06-25-2020, 10:08 AM
(06-24-2020, 10:46 PM)BostonCard Wrote: It indeed does get old, because Germany has had a grand total of 9,996 deaths, or just over 1 death per 10,000 of its people; the US has over three times the mortality. Its seven day moving average of daily deaths is 11 total; we'd be thrilled to have a number 10 times as high. Germany has reopened shops, museums, churches, hair salons, and many schools. Very early on this board, a number of people here were wondering why the apparent case fatality rate from COVID-19 was so low in Germany. It's because they tested a lot more than fellow European countries and a lot more than the US. In the critical mid-March period where every day was critical, Germany had tested 30 times as many people per capita as the US. Goose will remind us that in some ways they were a bit lucky, and that is true (as you can read in the article I link below), but they also played the hand they were dealt well.
We have obviously been doing this too long! Yes, they were lucky to some significant extent. I also believe the death count is artificially low because the German health system generally reports the proximate cause of death (i.e. pneumonia) even when the patient is COVID-19 positive. Steps have been taken to correct that, but it can't back-correct the totals from the beginning. I totally agree the Germans played their hand very well, and I further believe that was due to very competent state health departments.
Quote:They knew where COVID-19 was spreading and were able to act accordingly. The US pretty much didn't, and only intervened when it was too late.True. Why did Germany know? First, their "State" health departments are fairly well resourced and staffed. They weren't strong enough or large enough to be a Taiwan or a Korea, but they were up to the task of doing enough surveillance testing (and even significant contact tracing) to determine that they would be overwhelmed. If one looks at the link posted by GR, you will see that Bavaria actually beat the initial infection. This is despite the fact the source of the infection was a "super spreader" who gave the disease to people that would not normally qualify as "contacts". However, when North Rhine-Westphalia and Berlin both started reporting lots of cases it was clear there was no hope of containment.
The test developed by Berlin Charité was probably not manufactured there. I don't know who did the manufacturing, but I am pretty sure it was an ad hoc effort. It might have been done by several groups. In any case, they did what was necessary to get it done. Probably didn't go through the contracts department. The USA by contrast relied on the CDC to manufacture the test. This was a known weakness from 2008 that was never addressed. First big difference. Second, our State public health services are nothing like the German ones in terms of prestige or competence. In the US, the concept of "poor doctors for poor people" comes to mind. Probably a bit unfair, but for sure these organizations are not nearly as proactive as the German ones. It is not just that the German organizations are larger, rather that it is considered an important part of the State's function.
The good data coupled with the respect and trust the state health departments provided the federal government a credible picture of the problem, which makes decision making significantly easier. It would still be possible to not "do the right thing", but for sure you would get lots of push back from the state health departments if you didn't. One great strength (and sometimes weakness) of the German political system is that it tends to defer to expertise (Ms. von der Leyen non-withstanding). The federal health system is a two track organization (as I understand it), sort of like the US GS system. However, in Germany, the "Technical Track" has lots of influence.
Quote:This article compares Germany's response to France's.BC, the VOX article is long on unsupported assertions and short on facts. It doesn't actually compare anything to anything. If one examines the timelines of the response in Germany one sees the states were leading the way in the middle of March (with the Federal government trying to slow them down a bit). Both France and Germany started a nationwide response at about the same time, as near as I can see. The Germans enforced theirs, the French didn't. I would argue the superior result in Germany was due to far superior testing and tracing coupled with universal compliance. Superior compliance is easier to obtain if you can show people the actual extent of the disease. The Germans could do that.
https://www.vox.com/2020/4/17/21223915/c...death-rate
The bottom line, "Germany followed the playbook for saving lives. France didn’t." At least France seems to have learned its lesson; it has driven its infection rate down to about 450 new cases a day (7-day moving average) and its deaths to 22.


