COVID-19 Pandemic in Germany

Introduction

The outbreak of COVID-19 pandemic around the world has impacted all nations and induced severe consequences for health care systems, employment, and the economy. As the epidemic continues, repeated waves of outbreak emerge, requiring an innovative response from governments and health care institutions. High morbidity and mortality rates associated with the coronavirus are a call for immediate action from the side of the World Health Organization (WHO) and other international organizations. Since the science has not presented any specific treatment for COVID-19, and no vaccine has been invented yet, preventative measures and self-protection of the population remains the most effective tool in the struggle against the virus. At the same time, each country has its path in the war against COVID-19, in which it enacts specific measures and initiates particular procedures aimed at the effective ending of the epidemic.

Germany is one of the European countries that has encountered the outbreak of COVID-19 in January 2020 and has been struggling with the epidemic using all available resources since. As in the majority of countries, the outburst of the novel coronavirus disease occurred in Germany as a result of the population’s traveling. The high transmission rate of the virus triggered its fast spread across the different regions of the state and ultimately affected a significant part of the national population. A particular feature of Germany’s case is the long-lasting preparation stage during which the authorities claimed the health care system’s full preparedness to the outbreak and did not implement any protecting measures, such as social distancing, self-isolation, public places attendance limitation, and others. Also, for a long period of time, Germany demonstrated a significant difference between morbidity and mortality rates, where the number of cases was similar to those observed in other European countries, but the number of lethal cases was relatively low.

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These tendencies that specify the case of Coronavirus in Germany might be explained by the particular features of the anti-COVID-19 plan of action utilized by the nation to mitigate the adverse outcomes of the pandemic and minimize human losses. In this report, the particularities of COVID-19 in Germany will be discussed and explored in detail. A general overview of the disease will be provided to outline the world-wide implications of the crisis for health care systems, economies, and societies. Also, an outbreak stage when the first COVID-19 cases were detected in Germany will be discussed. The current situation in the country will be overviewed with the presentation of the emerging trends and statistics relying on credible official sources. The statistics demonstrating the morbidity and mortality rates in Germany at the beginning of the pandemic and at present will be compared to detect observable changes and achievements. Finally, the report will be concluded with summation statements as per the particular features of the COVID-19 pandemic in Germany.

General Overview of COVID-19

COVID-19 or the novel coronavirus disease originated in Wuhan, China, in December 2019. Initially, an outbreak of pneumonia of an unknown cause emerged in this region, which attracted the attention of authorities and the general public beyond China, involving the international community. The high level of the population’s mobility in the globalized world induced concerns about the rapid spread of the disease, which appeared highly transmissible. The immediate action of the Chinese authorities was aimed at isolating the infected patients, establishing their contacts and their isolation, implementing preventative measures for the general public, and disseminating the hygiene guidelines to stop the virus from spreading. At the same time, the scientists and health care specialists developed diagnostic and treatment procedures to enable timely identification and curing of the disease (Wang et al. 470-471). By January 7, 2020, “Chinese scientists had isolated a novel coronavirus (CoV) from patients” and sequenced genome data, which allowed for the development of “point-of-care real-time RT-PCR diagnostic tests specific for 2019-nCoV” (Wang et al. 470). However, the rapid reaction of China did not prevent COVID-19 spread, which ultimately impacted the whole world.

Indeed, during January 2020, the first cases of the coronavirus disease were located in other countries, even those not bordering with China. As the article published at the end of January 2020 states, multiple cases outside Wuhan were detected, as well as nine contamination cases were reported from Japan, Vietnam, Thailand, Korea, Singapore, and the USA (Jung et al. 363-364; Wang et al. 471). Air travel is claimed to be the main reason for the rapid transmission of diseases across the counties’ borders. Within the next months, the number of cases of infection rose, and the first fatal cases were registered. The most common symptoms of the disease are fever, dry cough, sore throat, and pneumonia, which are likely to be detected at the early stages of the disease occurrence (Bohmer et al. 1; Wang et al. 472). The most impacted population is regarded to include the elderly; however, the individuals of all ages become infected. The severity of symptoms and comorbidities depends on the overall health state of a patient. People with chronic cardiovascular and respiratory illnesses are at the highest risk.

Disease control measures and epidemiological interventions have been initiated internationally and in all countries impacted by the disease. On January 30, 2020, WHO announced COVID-19 a global emergency, which ultimately triggered a necessary response from the governments of all states (Nicola et al. 185). Social isolation, the country’s shutdown, and various quarantining measures were implemented globally, which induced severe concerns about the socio-economic implications for the separate nations, as well as the global economy after the pandemic. Germany was one of the first European countries where the cases of COVID-19 were registered in January 2020.

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Coronavirus Outbreak in Germany

As a developed country, Germany anticipated its stable management of the COVID-19 situation due to the overall high level of science development, high quality of health care facilities, and the preparedness of the state organization to deal with the crisis in an effective manner. The first case of the coronavirus disease in Germany was registered on January 27, 2020 (Robert Koch Institute, “Daily Situation Report of the Robert Koch Institute 04/03/2020” 1). The Bavarian Health and Food Safety Authority were informed about the infection detected in Bavaria in the patient who came from Wuhan on a business trip to Germany. Sixteen cases were identified in Bavaria between January 27 and February 11 (Bohmer 2). With the emergence of the very first case, the authorities aligned with the suggestions of the International Health Regulations Emergency Committee as per the possibility of stopping the spread of the disease “provided that countries put in place strong measures to detect disease early, isolate and treat cases [and] trace contacts” (Bohmer 2). Thus, German authorities started to investigate the contacts of the infected and implement treatment and preventative measures to stop the spread of COVID-19.

The epidemiological situation in Germany was traced and monitored with significant attention paid to the testing of the public and the registration of every new case across the country. The reports dated March 4, 2020, demonstrate that the number of registered COVID-19 cases was 262, while no coronavirus-related deaths were identified (Robert Koch Institute, “Daily Situation Report of the Robert Koch Institute 04/03/2020” 1). By the beginning of March, the statistical data on the patients tested positive has demonstrated the age from 2 to 85 with the median age 40 years; female patients prevailed. As shown in Figure 1, the data for which was retrieved from the official report of the Robert Koch Institute, the daily number of reported cases of infection with COVID-19 varied from two at the end of January and 20 at the end of February, while the period between the onset symptoms occurrence and the report dates was long (Robert Koch Institute, “Daily Situation Report of the Robert Koch Institute 04/03/2020” 4).

Epidemiological curve of the 148 electronically reported COVID-19-cases in Germany, by onset of symptoms and alternatively by date of reporting (04/03/2020) 
Figure 1: Epidemiological curve of the 148 electronically reported COVID-19-cases in Germany, by onset of symptoms and alternatively by date of reporting (04/03/2020) 

The early identification of the cases and the strict rules of isolation of the patients, as well as the detection and isolation of all possible contacts, allowed for terminating the high-rate outbreak of the disease at the early stages of the pandemic. Importantly, the statistics of no deaths upon the first month of the epidemic was associated with the specific features of Germany’s management of the virus. For comparison, the estimated case fatality rate (“the ratio of reported deaths to cases”) in Spain and Italy by the same time was 1.70% and 4.96%, respectively (Yuan et al. 313). Moreover, the increase of the number of cases was observed in Germany later than in other European countries, as shown in Figure 2, although Germany introduced quarantining measures later than others (Jung et al. 363; Yuan et al. 312).

Local transmission of COVID-19 in selected European countries 
Figure 2: Local transmission of COVID-19 in selected European countries 

The low fatality rate of Germany’s cases is related to rapid diagnostic methods involving multiple laboratories. According to Stafford, bApril 2 2, 2020, “872 deaths from COVID-19 had been recorded in Germany from 73 522 confirmed cases, translating to a fatality rate of 1.2%,” while the same rate were 11.9% in Italy, 9% in Spain, 8.6% in the Netherlands, 8% in the UK, and 7.1% in France (1). Such statistics differences are explained by the development of a laboratory testing system that enables qualified laboratory facilities to run tests without the allocation of such responsibilities to one central laboratory as it is in other European countries (Konrad et al. 1-2; Stafford 1). In such a manner, Germany managed to test more individuals and ensure early detection of cases and their timely treatment. However, the efforts aimed at the mitigation of adverse outcomes of the pandemic did not provide for complete elimination of the problem in the state as new cases are reported at present.

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The Current Situation with COVID-19 in Germany

Upon the implementation of government regulations as per physical distancing and shutting down of public places and businesses, the situation around the spread of COVID-19 remained relatively controlled. According to the official statistical data reported by the WHO on June 22, the number of cases of COVID-19 in Germany reported since January 28 is 190,359, and the number of registered deaths caused by the coronavirus disease is 8,885 (WHO). The reproduction rate (the number of individuals that might be infected from one positively tested person) of the disease in the country was below 1 in May; however, this rate has significantly risen to 2.88 due to the outbreak of COVID-19 cases “at a meat processing plant in the town of Gutersloh” (Pleitgen and Rahim par. 4). Indeed, as the authorities stated, the country needs to maintain the reproduction rate below 1 to succeed in stopping the epidemic.

However, the breaking of rules by the owners of the aforementioned meat plant caused a new outbreak. As reported, more than 1,500 workers were infected as the at the plant (Connolly). Thus, the number of cases detected daily remains relatively stable, with 537 new cases reported on June 22 (WHO). At the same time, the epidemiological situation and the demographic features characterizing the COVID-19 situation in Germany have changed. Indeed, the data from the latest report retrieved from the Robert Koch Institute shows that 4.7% of all cases are fatal, while “the cumulative nationwide incidence over the past seven days was 4.4 cases per 100,000 inhabitants” and zero cases were detected in 148 districts (Robert Koch Institute, “Daily Situation Report of the Robert Koch Institute 22/06/2020 – Updated Status for Germany” 1). Also, as shown in Figure 3, the number of cases of symptoms report has significantly reduced from 5,000 in the middle of March to less than 500 at the end of June.

Number of COVID-19 cases in Germany electronically reported to the RKI by date of symptom onset or alternatively by date of reporting from 01/03/2020 
Figure 3: Number of COVID-19 cases in Germany electronically reported to the RKI by date of symptom onset or alternatively by date of reporting from 01/03/2020 

Currently, the country is planning a steady exit from the quarantining period and puts effort into minimizing the number of cases and ensure effective treatment, diagnostics, and prevention.

Conclusion

In summary, the worldwide spread of the novel coronavirus disease is characterized by high transmissibility, short incubation period, and a high reproduction rate, which complicates the measures for controlling the disease. Originating in China in late December of 2019, COVID-19 spread to multiple countries within a month. From the first reported case in Bavaria on January 27, 2020, German authorities have been implementing swift actions aimed at the development of diagnostic procedures, early and numerous laboratory tests, isolation of the infected patients, and early detection of their contacts to regulate the spread of the virus.

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Although the country implemented its quarantining regulations and lock-down-measures for public places and businesses later than other countries of Europe, its fatality rate remains the lowest. Such successful results are validated by the well-organized diagnostic work and the developed system of early interventions for the infected populations. Currently, the state undergoes a complication in the managing of COVID-19 situation due to the recent outbreak of infection at a meat plant. However, the fatality rates remain low, and the number of new cases detected daily is stable, which provides an opportunity for anticipating a timely recovery.

Works Cited

Bohmer, Merle M., et al. “Investigation of a COVID-19 Outbreak in Germany Resulting from a Single Travel-Associated Primary Case: A Case Series.” The Lancet Infectious Diseases, 2020, pp. 1-9, Web.

Connolly, Kate. Meat Plant Must Be Held to Account for Covid-19 Outbreak, Says German Minister. 2020, Web.

Jung, F., et al. “How We Should Respond to the Coronavirus SARS-CoV-2 Outbreak: A German Perspective.” Clinical Hemorheology and Microcirculation, vol. 74, no. 4, 2020, pp. 363-372.

Konrad, Regina, et al. “Rapid Establishment of Laboratory Diagnostics for the Novel Coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020.” Eurosurveillance, vol. 25, no. 9, 2020, pp. 1-5.

Nicola, Maria, et al. “The Socio-Economic Implications of the Coronavirus Pandemic (COVID-19): A Review.” International Journal of Surgery, vol. 78, 2020, pp. 185-193.

Pleitgen, Fred, and Zamira Rahim. Germany’s Coronavirus Reproduction Rate Soars after Massive Outbreak at Meat Plant. CNN, 2020, Web.

Robert Koch Institute. Coronavirus Disease 2019 (COVID-19) Daily Situation Report of the Robert Koch Institute 2020. Web.

Coronavirus Disease 2019 (COVID-19) Daily Situation Report of the Robert Koch Institute 2020 – Updated Status for Germany. Web.

Stafford, Ned. “Covid-19: Why Germany’s Case Fatality Rate Seems So Low.” BMJ, vol. 369, 2020, pp. 1-2.

Wang, Chen, et al. “A Novel Coronavirus Outbreak of Global Health Concern.” The Lancet, vol. 395, 2020, pp. 470-473.

World Health Organization. Germany, 2020, Web.

Yuan, Jing, et al. “Monitoring Transmissibility and Mortality of COVID-19 in Europe.” International Journal of Infectious Diseases, vol. 95, 2020, pp. 311-315.

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