What has Germany got right?

Comparisons are difficult but my country has so far been able to keep down the number of fatalities

Successes hold lessons for our health service

All over the world people are scared of the coronavirus.

In that sense, the UK is no different from my country, Germany. Everywhere, governments are taking drastic action to protect the public. Schools are being closed, social contacts reduced to a minimum. Several European countries are not allowing citizens to leave their homes. Hospital staff are overwhelmed.

We are also all focused on statistics. How many people are infected and where? What is the rise in numbers since the last official report? And, worst of all, how many has the virus killed?

It is natural to compare between countries, but it is a difficult exercise. The numbers for testing, for example, vary massively from one place to the other. While in Britain there are tests for coronavirus post-mortem, this is not the case in Germany.

Still, there is one figure that has caught attention: the death rate in Germany. Compared to the number of people infected with coronavirus, the number of deaths in Germany has been maintained, at least for now, at a lower level to most other developed countries. As of Wednesday afternoon, there were more than 10,000 confirmed cases of coronavirus in Germany and 27 people had died. The UK during the same period had more than 2,600 confirmed cases and over 100 people had died. In Italy, more than 31,000 people were infected, with more than 2,500 fatalities.

Nobody in Germany can give a complete explanation for this. Above all, this is not a time for complacency. This is the worst crisis since the Second World War. Just as in the UK, the German media is filled with reports on Germany’s underfunded health service, the coming economic shock and a fearful population. Borders are closed, lorries with essential goods are stuck for miles, shelves are empty. Innumerable companies are facing ruin, and nobody knows how many jobs will be lost.

But it is still worth asking whether Germany is doing something right. A relatively well equipped health service might be one reason for the lower death rate so far. According to the Robert Koch Institute, which is advising the German federal government, German hospitals have around 28,000 intensive care unit (ICU) beds. Britain’s NHS counts around 4,100. Germany’s secretary for health, Jens Spahn, has confirmed that 25,000 ICUS are equipped with ventilators, besides other complex monitoring tools. The federal government ordered another 10,000 ventilators a few days ago to provide alternative care facilities. “The provision of ventilators for Covid-19 patients has been the bottleneck in countries such as China and Italy which have been gravely hit by the pandemic,” Christian Karagiannidis, head of a respiratory clinic in Cologne, told German radio SWR this week.

The German authorities have also been relatively quick to react. The regional administration in Berlin will swiftly start building a new 1,000-bed hospital for coronavirus patients in cooperation with the German army. On a federal level, the governments and the 16 Länder have agreed to repurpose some hotels and event venues as care facilities for people with the virus. The aim is to double the number of ICUS as soon as possible.

At least for now, the fact that all patients in Germany can be cared for in an ICU with ventilators could mean that they have a higher chance of survival. Many patients with coronavirus suffer pneumonia which can trigger a sepsis – a common cause of death. It is essential that Covid-19 patients get access to ventilators at the earliest stage possible.

There has also been a lot of testing. The daily test capacity is around 12,000 and many suspected cases were tested at an early stage, at least at the beginning of the epidemic. How many people have been tested in Germany so far, however, has not yet been confirmed by the authorities.

This is not to say that the coronavirus crisis in Germany will somehow have a better ending than in other places. The Robert Koch Institute declared yesterday that up to 10 million people, out of a population of 83 million, could eventually catch the virus. “We are seeing an exponential rise in cases,” its director, Lothar Wieler declared. But was my country better prepared? Ultimately, it may not matter. Germany, Wielder said, might eventually see the same death rate as Italy.

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