Germany has been in the coronavirus news lately because of a study from a town, Gangelt, that tested 80 percent of its population (of 11,634) for the virus. The study found that the infection morality rate was about 0.3 percent. (See here for criticism of the study.)
Without wanting to discount this study, it may be worth noting that, since the early days of the pandemic, Germany has been reporting extremely low death rates from the virus. Last month, I wrote:
The one number that stands out to me is the death total in Germany. Right now, Germany has around 33,000 reported cases, Spain has about 42,000, and France around 22,000. Yet, Germany reports only 159 dead, compared to around 3,000 in Spain and around 1,100 in France.
According to a Washington Post chart, the death rate in Germany is 0.4 percent [note: this is consistent with the Gangelt study result]. This compares to 9.5 percent in Italy, 6.8 percent in Spain, and 4.3 in France. In the U.S., the reported rate is 1.3 percent.
The numbers from Germany continue to stand out. As of yesterday, Germany had about the same number of reported cases as France (approximately 130,000 cases). Italy had about 155,000 cases. Spain had about 165,000.
Yet, Germany was reporting only 3,022 deaths. France was reporting more than 14,000. Spain was reporting around 17,000 and Italy nearly 20,000.
Another way of looking at the numbers is to consider deaths per 1 million people. The German number is 36. The numbers for France, Italy, and Spain are 221, 329, 368, respectively. (In the U.S., the number is 67.)
France, Italy, and Spain all have more reported cases of the Wuhan coronavirus per capita than Germany, but this doesn’t come close to explaining the disparity in deaths from the virus. Only in Spain does the number of cases per capita more than double Germany’s. It does not come close to tripling it. In France, the number of cases per one million people is 2,031, compared to 1,526 in Germany.
What accounts for Germany’s extraordinarily low death numbers? One possibility is that Germany classifies deaths differently. There is no settled, universally applicable way to decide whether a particular death should be attributed to the virus. Maybe Germany is counting differently.
Another possibility is that those infected with the virus are receiving substantially better treatment in Germany than are their counterparts in France, Italy, and Spain. We know that Italy and Spain were swamped by this virus early, and that Germany wasn’t. We also know that Germany is wealthier than Italy and Spain. Maybe a disparity in the quality of treatment partially explains the disparity in deaths.
Is it also possible that Italy, Spain, and France have been afflicted by a more deadly version of the virus? One might question this explanation given the proximity of Germany to France (not to mention Belgium and Holland where deaths per capita are also much higher than in Germany). However, it’s also true that in neighboring Austria the per capita death number is almost the same as Germany’s and that in Poland, it is considerably lower (only six per one million), if its reporting is reliable.
I don’t quite know what to make of all this. The good news, though, is that the U.S. death numbers per case and per capita, though certainly worse than Germany’s, are not as wildly out of line with the German numbers as are the numbers from France, Italy, and Spain.