What we can learn from Germany to flatten the curve

German Chancellor Angela Merkel addresses a news conference on coronavirus in Berlin, Germany, March 11, 2020. [Reuters]

Germany is often referred to as a positive example of how to manage the Covid-19 pandemic. We were successful in preventing the overburdening of our health system. The curve of infections is clearly flattening. And the proportion of severe cases and fatalities is lower in Germany than in many other countries. But this makes us humble, rather than overconfident.

I see three reasons why Germany is coming through this crisis relatively well, for now. First, the German health-care system was in good shape going into the crisis; everyone has had full access to medical care. This is a merit not just of the current government, but of a system that was built over the course of many governments. With an excellent network of general practitioners available to deal with milder Covid-19 cases, hospitals have been able to focus on the more severely ill.

Second, Germany was not the first country to be hit by the virus, and thus had time to prepare. While we have always kept a relatively large number of hospital beds available, particularly in intensive-care units, we also took the Covid-19 threat seriously from the beginning. Accordingly, the country’s ICU capacity was increased by 12,000 beds to 40,000 very quickly.

Third, Germany is home to many laboratories that can test for the virus, and to many distinguished researchers in the field, which helps to explain why the first rapid Covid-19 test was developed here. With a population of around 83 million people, we are able to perform up to one million diagnostic tests per day, and will soon have the capacity to perform around five million antibody tests per month. Extensive testing is like pointing a flashlight in the dark: without it, you can see only shades of grey; but with it, you can see details clearly and immediately. And when it comes to a disease outbreak, you can’t control what you can’t see.

To be sure, as Germany’s federal minister of health, I recognise we are seeing only momentary snapshots. No one can predict with confidence how the pandemic will develop in a few weeks or months. We have not imposed national curfews, but we have asked citizens to stay at home voluntarily. Like many other countries, we have been living under severe restrictions on public and private life for two months. From what we know, this response has been necessary and effective.

Yet, the consequences of the lockdown cannot be ignored, which is why we are gradually trying to return to normal. The challenge is that reducing protective measures is potentially as fraught an issue as introducing them in the first place. Though we are operating under conditions of deep uncertainty, we can be certain about the danger a second epidemic wave poses. Thus, we remain vigilant.

Only time will tell if we have made the right decisions, so I am careful about drawing lessons from the crisis at this point. But a few things already seem clear to me.

First, it is critical that governments inform the public not just about what they know, but also about what they do not know. That is the only way to build the trust needed to fight a lethal virus in a democratic society. No democracy can force its citizens to change their behaviour – at least not without incurring high costs. In pursuing a coordinated, collective response, transparency and accurate information is far more effective than coercion.

In Germany, we have succeeded in slowing the spread of the virus because the vast majority of citizens want to cooperate, out of a sense of responsibility for themselves and others. But to maintain this success, the government must complement timely information about the virus with open public debate and a roadmap for recovery.

In addition to informing the public, governments should show that they are relying on citizens to understand the situation and what it demands. Because they are informed, German citizens know that a return to normality is not possible without a vaccine. 

Like most crises, this one has brought out the best in us: a new sense of community, a greater willingness to help others, and renewed flexibility and creativity. 

[Written by Jens Spahn, German’s Minister of Health]