by Tom Chivers
Thursday, 14
January 2021
Spotted
15:46

What explains the Germany Covid surge?

Infection rates are soaring at a rate far higher than in the first wave
by Tom Chivers
Angela Merkel has been given credit for Germany’s response to the pandemic. Credit: Zick,Jochen-Pool / Getty

I wrote in October about the “German coronavirus mystery”. “Let’s get straight to the point,” I said. “About one in every 1,600 British people has died of Covid-19 since the first confirmed death in early March. Meanwhile, about one in every 10,000 Germans has.”

There were, I said, several factors, but that (pace the headline) there was no need to posit anything mysterious, any secret “immunological dark matter” or hard-to-interpret cultural factors. Instead, I said, “Germany was better prepared and reacted faster than Britain did, and in some ways got lucky, while making some mistakes of its own; it had a political system and, of course, politicians, which were better suited to the moment; and together, those factors added up to keeping several tens of thousand Germans alive.”

Now, though, things have changed. The second wave has been much harder for Germany; Germans are dying at more than three times the rate they were in the first wave. What’s happened?

Credit: Our World in Data

First, it’s worth noting a couple of things. Yes, Germany is doing worse than it did in the first wave. But it’s still doing better than Britain is in the second wave: our citizens are dying at 1.5 times the rate of theirs. It’s easier to do worse when you did so well the first time; it could simply be an element of reversion to the mean.

Credit: Our World in Data

Second, along the same lines, their cumulative number of deaths per million people is still less than half of what it is in Britain. Germany may be having problems, but they’re problems that Britain would love to have.

But there does seem to be a real change, and it is something that needs explaining. If it is just a reversion to the mean, that would suggest that Germany’s success the first time was significantly down to luck. It may be, too, that — like us, and many other places — they got complacent after the first wave went away.

I wonder if there’s something else going on as well. One reason Covid-19 is so out of control here is because of the new variant, which seems to spread about 50% better than the old form. But the UK is in a uniquely lucky situation, in that it knows about it.

Britain genuinely leads the world at sequencing the viral genome. Something like 60% of all Covid genetic sequencing worldwide was carried out in the UK. More than that, we got lucky that the new variant happened to have a mutation in exactly one of the three spots on the genome that our PCR tests look at. We simply have a better picture of what various Covid subtypes we have going around.

It may be that Germany has a lot more of the new variant than it realises, and therefore the policies and preparedness that kept a lid on the last wave just aren’t quite effective enough this time. The German government apparently thinks that’s a possibility too, since they’ve ordered a huge improvement in sequencing rates.

Whether that’s the explanation, or part of the explanation, I don’t know. But however you look at it, you’re still twice as likely to have survived the last 12 months if you lived in Germany than if you lived in Britain.

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Richard Pinch
Richard Pinch
1 year ago

But however you look at it, you’re still twice as likely to have survived the last 12 months if you lived in Germany than if you lived in Britain.

Well, the way I look at this is that it’s nonsense. Your chance of surviving the last 12 months if you lived in England was 99%. Whatever the rate in Germany was, it can’t have been twice that!

7882 fremic
7882 fremic
1 year ago
Reply to  Richard Pinch

wonderful post!

Mark Stahly
Mark Stahly
1 year ago
Reply to  Richard Pinch

If 99% survived in Britain and 99.5% survived in Germany that’s twice the survival rate of Britain isn’t it? If that 1% dead in the UK is 100,000 people. I suspect the 50,000 that are still breathing in Germany won’t appreciate your mathematics.

Tom Graham
Tom Graham
1 year ago
Reply to  Mark Stahly

No it isn’t, it’s 1.005 times the survival rate.

Raymond C
Raymond C
1 year ago
Reply to  Richard Pinch

He was probably a remainer who overshot himself.

Tom Fox
Tom Fox
1 year ago
Reply to  Richard Pinch

WE Brits had a 99% chance of surviving and they had a 99.5% of surviving. THAT is the way to look at it.

Mark Luterra
Mark Luterra
1 year ago

I normally trust UnHerd to avoid the doom-laden language mistakes that plague mainstream media.

In that vein, it is not at all true that Germans are twice as likely as Britons to have survived the last 12 months. The chance that someone alive 12 months ago is alive today is very close to 99% in both nations. Neither is the converse true: that Britons are twice as likely as Germans to have died in the last year. Statistics would seem to show a slightly higher population-level death rate in Germany (11.3 per 1000) than in the UK (9.4 per 1000), which likely represents population age structure more than anything else.

The only thing that can be accurately said is that one’s chances of dying of COVID-19 in 2020 were twice as high in Britain vs. Germany, but that needs to be put in the context of overall mortality rates if one is going to draw conclusions about the relative safety of living in different nations.

Quentin Vole
Quentin Vole
1 year ago
Reply to  Mark Luterra

The substantially greater population density in the UK probably plays its part, as well. Germany doesn’t have anywhere comparable with Greater London.

Roger Inkpen
Roger Inkpen
1 year ago
Reply to  Quentin Vole

That’s an urban myth. If you look at this map of population density, Cities in Germany are just as densely populated as London if not more so. And much more than your average UK city. London has a lot of heavily populated areas spread over a wider area.

If still you think London is densely populated, take a look at Barcelona!
Just google: EU Population 2011 by 1km grid v3

Tom Fox
Tom Fox
1 year ago
Reply to  Quentin Vole

This is true, and we have amazing levels of obesity here. I was getting a bit tubby a year ago. I lost 20 pounds in three months. Fortunately since I am seventy in three weeks, I have been sent an appointment for a vaccination. I will certainly make sure I am there on time with my sleeve rolled up?

Tom Fox
Tom Fox
1 year ago
Reply to  Mark Luterra

Yes it is near 99% but you are ignoring that the Germans have a 99.5% chance while we have a 99% chance. This translates into more than 50,000 MORE dead people here than in Germany. One ought if one is at all interested in reality try to avoid confirmation bias – the seeking out of information which confirms what you want to think and ignoring or dismissing information which doesn’t match with the way you’d like things to be.

Try to envisage 50,000 EXTRA dead people. It isn’t a pretty site. One of my neighbours the other day, a particularly stupid man, cheerfully said that he didn’t care because they were all old people and ‘ethnics’. He is a classic candidate to die of covid-19 complications himself. I shrugged and walked away.

David Slade
David Slade
1 year ago

To start on a pedantic point, I don’t think the doubting way the author puts quotation marks around imunological dark matter is very sensible and makes me less inclined to lend much credence to his conclusions. Some form of pre-existing immunity is the only thing that feasibly explains the large differences in mortality between Western and far Eastern populations with similar age profiles and varried suppression measures (to say nothing of why humanity is not rendered near extinct with every pathogen we encounter). Plus ‘dark matter’, whilst physicists don’t know what it is, it is undoubtedly there.

Germany’s worse outcome may be down to the onset of winter and the obsession with testing everyone for a virus – in the community and hospitals – and attributing all illness to a positive result. Add this to protocols which mean you have less hospital beds due to social distancing and less staff due to isolation (courtesy of the aforementioned testing obsession), and it’s no wonder everyone is struggling.

Germany’s better outcome in Spring may be down to the severe flu season she just had (ok – don’t get triggered lockdown lovers, that is a conclusion of Ivor Cummins -but you can check the data yourself).

Whatever, I don’t know why natural explanations for the trajectory of this virus are dismissed as unscientific, and only the hubristic explanation that herein lies the actions (or omissions) of man is the only thing considered ‘science’.

I expect an explanation more palatable to the current crop of commentators would be that Germany is in the EU and ‘science’ shows the virus stays away from supranational bodies run by politicians journalists approve of.

I must have missed that bit in science classes.

Dilia Regnier
Dilia Regnier
1 year ago

I can read doomsday prose about COVID literally anywhere else. I live in Germany and we are being accosted by numbers without any of the necessary context screaming at us from all media outlets all day every day. I am so sick of it and somehow can’t believe I am reading the same kind of thing on unherd. Wasn’t there supposed to be something about not running with the herd on this site? Well guys, this utterly pointless article is not how you do it. Cheers.

David Bouvier
David Bouvier
1 year ago

You really need to change your embarrassing ending: You are NOT “twice as likely to have survived
the last 12 months if you lived in Germany than if you lived in Britain.”

99.95% of Germans and 99.88% of Brits are still alive.

Being German gives you 0.07% greater chance of being alive, not a 100% greater chance of being alive that a Brit.

You absolutely ARE about 2.3 times more likely to be dead.

If you want to write about risks you need to learn how to understand and present absolute and relative risks properly.

Frederik van Beek
Frederik van Beek
1 year ago

Blablablabla. Johan Giesecke said it before me: ‘some countries do this and some do that’ In the end the virus doesn’t give a f*k. Nobody knows why some countries ‘do better’ than others. Chances are very big it has almost NOTHING to do with current policies. The first half of 2020 in Sweden still stands as that famous black monolith in front of Tom’s face. Monkey see monkey do.

7882 fremic
7882 fremic
1 year ago

Blablablabla, excellent summation. If he discounts the ‘Dark Matter’ immunity how does he explain China, 3 deaths per million, and the entire region the same? Maybe he should use them and his 4 points instead of Germany to enlighten us. But I do think it was Germany just being so sanitary, having lived in Germany and Italy, and UK, and the ME, and USA, it does seem to reflect the cultural sanitation of the people if they have other factors similar.

Eva Rostova
Eva Rostova
1 year ago
Reply to  7882 fremic

SARS planning and preparation in Asia?

7882 fremic
7882 fremic
1 year ago
Reply to  Eva Rostova

Yes, 20,000 years of planning, by being in an area with covids endemic and so acclimatizing to them. Like the Westerners going to the new world and causing a genocide by our illness they had no resistance to, so China has done to us, but on a much smaller scale, but same principal.

Dave Tagge
Dave Tagge
1 year ago
Reply to  7882 fremic

I doubt that “cultural sanitation” of Germans is a satisfactory explanation.

Search for “German annual flu deaths”, for example, and look at reports from sources such as the Robert Koch Institute. (I’d post links, but that triggers moderation.) Germany experiences per capita seasonal annual flu deaths that seem broadly in line with other Western nations, so they do have significant spread of other respiratory viruses.

Colin Elliott
Colin Elliott
1 year ago
Reply to  7882 fremic

My impression, too, is that Germany is culturally clean, although ‘statista’s’ charts show it only slightly better than the UK at hand hygiene.
There are fewer densely populated areas, with many non-indigenous people, than in the UK.
Finally, I’ve noticed that Germans tend to respect conventions more, such as cleaning stair wells, or not walking on the grass. (I often feel conspicuous in the UK when I take a few steps more to follow the pavement rather than the short cut worn across the grass.)

Eva Rostova
Eva Rostova
1 year ago

Australia? New Zealand? South Korea? Taiwan?

Dave Tagge
Dave Tagge
1 year ago
Reply to  Eva Rostova

An island with enough warning to keep SARS-CoV-2 largely out of the country is perhaps an exception to this rule.

The last two of these are also among the East and Southeast Asian countries that have all experienced very low COVID fatality rates, despite differences in response strategies and age demographics. Freddie Sayers wrote a post last month called “What really explains the Asia Covid exception?” discussing a few theories of possible biological factors, none of which have been proven at this point.

tkreider2030
tkreider2030
1 year ago
Reply to  Dave Tagge

A paper published in summer shows that Asia has been notably more exposed to coronavirus and that occurred between 5,000 and 25,000 years ago.

Fiona Cordy
Fiona Cordy
1 year ago
Reply to  Dave Tagge

I can only echo what you say, Dave. It is so frustrating when people bring up Australia and New Zealand, as well as suggesting that the only reason for the South Asian figures is good governance and well-behaved citizens.

Eva Rostova
Eva Rostova
1 year ago
Reply to  Dave Tagge

Certainly seems likely that Asia’s superior SARS preparation played a big role.

I think an argument can be made for “all” or “nothing” strategies, i.e. once the virus is widespread there are no overall good outcomes in terms of economy, public health, education, welfare etc. Meaning that in the absence of immediate draconian action to prevent the virus from ever taking hold, any subsequent government interventions are merely allocating where the greatest burden in society falls without really mitigating the inherently negative effects of a pandemic viewed holistically. In this sense, the UK/European approach of “lockdown one week, crowd bars and restaurants the next”, may be the worst of all worlds.

However, a big/more interesting question to my mind is the counterfactual “what if the UK had gone for Australian-style full suppression in the summer?”, when infection levels were low, rather than opening up and more or less acting as if Covid was over (a view encouraged by UnHerd’s beloved and consistently wrong epidemiologists such as Giesecke).

The UK is an island and in the summer had similar levels of infection to Australia, but suppression strategy was only attempted in the latter. We shall see what happens in Australia, but it seems we would be better off on pretty much all metrics other than civil liberties in the short and long term had we been able to suppress à la Australia. The question for scientists is whether it would likely have been feasible given epidemiological conditions in the UK at the time. Would have involved closing borders of course.

Bob Sleigh
Bob Sleigh
1 year ago

Are deaths from/with covid being counted in the same way in the two countries?

Victor Newman
Victor Newman
1 year ago
Reply to  Bob Sleigh

No. Germany and Austria are only counting those who die of CV19 as covid deaths (15%), excluding those expiring due to comorbidity (85%) with CV19. We are counting BOTH/

tkreider2030
tkreider2030
1 year ago
Reply to  Victor Newman

I don’t think this is correct although have read that Germany counts deaths more conservatively than the U.S., which changed its guidelines in March on how to fill out a death certificate. Can you put up a link that supports your claim?

I have read that with PCR testing Germany is testing at the low end of the recommended 25 to 32 magnification cycles whereas many states in the U.S. put the cut-off at 37 to 40 cycles, thereby picking up tons of RNA fragments and still calling them “cases.”

neilyboy.forsythe
neilyboy.forsythe
1 year ago

Is the UK’s compulsion with painting the worst possible picture of itself a factor?

Alex Lekas
Alex Lekas
1 year ago

Who is dying in Germany? Everywhere else it has been the elderly and those with other health issues. Respiratory viruses always rear their heads this time of year so the rise in infections shouldn’t be a surprise, leading back to the deaths. The fixation on artificial comparisons between one country and another don’t add very much, either.

TIM HUTCHENCE
TIM HUTCHENCE
1 year ago

Pretty rubbish really Tom. Because of the difference in classifying deaths between European countries Covid death number comparisons are problematic. France, for example excludes people dying at home from its Covid numbers. Italy’s ‘with’ Covd deaths could be 25,000 higher according to the NHI. As reported in the Sunday Times last weekend, Italy noted 27,000 more excess deaths than Covid deaths (84,000 vs 57,000 from February to the end of November). As the NHI report highlights, one has to look at some sort of excess ALL deaths metric if we really want to understand what’s going on. Without an understanding of proper numbers, your ‘analysis’ is the sort of middlebrow mush that we see on TV every day and adds nothing.

Jordan Flower
Jordan Flower
1 year ago

I’ll tell you what happened: the plebs and civs did not obey well enough and lockdown measures weren’t strict enough. The blame for these things can never be placed at the feet of policy or even nature itself. It’s always the fault of society. So stop forsaking your social duty, peasants, and do your part. You’re literally killing people every time you exhale.

Dave Tagge
Dave Tagge
1 year ago

“But however you look at it, you’re still twice as likely to have survived the last 12 months if you lived in Germany than if you lived in Britain.”

No, you’re most certainly not.

I hope that Mr. Chivers understands how his phrasing is wrong. We all make mistakes, and this strikes me as the type of error that he appropriately criticizes when it’s made by other commentators.

For someone to be “twice as likely to have survived the past 12 months in Germany than in Britain”, that would require that at least 50% of the British population has died in the last 12 months. That obviously – and thankfully – isn’t the case.

In fact – going by Worldometer #’s as of January 14 – the UK has reported COVID deaths totaling approximately 0.13% of its population. Germany’s reported figure is approximately 0.054%, somewhat less than half of that.

So – ignoring other reported causes of death for this overly simple analysis – the comparative figures simply for “chances of having survived COVID” are 99.87% in the UK compared to 99.95% in Germany.

Adrian Smith
Adrian Smith
1 year ago
Reply to  Dave Tagge

There is also the issue that if you lived in Germany you would have to put up with the Germans – I quite like the Germans in small doses but it is very easy to have too much of them. My idea of hell would be to be locked down with a group of Germans.

Clem Alford
Clem Alford
1 year ago

I am 75 and have been wating 10 months for tests for my heart, kidneys and lungs. The appointments were all cancelled or postponed due to the Covid virus.
So, I just sing this little ditty, ‘if the virus don’t get you, the hospital cancellations will.’

Fiona Cordy
Fiona Cordy
1 year ago

Only excess deaths can count in any comparison but even these can’t be relied on because who knows how they may have been affected by side effects of lockdown: excess stress, not being able to get medical attention, not to mention suicide. Early on, it was suggested that because a major source of German infection came from ski resorts, the vaccine spread overwhelmingly in the young. Also, I don’t believe that Germany made the huge mistake of discharging old people with Covid into care homes, which has been a significant factor in both the UK and Sweden.

Go Away Please
Go Away Please
1 year ago
Reply to  Fiona Cordy

Yes, excess deaths over the previous 5 or whatever years average is a measure. The best measure would be excess deaths with lockdown versus excess deaths without lockdown, which is a bit difficult to get to.
But it’s the only way of really working out if lockdowns worked or didn’t.
To be fair if we just look at our UK excess deaths and see they aren’t that high it might signify that lockdowns worked (rather than what most people who think lockdowns should never be considered would conclude which is they don’t work and that really can’t be a sensible conclusion under the circumstances).

Jeff Andrews
Jeff Andrews
1 year ago

Because Germany, Drosten, insisted on the fake PCR test, they’ve got to cook the books as well as Boris.

Andrew Thompson
Andrew Thompson
1 year ago

This reads like its written by a perpetually angry remainer having a knock at Boris to me.

Fiona Cordy
Fiona Cordy
1 year ago

Absolutely nothing to do with Remain. (And by the way, we don’t exist any more by that name.) It is possible to have opinions about different matters that don’t coincide with the herd, don’t you know?

David McKee
David McKee
1 year ago

“Whether that’s the explanation, or part of the explanation, I don’t know.”

That has to be the sanest thing I have read about the Covid pandemic so far. Shock, horror! An observer who is not gifted with second sight, so he can unerringly pronounce who is at fault and why. Maybe he should have borrowed one of the crystal b***s the Remainers used, when they gave their preternaturally precise insights into the future.

Admitting one’s ignorance is not a sign of weakness, it’s a sign of strength. Well done, Tom, for having the guts to write that.

Derek M
Derek M
1 year ago
Reply to  David McKee

True, but then again why write the article

7882 fremic
7882 fremic
1 year ago
Reply to  David McKee

China is at fault.

Fiona Cordy
Fiona Cordy
1 year ago
Reply to  David McKee

Once again, please stop equating the two issues. Don’t be part of the herd. But if you really want to talk about crystal b***s, you just need to look at the news to see how the ‘Remainers’ are proving right.

Tom Graham
Tom Graham
1 year ago
Reply to  Fiona Cordy

The remainers were sure right that the EU would be well ahead of the UK in obtaining and administering the coronavirus vaccine to it’s people.

Pete Rose
Pete Rose
1 year ago
Reply to  David McKee

I’ve got no problem with those who voted Remain in the EU referendum, as everyone has a right to vote in whatever way they choose. It’s the evangelical anti-democratic Returners that people should be wary of.

Eva Rostova
Eva Rostova
1 year ago

Like pretty much everywhere across Europe in the summer (when we more or less acted as if Covid was over), Germany’s population underwent a big change in behaviour after the caution of the first “wave”, with e.g. professionals returning to their offices and bars/restaurants open, as well as flying off on vacation etc etc. (Take a look at German mobile phone mobility data and other metrics.)

Of course, there could be virological reasons i.e. a more contagious mutation, but it seems reasonable that a lack of social distancing over the summer and autumn could just as likely be an explanation for the big increase in infections now.

Amid all the noise over “what works/doesnt work”, worth remembering the fundamental fact that it is impossible for viruses to spread if we are sufficiently distanced.

stevewhitehouse62
stevewhitehouse62
1 year ago

its a virus and will mutate like a cold..good luck with that u finger pointing idiots

Adrian
Adrian
1 year ago

Actually, looking at the graphs you realise how lucky the UK was.

Both the UK and Germany first got the virus at the end of the Winter season.

Since the virus spread slower in Germany, when cases started to fall they looked far better. Coming into Winter, it’s not such an easy task to pull off.

TIM HUTCHENCE
TIM HUTCHENCE
1 year ago

Possible factors to consider in comparing Covid success/failure. Alongside criticism of (lack of or slow) government interventions.
Caveat – the final whistle has yet to be blown on this match – my guess is we’ve just started the second half.
And there maybe more to add to the list.
1. BMI rates – UK is a more obese country generally than most. Obesity alongside Covid (or indeed any disease) is not a good combination.
2. Tourism and border – January is always a peak month for travel between China and Europe and the US and regular flights (>3 per week to each destination) continued to run from Wuhan to London, Paris, Rome, New York etc throughout January and early Feb. See also Belgium (EU HQ etc.). Do Germany and Norway, for instance, welcome the same amount of overseas visitors in these months?
3. Deaths in 2019 – lower than normal (dry tinder effect)?
4. Age profile of population
5. Population density
6. Prior immunity e.g. from SARS 1
7. Early take up of mask wearing in shops etc.
8. Compliance to government interventions.

Henry Longstop
Henry Longstop
1 year ago

Commentary on this article
highlights the apparent confusion between ‘relative risk’ (of mortality between UK and Germany), and ‘absolute risk’.
For those who are interested in this statistical conundrum Peter Doshi addresses a similar problem in the BMJ with the claimed 95% efficacy of the Pfizer vaccine in Trials.
I’m no statistician so so forgive me if I can only offer the reference.

https://blogs.bmj.com/bmj/2

To paraphrase the old adage:-“…lies, damned lies, and statistics”.

stevewhitehouse62
stevewhitehouse62
1 year ago

let the deaths continue