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Coronavirus: Why Germany’s death toll is so low

Christian Drosten, director of the Institute of Virology at Berlin's Charite hospital, poses after a press conference in Berlin on March 26, 2020, to comment the spread of the novel coronavirus in the country. (Photo by Michael Kappeler / POOL / AFP) (Photo by MICHAEL KAPPELER/POOL/AFP via Getty Images)
Christian Drosten, director of the Institute of Virology at Charite hospital, in Berlin, Germany. (Michael Kappeler/AFP via Getty Images)

Germany is the fifth most-affected country in the world, in terms of confirmed cases of coronavirus. As of Thursday 26 March, the number of confirmed coronavirus cases in Europe’s largest economy stood at 39,502, according to Johns Hopkins Coronavirus Research Center.

Yet despite tens of thousands of cases, Germany so far has reported 222 deaths from the virus, dramatically lower that the more than 7,500 in Italy and around 4,000 in Spain. This low fatality rate of 0.56% has attracted global attention and debate.

Christian Drosten, Institute for Virology director at Berlin’s Charité hospital, said that the low death toll from coronavirus is mainly down to extensive testing.

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"The reason why we have so few deaths compared to the number of infected people is because we do a lot of laboratory diagnostics," Drosten said at a press conference on Thursday. In Germany, over half a million coronavirus tests are currently being carried out every week.

Drosten was speaking at the launch of a new research network, a “national taskforce” that will pool the expertise of university clinics and scientists to collect data and speed research into understanding and tackling the spread of the virus. The government will back the network with €150m (£137m, $162m).

Making direct comparisons between national mortality rates can be misleading, not just because of recording lags and different methodologies on reporting cases and deaths, but also because of the extent of testing. The more aggressively a country tests for coronavirus, the more cases of mild infections will be found and recorded in the statistics, which pushes the fatality percentage rate down.

Read more: Angela Merkel’s first coronavirus test is negative – but remains in home quarantine

Various medical experts have attributed the low mortality partly to the fact that the first wave of coronavirus cases happened among younger people, many of whom had returned from ski holidays in other European countries, especially resorts in Italy and Austria, and recovered.

“These are predominantly people who are younger than 80 and who are fit enough to ski or engage in similar activities. Their risk of dying is comparatively low,” Hans-Georg Kräusslich, head of virology at the University Hospital in Heidelberg, told the Financial Times. “In most cases the illness is mild and shows few symptoms, and we assume that the detection of such mild cases varies from country to country. In statistical terms that leads to a difference in case fatality rates.”

Italy and Germany both have large ageing populations, but younger Germans tend not to live with or close to their families as is often the case in Italy, and this would also influence the spread of the virus to the elderly.

Germany’s coronavirus mortality rate may not remain this low: the Robert Koch Institute has warned repeatedly “we are only at the beginning” of the pandemic, and that the death toll can be expected to rise as more elderly people become infected.

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