"In the short term at least, mass testing feeds through into a lower fatality rate because it allows authorities to detect cases of Covid-19 even in patients who suffer few or no symptoms, and who have a much better chance of survival. It also means that Germany is likely to have a lower number of undetected cases than countries where testing is less prevalent. Indeed, one notable feature of the coronavirus outbreak in Germany so far is the high number of relatively young patients: according to data from the Robert Koch Institute, more than 80 per cent of all people infected with the coronavirus are younger than 60.
“Especially at the beginning of the outbreak in Germany we saw many cases connected to people returning from skiing trips and similar holidays,” said Matthias Stoll, a professor of medicine at the University of Hanover. “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, a professor of medicine and the head of virology at the University Hospital in Heidelberg, said: “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.”
However, Prof Kräusslich cautioned that the picture in Germany was likely to change in the weeks and months ahead: “We are still at a relatively early stage in the outbreak in Germany. The overwhelming share of patients became infected only in the last week or two, and we will probably see more severe cases in the future as well as a change in the fatality rate.”
That note of caution is echoed by virologists and epidemiologists across the country. Most expect the different national case fatality rates to converge as time passes and more countries uncover the true number of infections. But experts also point out that Germany has at least had the chance to prepare for a surge in serious infections, with hospitals across the country expanding intensive care capacity and boosting staff numbers and the government buying up as much critical equipment as it can.
Last week, the federal government ordered an extra 10,000 life-saving ventilators from a German manufacturer, on top of the 25,000 that are already in place in hospitals across the country. The city state of Berlin, which has so far recorded 391 cases of Covid-19, is converting parts of the local trade fair ground into a 1,000-bed hospital for future coronavirus patients. Similar steps have been taken across the country.
“We are at the beginning, so we can still implement all the measures that have been called for,” said Prof Wieler. “We can still ensure that severely ill people can get treatment in the hospital.”