CNBC is looking at how places around the world have tackled Covid-19. By talking to a wide range of experts, as well as everyday citizens, we’re taking stock of what’s gone well â and what hasn’t.
Germany has confirmed more than 200,000 cases of Covid-19 and more than 9,000 deaths in a population of more than 83 million. Germany’s mortality rate per 100,000 is among the lowest in Europe. By way of comparison, the U.S., with about four times the population, has had more than 3.8 million cases and 140,000 deaths.
What went really well
A women walks past street art painted by artist Kai ‘Uzey’ Wohlgemuth featuring a nurse as Superwoman on April 14, 2020 in Hamm, Germany.
Lars Baron | Getty Images
Germany, like many other countries, had a contingent of people who fought lockdowns and argued that Covid-19 was a hoax. But it also had a handful of prominent scientists communicating regularly and openly with the public. That played a huge role in drowning out rumors and misinformation, locals tell CNBC.
“We have a great educational system and everyone has access to it,” said Dennis Traub, a tech worker in Hamburg, Germany. “So I believe that many people and the majority listened to both sides and one of those sides sounded much more reasonable.”
Christian Drosten, Director of the Institute of Virology, speaks about the novel coronavirus 2019-nCoV, February 13, 2020.
Britta Pedersen | picture alliance via Getty Images
On the side of science, virologist Christian Drosten grew his podcast, “Das Coronavirus-Update” to millions of followers in the early days of the pandemic. Drosten is now a cult icon in Germany akin to Dr. Tony Fauci in the United States. He doesn’t dumb down the science. Instead, he shares complex ideas in an accessible way and gets real with the public about aspects of the virus that are not well understood. In addition to that, the public regularly hears from the (now very well-known) Minister of Health Jens Spahn, as well as Germany’s chancellor, Angela Merkel.
In April, Merkel drew from her own science background by walking Germans through the basic reproductive number (the “R0”) — a mathematical term that indicates how contagious a virus is — as a way to instill confidence in lockdowns.
Moreover, Germans say their children got educated on the coronavirus via popular television shows like “Die Sendung mit der Maus” (Germany’s equivalent to “Sesame Street”).
Germans say the guidelines now are clear.
“If you have a set of rules that are communicated well, people don’t feel like they’re on their own,” said Florian Otto, a German health tech entrepreneur who co-founded the payments start-up Cedar. “And when people know what to do, they encourage each other.”
Hospitals weren’t overwhelmed
Hospitals in Germany were not overwhelmed by Covid-19. That meant doctors could even treat patients from neighboring countries, including Italy and Spain, where critically ill people were airlifted in.
How did that happen? Well, in March, Germany’s hospital system started freeing up intensive care beds and pushing back elective surgeries to make space for a potential flood of Covid-19 patients. Many hospitals also shared data with a federal website to map out their supply chain needs relative to other facilities. “The website is (now) a live-dashboard of all available ICU beds in participating hospitals Germany wide,” said Niklas Rindtorff, a medical student in his final year of studies in Heidelberg, Germany, who also has a background in medical informatics.
Hospital doctors are instructed how to operate a ventilator at the Universitaetsklinikum Eppendorf in Hamburg, on March 25, 2020.
Axel Heimken | POOL | AFP | Getty Images
Germany also built out extra intensive care facilities just in case.
“After the collapse of the hospitals in northern Italy, the German government built up additional capacities in the intensive care units,” said Uwe Frers, an entrepreneur based in Berlin. “This was the right step, even if the capacities were ultimately not needed.”
Some experts believe that Germany’s high-quality intensive care — as well as its focus on testing — helped reduce the mortality of the disease in the country. Germany has one of the highest numbers of coronavirus cases, but relatively few citizens died compared with other European nations. Some experts are even referring to the phenomenon as the “German anomaly.”
Mental health support
After sheltering in place, many Germans were encouraged to exercise outdoors as long as they were able to keep their distance from others. There was also a concerted effort to encourage Germans to stay in contact via Skype or Zoom, so people wouldn’t feel lonely or isolated.
“There was a big campaign around mental health,” said Dr. Sandra Kamping, a psychologist based in Hamburg.
“Here people could go outside even during lockdown for a walk or a bike ride,” added Carlos Barragan, an IT worker based in Germany.
Nurse Sylke Pflugmacher takes a sample at a testing point for medical staff members at the community hospital in Magdeburg, eastern Germany, on April 16, 2020 during the novel coronavirus COVID-19 pandemic.
Ronny Hartmann | AFP | Getty Images
Access to doctors
Germany is known for its strong network of family practitioners, who are typically the first point of contact for accessing health care.
“There is very low barrier to entry to see a high-quality doctor,” said Christian Dierks, a lawyer focused on medicine who runs an innovation consultancy firm in Berlin. “Sick leave is also very easy, and you can take time off from work to see your doctor.”
Because of that, some locals say, citizens were able to access some routine care and get advice if they were experiencing symptoms of Covid-19. In some cases, they were told to stay home while others with more serious symptoms were referred to the hospital. That might have helped Germans navigate to the right place.
The Merkel effect
German Chancellor Angela Merkel adjusts her protective mask on her way to a Bavarian state cabinet meeting at Herrenchiemsee Island, Germany.
Peter Kneffel | Pool via Reuters
Many Germans agreed that Merkel, whether they support her politics or not, had the right brand of leadership during the pandemic. A scientist by training, Merkel provided data-driven updates to the public and deferred wherever possible to those with more expertise than herself.
She isn’t exactly known for her empathy, which can be a hallmark of good science communicators, but she makes up for it in other ways. Rindtorff noted that she has a particular brand of what Germans refer to as “Sachlichkeit,” meaning objectivity. Rindtorff, who has lived in the United States, said that many Germans pride themselves on being extremely fact based and cautious, so her approach resonated with them.
What went OK
States making their own decisions
In Germany, the federal government and the states haven’t always agreed about the right next steps during the pandemic. In some ways, that lack of consistency isn’t helpful. But others point out that it’s also an opportunity to share lessons learned:
“Germany’s federal system gives the individual states a very high degree of freedom in choosing the means of overcoming the crisis,” said Frers. “On the one hand good for learning from each other, on the other hand critical when quick decisions have to be made on a large scale.”
Citizens walk at the pedestrian zone in Guetersloh, western Germany.
Ina Fassbender | AFP | Getty Images
Ramping up testing
Germany is considered ahead of most other European countries when it comes to testing. It very quickly ramped up drive-through testing via nasal swabs and, according to the BBC, carried out more diagnostic swab tests than any other major European country.
It may still not be enough as the country reopens — a point that the local press have emphasized — but it’s better than most. “We are very good in testing because we have a centralized but still coordinated testing system,” said Christian Angermayer, an entrepreneur and investor from Germany. “Almost from the beginning, we had widespread testing.”
Contact tracing apps
When Germany released an app for contact tracing, called the Corona-Warn-App, more than 15 million people signed up. “Many people downloaded it, representing a huge chunk of the population in Germany,” said Otto. Germany’s Health Ministry has reported some success: More than 500 people who tested positive used the app to notify others who might have been exposed.
Health officials noted that the apps were designed with privacy in mind, but reports indicate that no system is perfect. One recent issue that’s emerged is that Google Android users must first turn on their device location, which could allow Google to follow their movements. Still, Germany embraced tracking (both the tech and more traditional, analog version) and testing early on, which may have contributed to its success.
Germany’s coronavirus contact-tracing app, Corona-Warn, is displayed on an iPhone in Berlin on Tuesday, June 16, 2020.
Krisztian Bocsi | Bloomberg via Getty Images
According to Kamping, the mental health expert, it also helped alleviate stress and anxiety that many Germans did not fear losing their livelihoods. If companies were struggling, there’s a program in place for employees to receive a high percentage of their usual pay rather than being laid off. The idea is that instead of having employers cut staff, workers can apply for unemployment benefits and the government will subsidize those employers directly.
Some 10 million Germans are benefiting from the program, called “Kurzabeit,” according to Propublica.
But some say that corporations might have fared better than small businesses.
“In my view, however, the small and medium-sized enterprises, which are so important in Germany, have been left behind due to a lack of lobbying power, unlike the large corporations,” said Frers. And the programs didn’t cover everyone: There has still been a bump in unemployment in Germany, which could rise further still with additional Covid-19 outbreaks.
What could have been better
Mask shortages and policies
In the early days of the pandemic, some Germans say it was a challenge to access masks. The problem was so stark that a group of doctors in late April even posed nude to raise awareness of the problem of personal protective equipment shortages. The idea was to show the public how vulnerable they were without protection.
In response, many Germans banded together to start making their own masks, including to sew them. “I received at least five offers (of masks) from family and friends,” said junior doctor Pascal Nohl-Deryk, who noted that his hospital also started sharing masks for his own personal use. Now, he says, masks are available across Germany at low prices.
One other issue that’s come up recently is whether to mandate the use of masks in supermarkets. There’s some debate about it, but some doctors say that politicians should support the measure. “There’s enough scientific evidence about transmission in indoor spaces,” said Dr. Harald Schneider, an endocrinologist based in Germany. “I’m convinced we need strong measures.”
Rumors and conspiracy theories
Germany may have had an enviable Covid-19 response, but it still had its fair share of conspiracy theories. As local reporters have shared, groups of protesters have mobilized to share unfounded rumors and misinformation. Some accused Bill Gates of forcing vaccinations on the population, while others targeted Merkel.
Drosten, the popular virologist, received death threats and was accused of spreading fear about the coronavirus. “For many Germans, I’m the evil guy who is crippling the economy,” Drosten told the Guardian.
Problems with easing lockdowns
Going into lockdown may have been easier for Germany than getting out.
After watching Italy and China, Germany began to get prepared and was relatively early in imposing restrictions to stem the spread of Covid-19. But as one local outlet points out, it could have even come sooner. Still, Germany used its time well and the lockdown, by all accounts, was fairly effective in combating the spread of the virus.
However, some have noted that Germany may have been a victim of its own success. Because some citizens didn’t have much exposure to the virus, they questioned whether the measures were too draconian. And once the country decided to reopen, some states rushed to open faster than others — (critics felt there could have been a more cohesive national strategy). Meanwhile, as recent outbreaks have struck a few regions, Germany has started to impose restrictions once again.
How Germany scores overall: 8.25/10
We asked every expert we spoke to for their score out of 10. (1 is the extremely poor and 10 is ideal.) It’s an extremely subjective measurement, but the average across all of them was 8.25.
‘”I think the vast majority of people are conforming to the measures,” said Schneider, the endocrinologist. “My general feeling is that most people know what to do.”
“I think we coped very well,” said Dierks. “Very few countries did better in Europe.”