Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 32 n° 220

A German Exception? Why the Country’s Coronavirus Death Rate Is Low

Posted by fidest press agency su giovedì, 9 aprile 2020

By Katrin Bennhold. They call them corona taxis: Medics outfitted in protective gear, driving around the empty streets of Heidelberg to check on patients who are at home, five or six days into being sick with the coronavirus.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.“There is this tipping point at the end of the first week,” said Prof. Hans-Georg Kräusslich, the head of virology at University Hospital in Heidelberg, one of Germany’s leading research hospitals. “If you are a person whose lungs might fail, that’s when you will start deteriorating.”Heidelberg’s corona taxis are only one initiative in one city. But they illustrate a level of engagement and a commitment of public resources in fighting the epidemic that help explain one of the most intriguing puzzles of the pandemic: Why is Germany’s death rate so low?
The virus and the resulting disease, Covid-19, have hit Germany with force: According to Johns Hopkins University, the country had more than 92,000 laboratory-confirmed infections as of midday Saturday, more than any other country except the United States, Italy and Spain.
But with 1,295 deaths, Germany’s fatality rate stood at 1.4 percent, compared with 12 percent in Italy, around 10 percent in Spain, France and Britain, 4 percent in China and 2.5 percent in the United States. Even South Korea, a model of flattening the curve, has a higher fatality rate, 1.7 percent.
“There has been talk of a German anomaly,” said Hendrik Streeck, director of the Institute of virology at the University Hospital Bonn. Professor Streeck has been getting calls from colleagues in the United States and elsewhere.
The average age of those infected is lower in Germany than in many other countries. Many of the early patients caught the virus in Austrian and Italian ski resorts and were relatively young and healthy, Professor Kräusslich said.“It started as an epidemic of skiers,” he said.As infections have spread, more older people have been hit and the death rate, only 0.2 percent two weeks ago, has risen, too. But the average age of contracting the disease remains relatively low, at 49. In France, it is 62.5 and in Italy 62, according to their latest national reports.Another explanation for the low fatality rate is that Germany has been testing far more people than most nations. That means it catches more people with few or no symptoms, increasing the number of known cases, but not the number of fatalities.“That automatically lowers the death rate on paper,” said Professor Kräusslich.But there are also significant medical factors that have kept the number of deaths in Germany relatively low, epidemiologists and virologists say, chief among them early and widespread testing and treatment, plenty of intensive care beds and a trusted government whose social distancing guidelines are widely observed.
“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,” said Dr. Christian Drosten, chief virologist at Charité, whose team developed the first test.
By now, Germany is conducting around 350,000 coronavirus tests a week, far more than any other European country. Early and widespread testing has allowed the authorities to slow the spread of the pandemic by isolating known cases while they are infectious. It has also enabled lifesaving treatment to be administered in a more timely way.“When I have an early diagnosis and can treat patients early — for example put them on a ventilator before they deteriorate — the chance of survival is much higher,” Professor Kräusslich said.Medical staff, at particular risk of contracting and spreading the virus, are regularly tested. To streamline the procedure, some hospitals have started doing block tests, using the swabs of 10 employees, and following up with individual tests only if there is a positive result.At the end of April, health authorities also plan to roll out a large-scale antibody study, testing random samples of 100,000 people across Germany every week to gauge where immunity is building up.One key to ensuring broad-based testing is that patients pay nothing for it, said Professor Streeck. This, he said, was one notable difference with the United States in the first several weeks of the outbreak. The coronavirus relief bill passed by Congress last month does provide for free testing. (font: The New York Times)

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