[BostonCard]

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.

I've seen that argument made several places, but I haven't seen any evidence that this is the case.  In fact, analyses of excess mortality in Germany (mortality above and beyond what would have been expected, which would catch COVID-19 related deaths that were attributed to something else) don't suggest there is a large number of deaths reported as being caused by something else that were really called by COVID-19.  Here are a couple of articles:

https://www.dw.com/en/coronavirus-german...a-53537500

Germany saw a slight increase in the average number of deaths in April, the Federal Statistics Office reported on Friday. April's death rate was around 5% more than the average number of deaths in April between 2016 and 2019....

"Excess mortality in Germany is low compared to other European countries," the statisticians reported. "Italy reports 49% more deaths in March 2020 than in the years 2015 to 2019, on average [...] Sweden reports twice as many deaths in the agglomeration area of Stockholm for weeks 14 to 16 [mid-April] as, on average, the five years before."

https://www.ft.com/content/a26fbf7e-48f8...5839e06441

Through May 24, the FT identified 9200 excess deaths in Germany.  Through May 24, Germany had reported 8,371 COVID-19 deaths, which is 90% of the excess deaths, which is within the error of the method of identifying expected mortality based on prior years at the same time.  Moreover, the gap is lower than it is in other European countries.  Also, excess deaths would include deaths due to other reasons (for example heart attacks) that were impacted by delay in seeking care either because of lockdown or fear of contracting COVID-19 in a hospital.

I conclude that German reports of COVID-19 deaths are a reasonably accurate reflection of the true number of deaths that occurred in Germany due to COVID-19, and that the idea that Germany was systematically mis-coding cause of death is either apocryphal or does not significant impact the numbers.

BC

[BostonCard]

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.

I've seen that argument made several places, but I haven't seen any evidence that this is the case.  In fact, analyses of excess mortality in Germany (mortality above and beyond what would have been expected, which would catch COVID-19 related deaths that were attributed to something else) don't suggest there is a large number of deaths reported as being caused by something else that were really called by COVID-19.  Here are a couple of articles:

https://www.dw.com/en/coronavirus-german...a-53537500

Germany saw a slight increase in the average number of deaths in April, the Federal Statistics Office reported on Friday. April's death rate was around 5% more than the average number of deaths in April between 2016 and 2019....

"Excess mortality in Germany is low compared to other European countries," the statisticians reported. "Italy reports 49% more deaths in March 2020 than in the years 2015 to 2019, on average [...] Sweden reports twice as many deaths in the agglomeration area of Stockholm for weeks 14 to 16 [mid-April] as, on average, the five years before."

https://www.ft.com/content/a26fbf7e-48f8...5839e06441

Through May 24, the FT identified 9200 excess deaths in Germany.  Through May 24, Germany had reported 8,371 COVID-19 deaths, which is 90% of the excess deaths, which is within the error of the method of identifying expected mortality based on prior years at the same time.  Moreover, the gap is lower than it is in other European countries.  Also, excess deaths would include deaths due to other reasons (for example heart attacks) that were impacted by delay in seeking care either because of lockdown or fear of contracting COVID-19 in a hospital.

I conclude that German reports of COVID-19 deaths are a reasonably accurate reflection of the true number of deaths that occurred in Germany due to COVID-19, and that the idea that Germany was systematically mis-coding cause of death is either apocryphal or does not significant impact the numbers.

BC