UKH

Does anyone have any idea why Germany's death rate is so low compared to the number of cases?

What are they doing right that others, included us, aren't?

Columns are in order :-

1. Reporting Country/ Territory/Area†  
2. Total confirmed‡ cases   
3. Total confirmed new cases
4. Total deaths
5. Total new deaths
6. % Who Die

• Italy                                    86498    5959       9136    971  10.5%
• Spain                                 64059    7871       4858    769  7.5%
• Germany                           48582    6294       325      72    0.67%
• France                               32542    3756       1992    297  6.12%
• The United Kingdom         14547    2885       759      181  5.21%
• Switzerland                        12104    1390       197      36   1.62%
• Netherlands                       8603      1172       546      112  6.34%

Potentially testing more people who dont have severe symptoms would be my initial thought.

Testing 500000 a week seems to be something to do with it. But quite what I don't know. 

I don't know this but I think it is down to testing more people quickly and therefore the denominator of the equation is bigger but also I think those who tested positive and had mild or no symptoms were told to self isolate.

Another question is how were Germany able to test so many people? Where did they get the test kits and we could not? Or did we decide not to test until it became clear from many experts that we need to, in the words of Tedros Adhanom Ghebreyesus, test, test, test?

Guessing again I think the large numbers of those tested in Italy, Spain are those countries catching up with the virus, as we are.

  Dave

This is the rate of detected infections, not infections.  They appear to be running far more tests.  I wish I could find a summary different countries data by day, along with numbers tested per day to help interpret this.  Posters more knowledgable than me have said they think the higher testing in Germany has a lot to do with it.  The good news is this suggests fatality rate isn’t so high, and the better news is that it suggests to me the UK is detecting less than 0.1x to 0.3x the cases of Germany which puts us some weeks closer to burning through this than a pessimistic model would suggest. (Because our real infection rate would be at least 10x or 3x higher than detected/reported).

That‘a my best speculation

Agree with the others - they are testing more so their numbers of confirmed cases are proportionally higher.  In the UK, we aren't testing everyone with symptoms, so we are only confirming a small proportion of infections.

So in essence what you are suggesting is we have a massive amount of undetected cases? Because we're not testing so many.

Amazing what you can do with some planning and two months knowledge the train is coming.   My understanding is you can do this testing with the right primers and qPCR machines which are in research and forensic labs across the country.  The navy collected 7 from Newcastle uni on Monday to move to a testing centre in Milton Keynes.  They should have gone a month ago...  But in his briefing the other day the CMO only talked about rolling out antigen tests and not qPCR tests so I’m clearly missing something.

The death rates will be basically the same across any significant population Germans are not special. It's likely due to deaths against confirmed cases rather than deaths against all cases.

I think they do a lot more tests including people asymptomatic or with mild symptoms. UK doesn't test these groups much, thus we detect less of the cases of CV19. Therefore death rate (no. deaths divided by number positive for CV19) is higher.

Might only be part of explanation eg better treatment of severe cases in different countries. I'm no expert.

I think if you read the German press you might have a different view.

What's you thoughts then?

https://www.spiegel.de/international/germany/the-big-wave-of-corona-cases-w...

I do not think it is any different. Also I have read that the stats have no uniformity. There is concern over the fact that in a pandemic the numbers should be roughly the same so under reporting may be happening .

its really too early to say they are doing better/ worse etc etc 

That's what I was trying to suggest in my reply at 16:57.

It makes things a bit more scary though

My sisters A&E dept. have 30 staff off sick, with 3 confirmed CV, but I'm not sure they've all been tested, not sure they have a test available to them.

Probably something to do with eating all that currywurst mit pommes frites

The Germans might not be special when it comes to their susceptibility BUT 3x the hospital bed capacity and 5x the ICU bed availability helps (and this is scheduled to be doubled next week). The refugee arrival centre in my village is being converted into an isolation centre for 1500 and opens on Monday, we've been locked down for weeks, all available medical staff have been called up and the whole machinery is jerking into action at a speed not seen since the blizkried. It helps that where I live Bavaria) they declared a state of emergency weeks ago.

I don’t know but they have the word “hamsterkauf” for panic buying, which is great.

and even the wherewithal to airlift urgent cases from Italy - that's the sort of thing the Federation are imagined to be capable of in Star Trek!

Yeah this.

in comparison Italy are only testing the very ill patients.

if you were young and healthy in Italy and got a fever you’d be safer just staying in as it might not be CV anyway, and if it is you are likely going to be fine anyway.

My wife was on phone to a German relative last night. Relative lives on Baltic in Schleswig-Holstein. Said she could no longer visit Hamburg, about an hour's drive away, because of road blocks at Hamburg / Schleswig-Holstein border. Hamburg is a separate state. Don't know if other German states have road blocks at borders. Obviously don't know if this has an effect on casualties and deaths but it might be a factor.

[My wife visited her between 6th and 9th March this year. No restrictions then. EG. Attended concert in Cotton Club, Hamburg's oldest jazz club. Hard to believe this was only 3 weeks ago.]

And Coronaspeck is the weight you gain during self-isolation.

The main differences seem to be 

1) testing far more people so you have a truer figure for mild cases

2) testing early, treating early and better medical facilities than most

but there is also 

3) no post mortem testing on patients not previously identified

so, they are probably under reporting compared to other countries 

I can’t see how road blocks would affect the survival rate, but they should reduce the spread of the virus and give greater control. 
If the clampdown works, it would be good if the UK could return to normal region by region. 

You mean everyone doesn't have an aircraft kitted out with 6 ICUs? The French patients we took came by ambulance though as it wasn't far.

Yes, exactly.

Like the French - who are only reporting deaths that occur in hospital, another nice way of reducing the numbers....

You only need 1 asymptomatic person to slip the net and the whole thing starts again in a 'safe' region...

The main advantage of antigen testing kits is that they are like pregnancy tests.  You don't need any special equipment beyond the test kit itself, you can do them at home, they don't require expert personnel to administer them, and the results are more or less instantaneous.  For this reason, this is a better option to roll out for mass testing.

I imagine they won't be rolled out for unsupervised home testing like pregnancy tests because the whole point is to be sure that results are recorded to get a better idea of infection rates.  Depending on the sensitivity and specificity, they may be used as a pre-screening to identify candidates who should undergo a PCR test.

Yes, true, but I’m pretty sure that with a decent level of testing, or an effective treatment, they can’t possibly wait for a total all clear anyway

Looks like we are comparing like with like. I don't care for aneil but he usually has his facts right.

https://twitter.com/afneil/status/1244235433694973952?s=19

Lots of info here. Remember to scroll down. Germany on same track as Italy, Uk worse.

https://twitter.com/jburnmurdoch/status/1243998677863145473?s=09

I live in France and would agree... The French approach to this has been pretty terrible and the numbers they publish aren't worth the paper or cyberspace they are written on. 

I understand that Germany tests  almost all.suspect cases, hence their apparently lower death rate... Why can they get tests and the French can not... Even for hospital staff?  

It's actually the border into Schleswig-Hostein that's shut to keep tourists and second-home owners out as the health system there is only designed for the normal resident population, Mecklenburg-Vorpommern the same.

Also available at https://www.ft.com/coronavirus-latest, which is updated daily and is exempt from the usual FT paywall.

Great word 😃

Loving this one too!

This from newstatesman is interesting. 28000 icu beds set to double in comparison to our 4100, amongst other things.

https://www.newstatesman.com/world/europe/2020/03/why-are-germany-and-austr...

But since we are not yet full, that can’t be the explanation currently.

Does it say that? It was just an interesting point I pulled out, as is Germany expects similar mortality to elsewhere. 😊

Say what? 

The main issue with curves like these is that they have very little predictive value. They mainly show common growth rates in a relatively short phase of uncontrolled expansion. Then measures are taken and the curves will deviate from the predictions. The things we actually want to know such as "when will the curve saturate and at what value" are hard to predict.

I don't think Germany is on the same track as Italy. The main predictive item for the fatalities is the amount of cases. When Italy was at 400 deaths, its cases continued increasing approximately exponentially for another 10 days. Germany has been on an approximately linear increase in the last two weeks and this can be expected to be further reduced in the coming weeks as the results of the tighter measures should show up. So Germany is flattening the curve earlier than Italy.

Here is the timeline data for the German cases: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberi...

Note that the curve in the above publication shows more flattening than the curve in the FT data. This is because the FT plots the data of the cases when they were reported and the report plots the data of the cases at the start of the symptoms. And from the start of the symptoms to getting a test to having the result of the test can easily take 1 week.

Sorry, I must have misunderstood your previous reply. 

As far as I could see from that twitter he was only examining how deaths due to CV19 were confirmed and recorded in Germany compared to UK. IF UK is not recording as great a percentage of its CV19 infections as Germany (due to less testing) then UK could have more deaths per known CV19 infection. I may well have missed something however. 

Me too. It is getting late for my brain. 

Sounds right. 

well it could in part - ICU beds only good with ICU staff - take out a % with C19 and you start to degrade performance. If Germany has the staffing for those beds it will be more resilient

You're lucky. It's always too late/ early or the wrong time for my brain well according to my nearest/ dearest anyway bless them