Behind Germany's Relatively Low COVID-19 Fatality Rate

Mar 25, 2020
Originally published on March 25, 2020 7:03 pm
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As the coronavirus pandemic continues to sweep through Europe, a figure that has some scratching their heads is Germany's low death rate. In Italy, the fatality rate from the virus is around 10%; in France, 5%. But in Germany, only a tiny fraction of people with the virus have died - just 0.5%. NPR's Rob Schmitz explains why.

ROB SCHMITZ, BYLINE: As confirmed cases of coronavirus in Germany soared past 10,000 last week, this was the scene at a park in Berlin.

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SCHMITZ: Hundreds playing soccer, basketball; kids on jungle gyms - conditions that seem ideal for the spread of coronavirus. Yet Germany's fatality rate is so far the world's lowest by a long shot.

CHRISTIAN DROSTEN: I believe that we are just testing much more than other countries, and we are detecting our outbreak early.

SCHMITZ: Christian Drosten is director of the Institute of Virology at Berlin's Charite hospital. He and his team developed the first COVID-19 test for public use outside China. Drosten estimates Germany has tested around 120,000 people a week for the last month, far more than countries in the rest of Europe and even Asia. As a result, German health officials know more about the true fatality rate of COVID-19. But it also suggests Germany has yet to suffer the same level of infection as Italy or Spain, where the number of undetected cases of coronavirus are likely quite high. So why has Germany tested so much?

DROSTEN: We have a culture here in Germany that is not supporting a centralized diagnostic system. So Germany does not have a public health laboratory that would restrict other labs from doing the tests.

SCHMITZ: In other words, Germany doesn't have an equivalent of, say, the U.S. Centers for Disease Control and Prevention that's calling the shots on testing for the entire country. Germany's 16 federal states make their own decisions on coronavirus testing because each of them is responsible for their own health care systems. Drosten says that's meant quicker, earlier and broader testing for COVID-19 in Germany.

Lothar Wieler is head of the Robert Koch Institute, Germany's federal agency responsible for disease control and prevention.

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LOTHAR WIELER: (Speaking German).

SCHMITZ: "We don't know exactly how many unknown cases there are," he says, "but we estimate that this unknown number is not very high."

But not everyone is as confident as Wieler. Berlin resident Nizana Brautmann says she was worried when a teacher at her son's school tested positive for COVID-19 and, a day later, she and her son woke up with fevers and coughing. She says it took her hours to get a human on the line.

NIZANA BRAUTMANN: And I told her, I think we need to be checked because we have some symptoms. The lady was just saying, we make no tests here. I can't help you. I would advise you to stay home and drink tea.

SCHMITZ: A doctor she spoke to told her to wait in line outside a local hospital to get tested. But she didn't have masks, so she stayed home. She and her son are now in good health, but she says the episode left her wondering how prepared German society is for this pandemic. Virologist Christian Drosten says that may have happened in Berlin, but it's probably an exception, not the rule.

DROSTEN: My feeling is that, actually, the supply of tests is still good. And of course, our epidemic is now also very much up-ramping, and we will lose track here, too.

SCHMITZ: Drosten says the growing number of cases in Germany will soon exceed testing capacities. But for now, he thinks the country has had a robust response to the coronavirus pandemic. He's most worried about countries in Africa who aren't well set up for this - countries that, once the crisis comes to them, will find it more difficult to flatten the curve.

Rob Schmitz, NPR News, Berlin.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.