Coronavirus: few victims in the epidemic in Germany

Text by: Pascal Thibaut Follow

If the country is confronted as elsewhere with an exponential growth in the number of people infected, that of the dead remains surprisingly low compared to that of neighboring countries. How is this "German model" explained?

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From our correspondent in Berlin,

“ If we have so few deaths compared to the number of people infected, it is also because we carry out numerous tests, half a million per week. The statement by Germany's most advanced virologist, Christian Drosten, on Thursday struck everyone's mind. His country is probably the one that tests the most in the world. Elsewhere, the figures are considerably more modest; those diagnosed often have serious symptoms or already require hospitalization.

Early awareness and numerous tests

The number of these tests has increased in recent weeks thanks to a large network of laboratories. As early as January, the Charité hospital in Berlin, where Christian Drosten works, had informed his counterparts on how to produce the tests to detect the new virus. Their large-scale use partly explains the much lower death rate in Germany than elsewhere. As of Friday, more than 40,000 cases were identified; 253 deaths were reported. By testing on a larger scale, also people who have only minimal symptoms or are not at risk groups, Germany has a very low mortality rate of around 0.5% against almost 10 times more in France. In Italy, this rate is around 10%. Only half of the people tested in Germany suffer from cough, a symptom typical of Covid-19; four in 10 have a fever. Germany also does not carry out post-mortem tests, which worsen the death rate.

This earlier awareness and the many tests have saved time and prepared hospitals for a larger influx of severe cases requiring intensive care and respiratory support. Germany is the country in Europe which has the largest number of places in this area. It must be doubled and has already gone from 20,000 to 30,000, according to the president of the Federation of German Doctors. “Bonuses” of 50,000 euros per space created will be paid. Preventively, non-vital operations have been postponed (the shortfall must be compensated for hospitals) and staff are trained to learn how to use these devices. Germany has also clearly separated Covid-19 and other patients in hospitals, including when they arrived on site, to avoid unnecessary contagion.

Advantages and limits of federalism

Federalism has advantages in such a crisis, with a large network of laboratories or appropriate reactions to concrete situations, such as the isolation of particularly affected districts or communes. However, this decentralization has also shown its limits as to the measures to be taken to restrict the freedom of movement of the population. We have seen this when deciding to close crèches and schools with measures taken separately by the different regions. This happened again with the closing of shops and other restaurants, but also for the displacement of the population. Bavaria took the lead with strict measures, before a conference of the different regions resulted in common guidelines, probably more reassuring for the population than the juxtaposition of variable rules.

Containment as in France or Italy has not been retained in favor of a less coercive practice. Gatherings of more than two people are prohibited (except for a family living under the same roof or for workplaces). Travel is regulated but remains flexible: shopping, going to the doctor or to work, taking an exam, playing sports alone, all this is possible.

These measures must reduce social contact and therefore the number of infections in order to avoid, as in Italy or Spain, that hospitals are overwhelmed in the face of the influx of patients in serious condition. Already, some are wondering about the conditions and timing of a relaxation of the measures. Angela Merkel, herself in quarantine after being vaccinated by a doctor who turned out to be infected, stressed that it was too early to speculate on such hypotheses. Health Minister Jens Spahn said on Thursday that the current situation was comparable to " calm before the storm " to emphasize that the crisis had not yet far reached its peak by far.

Towards a Korean strategy?

An internal document from the Interior Ministry, which several media released on Friday, calls for the resumption of the solutions adopted in South Korea, namely mass tests to be able to large-scale to know who is infected before these people do are isolated from the rest of the population. A method that allows healthy people to continue to lead normal lives and the economy to turn. Such an option would imply by the end of April an increase in the number of tests carried out, reaching 200,000 per day. The Bosch company announced Thursday that a rapid method, the results of which would be available after two and a half hours, could be delivered in April.

The tracking of infected people using data from their mobile phones to find the contacts they met is also raised, but raises ethical questions regarding the protection of private data and respect for private life. Such measures, if adopted, could allow Germany, provided the crisis does not take on too serious a dimension, to reduce the current restrictions sooner.

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