In Depth

Behind Germany’s low coronavirus death rate

The country’s reported fatality rate is 16 times lower than that in UK

Scientists are struggling to understand how so many coronavirus patients in Germany are surviving despite the country being among the hardest hit by the pandemic.

The unusually low death rate has also been noted in political circles, with two Italian MEPs from the far-right Brothers of Italy party submitting a question to the European Parliament last week asking why Germans were “quasi immune” to the disease.

How low is the death rate in Germany?

As of Friday morning, Germany had recorded 16,046 coronavirus infections and 44 related deaths, according to latest figures. That equates to a death rate of 0.27%.

By contrast, the UK has recorded 3,269 cases and 144 deaths, giving a death rate of 4.4%.

In Italy, officials have recorded 41,035 cases and 3,405 deaths, putting the death rate at 8.3%.

Testing

German government adviser Christian Drosten, a virologist at Berlin’s Charite hospital, told the Watson.de news site earlier this month that one of the key reasons for the country’s low fatality rate is strict adherence to instructions from the World Health Organization (WHO) to “test, test, test”.

“Our laboratories are technically very well equipped,” said Drosten. “Our regulations for the introduction of new test procedures are very flexible and our statutory health insurance association already introduced a code for these tests in January, which means that [insurers] are financially supported.”

The Guardian reports that guidelines have been in place for more than a month for German citizens to be tested “if they show the usual symptoms and have either had contact with an infected person or recently visited a ‘high-risk area’ such as Lombardy or Wuhan”.

Lothar Wieler, president of the Berlin-based Robert Koch Institute (RKI) disease control agency, says German laboratories are now conducting more than 160,000 coronavirus tests every week, and claims that figure “can be increased further”, the Financial Times reports.

“This is about capacity. The capacity in Germany is very, very significant,” said Wieler.

The testing has revealed a wider spread of people infected with the virus, including those who are asymptomatic or have very mild symptoms, and the number of younger people being tested skews the death rate even lower.

“Especially at the beginning of the outbreak in Germany, we saw many cases connected to people returning from skiing trips and similar holidays,” said Matthias Stoll, a professor of medicine at the University of Hanover. 

“These are predominantly people who are younger than 80 and who are fit enough to ski or engage in similar activities. Their risk of dying is comparatively low.”

Better health system

Richard Pebody, who leads the High Threat Pathogens Infectious Hazard Management team at WHO’s Europe office, says another reason for Germany’s low death rate is likely to be the quality of care available there, report The Times.

Germany currently has about 25,000 intensive care beds with respiratory support, and the government plans to double this capacity in the coming weeks to give hospitals additional support.

Hotels and large public halls will 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, reports the Daily Mail.

Meanwhile, healthcare services in other European countries are under immense strain. France has around 7,000 intensive care beds with ventilators, and Italy around 5,000.–––––––––––––––––––––––––––––––For a round-up of the most important stories from around the world - and a concise, refreshing and balanced take on the week’s news agenda - try The Week magazine. Start your trial subscription today –––––––––––––––––––––––––––––––

No post-mortem tests

In some other countries including Italy, tests are being carried out on a high number of people who have died during the outbreak to determine if the deceased had coronavirus. This has inflated the number of coronavirus-related deaths reported in these nations.

However, experts at Berlin's RKI disease control agency say they do not “consider post-mortem tests to be a decisive factor. We work on the principle that patients are tested before they die.”

Is testing going to change in the UK?

Only people in hospital with pneumonia or in intensive care units are currently being routinely tested in the UK.

“So if you have symptoms and you are not sure if you have the virus, you may well not be able to find out,” says the BBC.

However, the numbers of people in the UK being tested has risen gradually since the process began in late February, when just over 1,000 tests a day were carried out, to more than 6,000 tests a day now.

The government plans to continue increasing the number of daily tests, first to 10,000 a day, with a goal of reaching 25,000 tests per day within the next four weeks.

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