Germany was super-efficient at containing the coronavirus first wave – so what's gone wrong?

·5 min read
Germany has hit 1m infections  - AFP
Germany has hit 1m infections - AFP

As Germany passed the grim milestone of 1million coronavirus infections on Friday, the lustre of its success against the first wave was somewhat faded.

In the spring, no major country in Europe was as effective at containing the virus, and Britain and others could only look on in envy. But the second wave has engulfed Germany along with the rest of Europe, and there is no more talk of a “German exception”.

Daily new infections peaked at 23,648 last week — fewer than the 33,470 recorded in the UK on Nov 12, and far fewer than France’s bleak Nov 7 record of 86,852.

But unlike in other European countries, where advances in treating the virus have resulted in fewer deaths, Germany has experienced a higher daily toll in the second wave.

It recorded its highest 24-hour toll since the pandemic began on Wednesday, with 410. The previous record, set on April 16, was 315.

Compare that to the UK figures and it is almost as if the roles have been reversed. Britain also recorded its highest toll of the second wave on Wednesday, with 695. But it saw 1,172 deaths in 24 hours on April 20.

So has Germany got its response wrong this time, or has the virus just caught up with it? In part, there may simply be more deaths this time because there are more infections, say scientists.

The rate of deaths per infection is far lower than during the first wave in Germany, as in the UK and elsewhere. 

But there are other underlying factors behind the change that have as much to do with what countries like the UK got wrong during the first wave as anything Germany is doing now.

“My impression is that the situation in Germany and Great Britain is currently quite similar in terms of infections and deaths — perhaps a little better in Germany, if you look at the seven-day incidence, which makes more sense than looking at the daily positive tests,” says Prof Hajo Zeeb of Leibniz Institute for Prevention Research and Epidemiology.

“There are no longer any major differences. The UK had bigger problems in the first wave, and has now been able improve a bit in terms of death rates. Germany did better in the first phase, but did not succeed in maintaining that over the summer.”

One thing the experts agree Germany got right in the first wave was test and tracing. While Britain was struggling to set up an effective system, Germany had its ready before the virus reached Europe and was remarkably effective at tracing chains of infection and containing them. 

But second time around, even Germany’s test and tracing system has been overwhelmed by the sheer number of positive tests. There simply aren’t the resources to chase every chain of infection.

Germany's test and trace system has been overwhelmed  - Getty Images Europe 
Germany's test and trace system has been overwhelmed - Getty Images Europe

German Chancellor Angela Merkel announced plans to recruit 100,000 new tracing staff in October, but that still wasn’t enough, and it was the crisis in contact tracing that prompted a new lockdown.

“We have to get the situation under control to the point where the local public health offices can trace contacts again — otherwise the exponential growth will simply spiral further upwards,” she warned earlier this month.

The Robert Koch Institute, Germany’s centre for disease control, points to another key difference from the spring. “There are now significantly higher numbers of cases than in the first wave, but the age groups affected are decisive. This time there are more cases among the elderly,” said a spokesman.

German virologists have always conceded they were lucky in one key respect during the first wave. The virus was largely brought to Germany by people returning from skiing holidays. That meant it initially infected the young, and the authorities were able to prevent it spreading to the elderly.

That is in marked contrast to the UK, where the fatal decision to send elderly people from hospital to care homes without testing was taken, allowing the virus to spread like wildfire among the most vulnerable.

Neither country has made so egregious an error during the second wave, but the sheer number of infections has meant Germany has been unable to prevent the virus spreading to the elderly.

But scientists caution that the dramatic difference in testing since the spring means it is difficult to be certain of the reasons behind the change in deaths.

“You cannot answer the question empirically, you can only make a guess,” says Prof Max Geraedts, an epidemiologist at Marburg University.

“You have to bear in mind that there around 350,000 tests a week during the first wave, while there are now 1.4m. 

“We don't really know that there weren't as many deaths during the first wave as there are currently, because we didn’t test as much, or investigate the deaths the same way.

“During the first wave, the majority of the infections came in clusters, while in the second wave there are more scattered cases. That could mean more people from high-risk groups are infected. One could speculate like this forever.”

One figure that does emerge is that despite the huge difference in the numbers being tested, the percentage of positive results is pretty much the same as during the first wave, at around 9 per cent.

Customers sitting in their cars receiving goods at a drive-in Christmas market during the second wave of the coronavirus pandemic in Landshut, Germany - Alexander Hassenstein /Getty Images Europe 
Customers sitting in their cars receiving goods at a drive-in Christmas market during the second wave of the coronavirus pandemic in Landshut, Germany - Alexander Hassenstein /Getty Images Europe

In terms of the government response, Germany has continued to rely on a relatively light touch. While the country has been back under a form of lockdown since the beginning of November, it is far less draconian than that seen in other European countries.

Restaurants, bars, gyms and places of entertainment are closed, but all shops remain open and Germans are free to leave their homes as much as they like.

A maximum of five people from two households are allowed to meet socially and non-essential travel around the country is prohibited.

Yet, strikingly, so far Germany has experienced no excess deaths compared to previous years during the second wave, whereas it saw a small excess during the first wave, according to the European Mortality Monitoring Project.

The UK, by contrast, saw a dramatic number of excess deaths during the first wave and is experiencing a smaller but significant excess in the second.

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