What's Germany doing so right?

[kiaa]

The daily Coronavirus update by country:

Notice something? Out of 35K+ total cases in Germany, just below 200 deaths. A stunning difference from the other countries. So what's Germany doing so right? Why are so few people dying in Germany compared to Italy, Spain, etc? It's not like there aren't old people there too, right? Well, the answer might be a bit complicated. As you might suspect, it's a combination of factors.

When the epidemic broke out, there were many cases of infected people returning from skiing vacations in the Alps and elsewhere. Those were mostly people under 80 years of age, and in a generally good health condition. Naturally, the risk of a fatal end is relatively smaller in that group.

But one of the main reasons for the very low mortality rate is that an average of 160K tests are being done in Germany every week. And not just of people with heavy symptoms. This way, people from the risk groups could be given a better treatment, and most importantly: early treatment.

Another reason is the high capacity of the ERs in the German hospitals. In Italy, where the largest mortality rate is observed, there's a relatively low share of the accessible beds in the hospitals (318 ER beds per 100K people, compared to 800 in Germany, with a steady growing tendency). The capacities for ER treatment are being raised all throughout Germany, as is the number of medical workers, and the equipment. North Italy may have an awesome health care system, but Germany's is much better structured for such situations.

But none of this should make anyone complacent. Most patients in Germany have contracted the disease within the last couple of weeks, and the heavier cases will be probably mounting exponentially in the near future. The mortality rate will inevitably surge then.

In the meantime, the German association for care for leprosy and tuberculosis patients has sounded the alarm that the Coronavirus pandemic could contribute to an increased tuberculosis mortality rate as well. This is the most vulnerable group, and the problem is, about a million of them have no access to the medical care, and their bodies are far from capable of coping with the disease.

Comments

[abomvubuso]

Germany is still in the early stages of the pandemic. The exponential stage is only just beginning there. We can draw conclusions only after it has reached its zenith, and then compare with other countries.

[tcpip]

> Another reason is the high capacity of the ERs in the German hospitals.

Yes, especially this. When demand exceeds supply then you will have major problems.

Like in Italy
https://twitter.com/i/status/1242798221073608705

[dancesofthelight]

Watching people in the USA wanting to overtly throw open the gates of damnation to glut Grandfather Nurgle is....an experience.

I'd point to the gap in Germany and South Korea as being leadership, and would make a pointed note that Bernie Sanders' idea of socialism is that his Presidency magically would disrupt the proteins that made Covid-19 exist and UHC would be an anti-viral by its mere existence. Someone might tell that to all the people in Italy dying of Covid-19, given that they've got a fairly solid UHC system.

If Sanders by some ill miracle had won four years ago the USA would be in the exact situation now that it was then, and the people saying 'kill the old folk so the POTUS gets re-elected' would be Sirota and company, not the National Review and Trumplandia.

[mikeyxw]

It could very well be that Germany is testing a lot more and therefore finding more milder or asymptomatic cases than other countries. It could also be that Germany is still early in the outbreak and they certainly haven't had their health care system overrun. Yeah, there are some lessons here.

However, to me, Germany didn't really stick out. The ones that did are Japan, Hong Kong, South Korea, and Taiwan. Even China a bit. Hong Kong and Taiwan are the countries that have the closest ties to China. I mean, they're not even officially countries but rather some kind of vague appendage to China. They haven't seen the kind of uncontrolled community spread you see in Europe. Japan had some cases early, but despite having the world's oldest population and a population of 126 million, they've had just over 1300 cases and 47 deaths.

All of these countries have responded well, staying ahead of the virus even with quite a bit less warning than the countries in Europe. They're also countries that have had to deal with outbreaks recently, SARS, MERS, and various flavors of influenza and therefore had a well prepared health system.

Something else, people in those countries are used to wearing face masks to stop the spread of influenza, which for some reason hasn't caught on in the West. In China, it cost me about $3 for a 100 pack of surgical masks, which is about what it takes to get through a flu season. Reusable cotton masks cost about $5. They might not be a silver bullet, but they seem to help. They're so ubiquitous in Eastern Asia not because they protect people, which they are okay at, but because they prevent the spread of the flu, which they do well considering how cheap they are. To some extent, I feel like the crazy uncle when I start talking about this as part of a solution in the West, and I realize this goes against what the experts say. The Taiwanese government, on the other hand, provides everyone with a weekly supply of face masks and the Chinese police will stop anyone not wearing one. My family and friends in Taiwan and China keep talking about how reckless it is for people in the middle of an epidemic to ignore this simple, cheap way of making things better. They also keep offering to send me surgical masks... by the thousand.

[asthfghl]

Yes, it's a cultural thing. And I'm talking of hygiene culture.

[mikeyxw]

My take is that it's a bit more. Anyhow, Japan, who had the second case outside of China on January 14th and has the oldest population in the world, has had 49 deaths. South Korea got very unlucky and had one huge outbreak centered around members of a church and their family early on, they controlled this and have had 144 deaths. Taiwan, which is incredibly close to China, has had 2 deaths. None of these countries had some general lock down. Hong Kong has had 4 deaths and has ended their lock down, something no other country has done.

I'm not saying these countries should be doing victory laps, however, I'd say that if we want to learn lessons, these are the guys we should be learning them from. However, it seems like every Western country is going the opposite direction, restricting testing and recommending against wearing masks. These are measures that are meant to allow their health care systems to deal with the crisis, they're not the measures others have successfully used to avoid it. Tactically sensible, strategically, not so much.