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Corona Fight: German Healthcare Model, considered lately to be the best one in the world

How did Germany maintain a low fatality rate despite a huge number of infected patients ?

GERMANY: The virus and the resulting disease, Covid-19, have hit Germany with force. According to the latest data on Worldometer, the country has 151,332 laboratory-confirmed infections as of Saturday morning, more than any other country except the United States, Italy, Spain & France.

But with 5,369 deaths, Germany’s fatality rate stands at 3.5% compared with 13.4% in Italy, around 10.4% percent in Spain, 13.5 % in France & UK, 5.6% in China and the United States.

The data clearly presents an anomaly as of how Germany, the country at 5th highest place in number of infected patients manages to maintain a very low death rate as compared to other countries. 

There are several answers experts say, a mix of statistical distortions and very real differences in how the country has taken on the epidemic.

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.

The Significant Factors of Germany Healthcare Model that have proved to be successful against the Pandemic Covid-19 : 

I.Tracking

On a Friday in late February, Professor Streeck received news that for the first time, a patient at his hospital in Bonn had tested positive for the coronavirus: A 22-year-old man who had no symptoms but whose employer — a school — had asked him to take a test after learning that he had taken part in a carnival event where someone else had tested positive.

In most countries, testing is largely limited to the sickest patients, so a person with no symptoms probably would be refused a test. But not in Germany. .

As soon as the test results were in, the school was shut, and all children and staff were ordered to stay at home with their families for two weeks. Some 235 people were tested.

Learning by their own mistakes and others’ experience

“Testing and tracking is the strategy that was successful in South Korea and we have tried to learn from that,” Professor Streeck said.

Germany also learned from getting it wrong early on: The strategy of contact tracing should have been used even more aggressively, he said.

All those who had returned to Germany from Ischgl, an Austrian ski resort that had an outbreak, for example, should have been tracked down and tested, Professor Streeck said.

II.Testing on a mass scale

In mid-January, long before most Germans had given the virus much thought, Charité hospital in Berlin had already developed a test and posted the formula online.

By the time Germany recorded its first case of Covid-19 in February, laboratories across the country had built up a stock of test kits.

“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 diagnosis,” 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.

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.

Corona virus Relief Bill for Free testing

One key to ensuring broad-based testing is that patients pay nothing for it, said Professor Streeck.  The coronavirus relief bill passed by Congress last month does provide for free testing.

“A young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people,” he said.

III.A Robust Public Health Care System

Before the coronavirus pandemic swept across Germany, University Hospital in Giessen had 173 intensive care beds equipped with ventilators. In recent weeks, the hospital scrambled to create an additional 40 beds and increased the staff that was on standby to work in intensive care by as much as 50 percent.

All across Germany, hospitals have expanded their intensive care capacities. And they started from a high level. In January, Germany had some 28,000 intensive care beds equipped with ventilators, or 34 per 100,000 people. By comparison, that rate is 12 in Italy and 7 in the Netherlands. By now, there are 40,000 intensive care beds available in Germany.

“We have so much capacity now we are accepting patients from Italy, Spain and France,” said Susanne Herold, a specialist in lung infections at the hospital who has overseen the restructuring. “We are very strong in the intensive care area.”

Higher health spending

Germany spent €4,271 (£3,744) per person on healthcare which was 11.1% of GDP  in 2016.

The UK spent €3,566 per person on healthcare which was 9.7% of GDP. The European Union average was 9.9% of GDP.

So, ultimately expenditure on healthcare directly or indirectly had an impact on the country in such a time of crisis.

IV.Trust in Government

Beyond mass testing and the preparedness of the healthcare system, many also see Chancellor Angela Merkel’s leadership as one reason the fatality rate has been kept low.

Ms. Merkel, a trained scientist, has communicated clearly, calmly and regularly throughout the crisis, as she imposed ever-stricter social distancing measures on the country. The restrictions, which have been crucial to slowing the spread of the pandemic, met with little political opposition and are broadly followed.

The chancellor’s approval ratings have soared.

“Maybe our biggest strength in Germany,” said Professor Kräusslich, “is the rational decision-making at the highest level of government combined with the trust the government enjoys in the population.”

Federal Political System

Federalism is useful for creating a dynamic business environment between different regions, but it can make it hard for an entire country to move in sync.

But Germany didn’t let it become a problem in its fight against the pandemic rather used it to benefit itself. Germany’s federal political system devolves power over large areas of health policy – including testing – away from central government to state level and below. And that has created more autonomy and flexibility, allowing private labs to start testing far more quickly than in the UK.

German public health services are provided not by one central authority but by approximately 400 public health offices, run by municipality and rural district administrations.

Such an environment allows for a variety of laboratories – some attached to universities or hospitals, others privately run, medium-sized businesses – which act largely autonomously of central control.

“I don’t have to wait to get a call from the health minister before I can go ahead with a test,” said Matthias Orth, of the Institute of Laboratory Medicine at Stuttgart’s Marienhospital.

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