Death in numbers: Us vs. Germany
Why the Covid-19 death rate is ten times higher in the United States than in Germany
The United States confirmed its first case of Covid-19 on January 21st 2020, but the American government failed for weeks to take decisive action to impose strict social distancing measures or promote large-scale testing. Germany, on the other hand, with their first case confirmed only a week later than the US, immediately began aggressively testing and tracking people with symptoms.
The experience of these two countries show that just having substantial national wealth isn’t enough to keep citizens safe from the deadly coronavirus. Saving lives is also about how quickly, thoroughly, and effectively the government responds to the brewing crisis and any delay, is very costly. One thing is sure and it’s that countries that were slow to respond (like the US) have, so far, paid the price and if there’s a lesson for world governments, it’s to be more like Germany – definitely not America.
HOW GERMANY KEPT ITS CORONAVIRUS DEATH RATE SO LOW
It’s not surprising that Germany has the world’s fifth-largest coronavirus outbreak. It’s in the middle of Europe and nearly borders Italy, which early on in the crisis became the continent’s epicenter. If the disease was going to spread, surely Germany was bound to get hit hard.
What wasn’t predetermined, though, was its low death rate. That result came from a combination of luck and the government’s quick action.
Here’s why they were lucky.
The average age of those infected is lower in Germany than in most other countries. The country’s earliest coronavirus carriers were skiers returning home from Austria and Italy. Health authorities say that older adults, especially those over 60, are at risk of severe complications. Most skiers, however, don’t fit that age demographic. So while some still got sick, the chance of them dying from the disease was low.
This continues as the average age of an infected person in Germany is 49 years old. Whereas in the United States, about 8 in 10 of the coronavirus-related deaths been in individuals 65 and older, according to the Centers for Disease Control and Prevention (CDC).
Another factor that helped Germany was a slow increase in the number of infections and that the vast majority of early cases were clustered in the western region of Heinsberg. That just so happens to be near some of Germany’s best hospitals (including those in Bonn, Dusseldorf, Aachen and Cologne), which means those patients were able to access some of the best care in the country.
But still, young carriers in the area, even if they were asymptomatic, could spread the disease around the country to more vulnerable people. Why didn’t that happen on a wide scale? The answer is testing and tracking.
“The reason why we in Germany have so few deaths at the moment compared to the number of infected can be largely explained by the fact that we are doing an extremely large number of lab diagnoses,” Christian Drosten, the chief virologist at the Charité hospital in Berlin, told the New York Times this month.
Germany has Europe’s best pharmaceutical industry, allowing it to respond quickly to disease outbreaks. In the case of Covid-19, German laboratories started accumulating testing kits as signs of a global spread became more real in early 2020. These labs were well stocked ahead of Germany’s first confirmed coronavirus case in February.
While other nations were still struggling to test for infections, Germany was doing that and much more. They aimed to sample the entire population for antibodies. This testing helped the country’s public health officials get a better understanding of where the outbreaks were, whether immunity might have been developing, and how far the disease had spread before things got out of control.
This also helps explain why the number of confirmed cases is so high but the number of deaths is so small. Hundreds and thousands were getting tested each week and every following test, then, makes the infection-to-death ratio smaller.
On top of all of this, Germany has also gone the extra mile to track those with the disease.
In the city of Heidelberg, for example, the New York Times reports that vehicles known locally as “corona taxis” transport physicians to the homes of those who have been sick for five to six days.
“They take a blood test, looking for signs that a patient is about to go into a steep decline. They might suggest hospitalization, even to a patient who has only mild symptoms; the chances of surviving that decline are vastly improved by being in a hospital when it begins,” the New York Times’s Katrin Bennhold wrote.
This not only helps authorities keep tabs on a known patient, but also enables them to intervene at a critical point in the disease’s progression, thereby reducing the chances of death.
“Testing and tracking is the strategy that was successful in South Korea and we have tried to learn from that,” Hendrik Streeck, who leads the University of Bonn’s virology institute, told the New York Times.
It appears Germany plans to keep up intense tracking for the foreseeable future. “Once ... we are down to, let’s say, a couple of hundred cases per day or even better, less than a hundred cases, we will try to follow up on every case and get in touch with everyone who has been in touch with those new cases, quarantine and test them,” Karl Lauterbach, an epidemiologist at the University of Cologne, told CNBC on April 3.
Because Germany had good fortune and the good sense to start testing early and as frequent as possible, the German government is pursuing “free travel in Europe” by mid-June and Germany’s borders to France, Austria and Switzerland will be completely opened.
HOW THE UNITED STATES BUNGLED ITS CORONAVIRUS RESPONSE
From insufficient testing to a lack of coordination, Trump’s Covid-19 response has been a disaster years in the making.
Yes, the Trump administration’s inability to send out the millions of test kits as well as the protective medical gear for health care workers are both major causes for the country’s failure to respond to the coronavirus pandemic. However, it didn’t quite start with Trump’s continuous message downplaying the crisis even as it worsened, nor with his mid-March insistence that social distancing measures could be lifted by Easter.
It began in April 2018 – more than a year and a half before the SARS-CoV-2 virus and the disease it causes, Covid-19, sickened enough people in China that authorities realized they were dealing with a new disease.
The Trump administration, with John Bolton newly at the helm of the White House National Security Council, began dismantling the team in charge of pandemic response, firing its leadership and disbanding the team in spring 2018.
The cuts, coupled with the administration’s repeated calls to cut the budget for the Centers for Disease Control and Prevention (CDC) and other public health agencies, made it clear that the Trump administration wasn’t prioritizing the federal government’s ability to respond to disease outbreaks.
That lack of attention to preparedness helps explain why the Trump administration has consistently botched its response to the coronavirus pandemic.
Testing is crucial to slowing epidemics. As we saw in Germany, it lets public health officials identify those infected, isolate them, and then trace the infected’s recent contacts to make sure those people aren’t sick and to also get them into isolation. It’s one of the best and most effective tools we have for an outbreak like this. Something that should be protocol managed to be America’s first sign of massive failure. Even after it became clear that the coronavirus outbreak was becoming a global threat, the Trump administration was still too slow to properly prepare and react.
One of the problems is how Trump consistently downplayed the coronavirus, comparing it to the common flu and claiming that his administration was keeping things under control even though everyone knew things were only getting worse.
Politico reporter Dan Diamond told NPR host Terry Gross that, based on his own reporting, Trump “did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear — the lower the numbers on coronavirus, the better for the president, the better for his potential re-election this fall.”
Trump’s failure to admit to the pandemic’s severity in the earlier months is still costing thousands of American lives.
Covid-19 reveals that, when it comes to an actual crisis – a global pandemic– the United States seems to be a petty tyrant, lacking the skills and sensibility to protect its people. What can we do when our own president dismisses an extraordinary threat to public health as a “hoax” in the most crucial time for saving lives? And what good are all those tools to fight a pandemic when the federal government threatens to withhold those resources from states whose governors don’t sufficiently slobber over our president’s ego? It will take yers until we can began to estimate how many lives America lost because of the shame and misfortune of having elected Donald Trump to the White House.
– Justine Goldberg
Justine is a rising senior at Pitzer college, majoring in Media Studies. Originally from New York, she is currently living off-campus in Claremont with friends, wondering why she didn’t choose to stay in Berlin after spending a semester abroad there.