Is Germany handling the coronavirus crisis better than France?

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With Covid-19 ravaging Europe for almost two months now, the death rate in Germany is considerably lower than that of France, two similarly sized highly developed Western European countries.

According to the Robert Koch Institute, as of Friday April 3, 1,017 Germans had died of the virus out of 79,696 confirmed cases (a mortality rate of 1.3%) compared to 4,503 French people out of 59,105 confirmed cases (a mortality rate of 7.6%), according to data made public in this country.

The pressure on health infrastructures is felt more strongly in France than in its neighbor to the Rhine. German hospitals are far from the point of saturation, so much so that Berlin has been welcoming patients from the east of France since mid-March, in addition to those it has accepted from Lombardy.

Very divergent strategies

In Germany, testing for Covid-19 started very early, and it was orderly and orderly. An extensive testing program was an integral part of German strategy from the start. The parameters of the screening program were quickly established by the eminent Robert-Koch Institute, and then the plan was sent to the vast network of independent laboratories across the country who are well versed in screening for infectious diseases.

I think Germany had a handle on this thing from the very start, “ said Christian Drosten, director of the virology institute of the CHU Charité in Berlin, “We took decisive action two or three weeks before the neighboring countries. So far, we have been successful in fighting coronaviruses because of the extensive screening program that has taken place in this country.. “

Every week, between 300,000 and 500,000 people are tested in Germany, exceeding the Merkel government’s target of 200,000 per day. Those tested are mainly in one of two categories; people with symptoms of the virus, even mild, and those who have been in contact with the sick.

These tests are performed in hospitals, general practitioners’ offices and even in people’s cars. The goal is to isolate the sick as quickly as possible. In Germany, there is no explicit containment measure, “the fact that we acted quickly to limit contacts of infected people with others has limited the number of deaths in this country“Said Hanover virologist Thomas Schulz.

In France, the test rate is pale in comparison. There are several reasons for this, including a shortage of nasal PCR kits, a type of test that allows rapid detection of the virus. Since these types of products must generally be imported by France, this has led to rationing of the kits in certain cases, people with severe symptoms becoming priority. Since mid-March, the WHO has recommended that countries test as humanly as possible, which has forced France to rethink its strategy, the country having only carried out 10,000 tests per day at this stage. The new objective outlined by the French Minister of Health Olivier Véran, is to increase the rate from 30,000 tests per day in early April to 100,000 in June. To increase the number of people who can be screened for Covid-19, German-style drive-through tests have started to take place in several French cities.

Health care armor gaps

Germany has 28,000 intensive care beds, 25,000 of which have ventilators. With six intensive care beds per thousand people, it is one of the best-equipped OECD member states in this category. The wide availability of this equipment in Germany can be explained by the fact that two of the world’s largest manufacturers, Draeger and Löwenstein, are German companies.

The crisis also highlighted some weaknesses in the German healthcare system, the main one being its dependence on non-national nurses. The government did not anticipate the amount of nurses from Poland, Ukraine and the Baltic States who would return to their home country in March, with 200,000 people estimated to do just that. The country has been forced to call student nurses and bring in retirees, but the shortage of medical staff could prove dire if the coronavirus crisis in Germany worsens.

France, a nation known for the strength of its healthcare system, has nevertheless seen the hospital capacity of the covid-19 stretch to the limit, putting additional pressure on an already creaky service.

France is slightly below the OECD average in terms of hospital bed capacity, with 3.1 beds per thousand inhabitants. This is half of what Germany has, according to Eurostat figures. French capacity has decreased by about 10% over the past decade, due to factors such as the priority given to ambulance treatment and budget cuts.

The Macron government has pledged in recent weeks to increase the number of intensive care beds from the total pre-Covid-19 from 5,000 to more than 14,000, but it’s a race against time as hospitals in some regions French near the saturation point.

OECD statistics for 2019 indicate that France has the third-largest health budget in the world, but only one-twelfth of health spending per capita. According to the French newspaper, The diplomatic world, in 2019, health spending per capita was € 5,200 in Germany and € 4,300 in France, the former residence with 18 million more people than the second.

Investment in R&D as a key element

Maintaining a high level of scientific and medical research is essential if a country is to be in any way prepared for a surge in the speed and scale of Covid-19. After a peak in virological research in France at the time of the Sars epidemic, funding for research on coronaviruses had decreased in recent years. If Germany was more numerous in terms of tests than France this time, this is largely due to the fact that the first viable test for Covid-19 was discovered in Germany by Olfert Landt, WHO approving the test. for use in mid-January, one week before the start of coronavirus testing in Wuhan.

If France is not to be outdone, Germany is a world leader in financing research and development, with 90 billion euros invested annually in R&D, against 50 billion euros in France.

One last feather in the Tirolerhut – The German had already simulated the most likely post-coronavirus scenarios last month, while France is just beginning to sketch them.

Under the supervision of Aude Ghespière

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