
Germany's Coronavirus Death Rate Is Lower Than in Other Countries - prostoalex
https://www.npr.org/2020/03/25/820595489/why-germanys-coronavirus-death-rate-is-far-lower-than-in-other-countries
======
asdfasgasdgasdg
I think in the end the number I'll judge countries by is how low they held the
death rate per population. A better number would be a population death rate
weighted by demographics, but I don't think that'll be easy to construct.

Increasing the denominator by testing lots and lots of people is important
only if testing lots and lots of people helps you prevent more people from
dying. Germany is doing pretty well on this front compared to its European
neighbors. But if you look at its absolute death rate graph it is headed up
and to the right, like everywhere else. It'll be a little while before the
dust settles and we can actually see whose public health policies were
effective.

~~~
disabled
Croatia also does well. Croatia has both land and maritime borders (also
ferries running back and forth) with Italy.

Croatia is ranked number one by Oxford for government responses to the
epidemic: [https://www.bsg.ox.ac.uk/research/research-
projects/oxford-c...](https://www.bsg.ox.ac.uk/research/research-
projects/oxford-covid-19-government-response-tracker)

Note: HRV is Hrvatska which means Croatia in Croatian. It is the three letter
ISO country code.

The Croatian government website on coronavirus is:
[https://koronavirus.hr/en](https://koronavirus.hr/en)

There is an interesting interview by a Croatian epidemiologist here:
[https://www.total-croatia-news.com/lifestyle/42484-igor-
ruda...](https://www.total-croatia-news.com/lifestyle/42484-igor-rudan)

~~~
Marsymars
> Croatia is ranked number one by Oxford for government responses to the
> epidemic: [https://www.bsg.ox.ac.uk/research/research-
> projects/oxford-c...](https://www.bsg.ox.ac.uk/research/research-
> projects/oxford-c..).

It's ranked as number one in stringency of response - they explicitly say it's
not to be interpreted as a rating of the appropriateness or effectiveness of a
country's response.

------
_trampeltier
I know from italy for ex. if you are tested positive on Corona, no matter how
you die (a tank drove over you twice) you will end up in the "death with
Corona" spreadsheet. I don't know about other countrys does this handle. Also
normaly, if very old people get sick (like my grandma died) they don't go to
the emergency hospital. They might go to a hospital, but usually they don't
try to save lives at all costs.

~~~
splintercell
How many Corona positive people are dying of non-Coronavirus related issues?
Is that number really that much to impact the total figures?

~~~
s9w
The age distribution is quite a signal that this is plausible. Then we have
the Italian study that said only 1% had no other comorbidity. And then you
have a few cases with enough details to go looking, usually the first death in
a city/region or notable cases. As a random example this:
[https://www.lehighvalleylive.com/coronavirus/2020/03/first-l...](https://www.lehighvalleylive.com/coronavirus/2020/03/first-
lehigh-county-resident-to-die-from-the-coronavirus-was-80-official-says.html)

~~~
vanniv
Yowza,

Fellow falls hits his head, dies from head trauma -- but because he had COVID,
he "succumbed to the virus"

Good grief

------
vanniv
There is an aspect that is missing in this article's analysis: what counts as
a COVID-caused death.

In Italy, for example, all in-hospital deaths of COVID-positive patients are
recorded as COVID deaths.

If you're 85 years old, with emphysema, heart disease, diabetes, and COVID,
and you die of acute respiratory distress... did COVID kill you?

In Italy, it did, 100%

In New York, it is up to the doctor who declares you dead, but it probably
did.

In Germany, it most likely didn't.

That is not to say that Germany isn't doing a good job -- they are. They are
doing a lot of testing, isolating, and contact tracing. They are also going
full-speed-ahead with the experimental hydroxychloroquine/azithromycin
treatment, offering it everyone without contraindications, starting almost
from the beginning of the outbreak.

Both of those things contribute to the low death rate.

They are also detecting a higher percentage of cases, which automatically
lowers the apparent mortality (since every country detects most of the
hospitalizations, more testing means finding more inherently non-lethal cases,
meaning more detected recoveries)

~~~
s9w
In Germany too. Every death plus Positive sars-cov-2 test == death "from"
corona

------
losvedir
Worth noting this is from last week. What's Germany's rate now? Since Germany
started testing extensively and early, and death is a lagging indicator, I
wouldn't be surprised if this creeps up to the more expected ~1.5% we see in
Korea or the Diamond Princess.

I check the worldometers numbers everyday, and already Germany is up about
half a percent from when that article was written, but I'm not totally sure
that site's numbers are trustworthy.

~~~
adventured
The latest I have is 1.08%. Johns Hopkins has it at 775 deaths on 71,808
cases. Their very low mortality rate has held throughout, and they currently
have a very large number of recovered patients, implying it's holding through
the progression (most countries with good mortality numbers lose that as the
cases get worse; you can spot this delay by the very low recovery cases as a
percentage).

So far among nations in Western Europe, 1.08% is extraordinary. France is at
6.6% at a similar point in recovered cases vs positive tests. And Germany is
the second oldest nation at the median, behind Japan, among major nations.
That mortality rate is a remarkable achievement so far.

~~~
Zenst
That also may be case of better testing and by that, more widespread. Many
countries playing catch up, well they all are and may well be case that many
countries with high death rates also have many untested people who had what
they thought was mild cold and in some countries those mild cold's would of
been tested.

So it is one of those things when we won't be able to compare until down the
line, and able to compare like for like.

------
kanox
This is because other countries are understating infection counts because of
poor testing.

Wikipedia has a very interesting table with testing stats:
[https://en.wikipedia.org/wiki/COVID-19_testing#National_stat...](https://en.wikipedia.org/wiki/COVID-19_testing#National_stats)

Many countries or regions have extremely high positive test ratios, for
example Lombardy is at 37% positive, France at 20% while Germany is at 7.4%
and South Korea at 2.4%.

If Lombardy tested more people they would find many many more cases and their
reported death rate would decrease.

The fact that areas with high infection counts like New York and Northern
Italy are reporting high positive test ratios is terrifying. It means that
they are doing _worse_ than the numbers indicate and they're limited by
testing capacity.

------
s9w
The media should stop calling this death rate or corona deaths. These deaths
are not (all) _from_ the virus, rather occurred in people who died and had a
positive test. These things can be (and I assume are) vastly different.

Just as a thought experiment: The same metric would give herpes a 100% death
rate.

~~~
sgc
Influenza _related_ death rates are estimated after the fact from several
sources of data and are about 25x higher than official influenza confirmed
deaths. Everybody talks about the number of influenza related deaths as the
real death rate. the chance is coronavirus _related_ deaths are also higher,
not lower, than the official count.

~~~
s9w
How is that possible if every death is counted as corona death? Besides a
missing test of course.

~~~
sgc
There are plenty of missing tests. Testing is limited almost everywhere. Due
to the testing that is in place I don't expect the same ratio, but also, not
all countries count all tested deaths as corona deaths, only a few do as far
as I understand.

~~~
s9w
Fair enough. From what I make of this all we do not have strong enough data to
really say this is as bad as we make it. We'll see in a month or two I guess
when we can conclusively look at the total mortality.

~~~
sgc
I agree we don't know yet, it could be worse or better. But I think it will
take a year or two to know based on how long it takes to do a post mortem on
an influenza season. Certainly failure to quarantine would be devastating so
whatever the final numbers are is irrelevant. We already have overwhelmed
health systems around the world, and the fatality rate would be a whole
different level if that was more widespread.

~~~
s9w
I can't follow along with that. We're in peace times.. banning people from
going out of their home is something I would not have believed possible until
russian tanks are at the gates of Berlin again, or the day of reckoning is
coming after all.

The mortality is not increased [1], the number of acute respiratory illnesses
is not increased [2]. German hospitals are not overwhelmed, indeed we gave
away hundreds of respirators and treat a large number of patients from
neighboring countries right now.

There are single cases of overwhelmed medical systems, but those are few and
in places where this has happened before [3] and frankly those places have not
been in great shape before.

I can't see the justification for these draconian measures with so little
evidence. What I do see however is a perverse dynamic between sensationalist
media and power hungry politicians. It's infuriating how critics are defamed
by newspapers [4] and even high-profile experts ignored [5]. The economic and
social downfall from these measures will be insurmountable I fear and dwarf
any risk now or even in the foreseeable future from sars-cov-2.

[1] [https://www.euromomo.eu/](https://www.euromomo.eu/) [2]
[https://image.jimcdn.com/app/cms/image/transf/none/path/s56f...](https://image.jimcdn.com/app/cms/image/transf/none/path/s56fbd84d0e131e9b/image/i2dc7965015368c97/version/1585168811/image.png)
[3]
[https://milano.corriere.it/notizie/cronaca/18_gennaio_10/mil...](https://milano.corriere.it/notizie/cronaca/18_gennaio_10/milano-
terapie-intensive-collasso-l-influenza-gia-48-malati-gravi-molte-operazioni-
rinviate-c9dc43a6-f5d1-11e7-9b06-fe054c3be5b2.shtml) [4]
[https://www.welt.de/gesundheit/article206667595/Wolfgang-
Wod...](https://www.welt.de/gesundheit/article206667595/Wolfgang-Wodarg-Warum-
dieser-Mann-die-Fakten-ignorieren-will.html) [5]
[https://www.statnews.com/2020/03/17/a-fiasco-in-the-
making-a...](https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-
the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-
data/)

~~~
sgc
I would not be surprised if fatalities overall remain flat due to lowered
activity. That doesn't mean they would not explode without them. Germany is an
outlier, not the norm as basically all statistics we have at this point
indicate. I agree that Germany needs a different course of action than other
countries, but I don't think that is widely applicable.

Milan was not overwhelmed by influenza, that is just an Italian title, which
is full of energy/exaggeration as usual. The article talks of 48 _cases_ ,
which is a far cry from the 40,000+ they have in that region now.

Frankly, anybody peddling that a crushing blow to the world economy is
conspiracy to get a little more funding for one sector should be discredited
whoever they are. That is ludicrous. There is far to much avarice in too many
competing sectors, just for starters. And scientists are not that cutthroat as
a group.

I think you misinterpret the last link you posted. He does not advocate for
doing nothing, but for quickly gathering data and changing our tactics as new
information comes in, since there are risks both in quarantine and in not
quarantining. I think everyone agrees with this and it is actually what all
countries are doing. Even Italy is reevaluating their quarantine measures
weekly, etc.

I do agree with you that the economic risk is enormous, and I am unconvinced
that my business will exist when I can work again. But at the same time there
is nothing to say what we did in the face of illness before this quarantine
was human or correct. I think we are too callous about "normal" annual deaths
from other causes and if anything comes from this massive effort, I hope it is
an awareness of these other causes of death and funding and concrete action
going towards them. It's no conspiracy to recognize that investing in better
health of the population by effective, concrete steps to guarantee and promote
diet, exercise, _etc_ would be a worthwhile item to invest far more resources
to than we currently do.

~~~
s9w
> I would not be surprised if fatalities overall remain flat

What would be enough evidence in a month or two that you would agree that this
was fantastically overblown? I fear that even after this is over, the numbers
will be be same same but still misrepresented by everyone to say that it was
all necessary.

~~~
sgc
I doubt that would be possible in that time frame. But I would need to see
evidence of basic herd immunity or a massive chunk of herd immunity (50%
population including representative percentage of the elderly) with low death
rates, including in areas where medical systems were overwhelmed. Otherwise an
effective preventative quarantine will always on face value look like an
exaggeration, since the goal is to avoid something before it happens. But
looking at New York and Milan, etc, I think that option is fast becoming a
fantasy if it is not one already.

Solidarity and group effort are important parts of what it means to be human.

~~~
s9w
That is a very high bar to prove and therefore a very low bar to implement
these harsh measures. The measures themselves are inhuman too.

I think we both weight our rights, the medical risk and economic danger
differently but I can see your reasoning.

~~~
sgc
Maybe we should be infecting under 40s with a very low dose of the virus so
they have an ever higher probability of getting just a little sick, and jump
start the herd immunity process. It would be a form of vaccine-lite and allow
a lot of people to get back to a normal life sooner rather than later.

------
omazurov
The article could have mentioned this as well:

 _German researchers want to send out hundreds of thousands of coronavirus-
antibody tests over the coming weeks, Der Spiegel reported.

People who test positive for the antibodies could be given an "immunity
certificate" that would allow them to leave their coronavirus lockdown early.

Other countries, including the United Kingdom, are planning mass testing to
ease lockdowns._

[https://www.businessinsider.com/coronavirus-germany-
covid-19...](https://www.businessinsider.com/coronavirus-germany-
covid-19-immunity-certificates-testing-social-distancing-lockdown-2020-3)

------
RickJWagner
So much contradictory information through this epedemic.

CNN just ran an article highly critical of decentralized approaches. (They
were advocating top-down, unified actions on a country-wide basis.)

Here, NPR tells us Germany is doing well because the regions are able to act
autonomously.

Hard for us armchair quarterbacks.

~~~
Semaphor
The "decentralized approach" thing wrt Germany is something I’ve seen
mentioned several times in English media (I assume Drosten said it in a press
conference). I don’t know how it is in other countries, but it seems to me
this is only great in comparison to the US problems of broken centralization,
and only regarding the testing. There are several demands of higher
centralization in Germany when it comes to information: reporting of cases,
information about hospital beds, and distribution of patients based on those.

~~~
Barrin92
I think if you look at the level of care in Germany that you get even in
remote towns (corona virus aside), there is a lot to be said for the
decentralised model.

A lot of states, not just the US have highly unequal public infrastructure.
France being one of the bigger examples, but the UK too.

There's a very basic Hayekian argument about the problems of concentrating so
much knowledge and capacity in the capital alone. It simply impedes flow of
information, it creates distrust and simply put dysfunction.

People in the anglosphere don't just ask these questions about Germany when it
comes to healthcare, they also often ask them when they see regions like the
Rustbelt or North England and compare it to the German Mittelstand. In many
ways the centralised model is broken.

~~~
Semaphor
> I think if you look at the level of care in Germany that you get even in
> remote towns (corona virus aside), there is a lot to be said for the
> decentralised model.

Is it better? I really don’t know, all I heard about this are the complaints
about rural areas being underserved by doctors, especially GPs

~~~
Barrin92
They're sometimes maybe not quite up to the standards you'd find in a urban
university clinic, but compared to other places I've been it's quite
astonishing how high quality the care is even in small remote hospitals. The
demographics are increasingly affecting the number of physicians though, that
much is true.

------
jariel
a) Not the death rate. It's just 'deaths/tested' which is something else.

b) I don't see how the decentralized system entails more testing. Canada is
decentralized and has more testing by the US, but it's because the respective
authorities 'just did it'. The logic of 'some labs blocking others' makes no
sense. If S. Korea wanted to do 'the most testing' it might be in their self-
interest to 'centrally plan' thereby ensuring that it's also pointed in the
right direction.

c) Canada has 1/3 the per-capita cases of Germany.

------
rurban
NPR did better reporting on this phenomenon than German media, well done!

~~~
Semaphor
They did? There was literally nothing in there that hasn’t been said several
times and the structure of this pretty short article was "1\. Official data
and official analysis; 2. A single anecdote as counterpoint; 3. Meaningless
official opinion on the anecdote that’s meaningless as it’s nothing but a
single anecdote". I like NPR, but highlighting this as "better reporting"?

~~~
rurban
So far I only read the Welt interview with the 2nd German expert who is on
site. The famous one, who dominates the media, is only sitting in his lab in
Berlin and looks at the numbers. He always talks about fantastic the testing
goes, but only in this article you'll see why.

Whilst on site you see nothing much, as you won't get tested if you cannot
prove contact and risk or symptoms. Only symptoms will not get you tested,
even in Germany. Only Korea is able to do that. So anecdotes are appreciated.

Maybe manifacturing and PCR sequencer availability and how these tests are now
prepared automatically should have been mentioned also. But nobody went that
far. Only the recent Atlantic article on Quest touches that a bit.

------
wavesounds
If theres a silver lining to this pandemic hopefully it will make people
realize the importance of having competent leaders and institutions.

~~~
Zenst
Hypothetical question - If you had to pick a leader from anybody in the World,
from the entire history of humanity to lead in such a situation - who would
you pick and why?

~~~
tatersolid
Eisenhower. He steered us through the greatest catastrophe the world has ever
seen, and was wary of his own power.

------
jdkee
testing, testing, testing

------
IXxXI
Germany's numbers are as accurate as china's.

