Although Germans remain widely supportive of their government’s response to the crisis, support is still not universal, with just over half of Germans surveyed believing that they are doing either a good or a very good job of handling the pandemic.
With infections falling and Germany seemingly through the worst of the crisis, Germany is beginning to open up. Football has returned behind closed doors, schools are reopening, and lockdown measures are being relaxed. Germany’s testing capacity means that immunity passports, for key workers that have recovered from Covid-19 and the general public, could be introduced.
The RKI are currently testing 100,000 volunteers across Germany in a major study into Covid-19 immunity, with this in mind. The results will be watched keenly by the international community as they look to learn from Germany’s pandemic response, and could have a major impact on how other nations reopen after lockdown.
It is likely that Germany will be considered the model for future outbreaks for European countries. The figures show that by acting promptly and decisively, listening to the science and testing extensively, the outbreak has been controlled much more effectively (given the initial rate of infection) here than any other country in Europe.