Asked at Tuesday’s evening briefing why Germany appears to have a lower coronavirus death rate than Britain, the Chief Medical Officer Professor Chris Whitty said: ‘We all know that Germany got ahead in terms of its ability to do testing for the virus, and there’s a lot to learn from that.’ Germany has the capacity for 500,000 tests a day, while our own government is promising only 100,000 tests a day by the end of April.
As has been explained here and elsewhere many times before, the more people you test, the lower your infection mortality rate will be – for the simple reason that you will be dividing your deaths by a larger dominator. In Britain, we gave up routine testing as soon as the fight against coronavirus moved from the ‘contain’ to ‘delay’ phase. Consequently, the people who are currently being tested for coronavirus in Britain are mostly those sick enough to seek hospital treatment – mild, or entirely asymptomatic cases (which according to Chinese and Italian studies could constitute between 50 and 80 per cent of total infections) go uncounted and therefore our infection mortality rate is relatively higher.
That doesn’t mean to say, however, that Germany’s low death rate is necessarily only a statistical quirk. It is also very notable that Germany has a much lower death rate per 100,000 than does Britain – by Tuesday, Germany had suffered 1,607 deaths compared with Britain’s 5,373. Considering that Germany has a population of 82 million compared with Britain’s 64 million, there is a very big difference here. Maybe Germany is at an earlier stage of the epidemic and deaths will carry on rising after they have stabilised in Britain, but not necessarily.
The other question that needs to be asked is whether there is something about Germany’s treatment of coronavirus victims that has resulted in a lower death rate. That is how Dr Thomas Voshaar, a lung specialist who runs a clinic in the town of Heinsberg in North Rhine-Westphalia sees it. In an interview with the Frankfurter Allegmeine, he speaks of how he has treated 29 patients without suffering a single death so far. It isn’t testing that makes the difference, he says – he doesn’t even bother with the tests because he finds them unreliable. Instead, he gives suspected Covid-19 patients a CT scan of their lungs in order to assess the extent of damage – and then treats them occasionally.
What he doesn’t do, he says, is rush to put patients on a ventilator. In fact, only one of his patients so far has been given this form of treatment. It is best avoided for as long as possible, he says, because the machines exert too much pressure on the lungs, and the air supplied is too rich in oxygen. That can lead to patients dying of collapsed lung. He says he was astounded at the extent to which ventilators have been used to treat patients in Italy.
It backs up what critical care specialist Matt Strauss wrote here last week: that however much store politicians have put into their supply, ventilators are no panacea for coronavirus and indeed are themselves injurious to a patient’s health.
Dr Thomas Voshaar is only one lung specialist working in one German clinic, but the nature of the treatment being given to patients in Germany compared with that in Britain, Italy, Spain and elsewhere should also be considered by Professor Whitty. In the meantime, we can be thankful that our Prime Minister is one of those admitted to intensive care who have not yet been hooked up to a ventilator.