COVID-19: A View on the German Response
By Ramesh Karuppusamy
June 2020
Introduction
Germany’s response to the COVID-19 crisis is largely seen as a success by many around the world. The following is a non-expert’s perspective from the standpoint of a non-native resident, hopefully offering an objective view of the situation. The status quo as of June 25, 2020, is 192079 infections with an estimated 92% recovered and 8927 dead translating to a death rate of 4.6%. The number of active cases started declining from the third week of March and deaths started declining from early April. While these are comparatively low numbers for a country of 82 million, there is little rejoicing over the virus’ impact on the export-oriented economy. It is clear that the public and leadership have taken the crisis in its stride, worked pragmatically and have managed to minimize the deaths. Somewhat unsurprisingly, the Germans are dealing with this result rather stoically unlike the pompous and sometimes irrational approach of the political leadership in some countries. This rather matter-of-fact German approach with a well-thought plan has played a major role in stemming the effect of the virus.
Onset of the pandemic
The gravity of the COVID-19 situation did not sink into the psyche of the nation until the start of March. Towards the end of January, the federal health minister, Jens Spahn, had said in a public statement that Germany is watching closely and following the developments elsewhere but had made no concrete announcements. After this, he kept reassuring the public that the State is prepared to deal with the pandemic. In the crucial first weeks of March, nothing much happened while the situation in Italy was rapidly worsening. With no clear signals coming from the political leadership in the second week of March, it was becoming abundantly clear that Germany had to act. This event, as elsewhere, brought the federal set up in Germany to a stark focus – the Chancellor, Angela Merkel was able to issue a statement only after intense politicking with the prime ministers of the German states, with some having divergent plans for the pandemic. When an agreement was finally reached, the task of communicating to the public arose. Anything like a curfew or a strict lockdown would have had little public support, given Germany’s past. The proposed lockdown was limited in nature (called “Ausgangsbeschraenkung” translating to limited mobility), unlike the strict policing in other countries. One of the states, Bavaria, imposed something akin to a curfew on two towns. A foretaste of the shutdown was given by the closing of schools on March 16, in several states. On March 22, the Chancellor, in a very rare broadcast, announced that country has to be shut down to protect the citizens’ health.
The imposition of the freedom of movement was not without opposition. Discussions ranged from religious freedom and economic impact to whether curtailing public gatherings was constitutional. Because of the two World Wars, the German public is, in general, wary of military display and their privacy laws and public policies are highly scrutinized and the public places a very high value on the freedom of movement. This was clear in the discussion ensuing the mild panic buying prior to the shutdown. For instance, the outcome to the political debate on whether the army should be enlisted to protect the supermarkets (in fear of riots owing to the breakdown in supply chains) was unanimous – the public has the discipline to avoid deploying the armed guards. Constitutionally too, the armed forces can be allowed to impose law and order if, and only if, it can be proved that the civil police is unable to handle the situation. Much of this is, of course, guided by Germany’s history.
Nature of the shutdown
The shutdown broadly meant that the schools and childcare facilities were closed and quite a number of non-essential businesses and the hospitality industry were shutdown. More than two non-related persons could not meet. Strict social distancing was to be maintained. Families were allowed to take a walk, bike or exercise together. Visits to care homes for the elderly were restricted which also meant grandparents and families were not allowed to meet. Home office and home-schooling became the new norm, resulting in significant disruption to daily lives. Other organised sports activities were banned – a topic of intense discussion given the love of ‘Bundesliga’!1 Much of these regulations were enforced by means of hefty fines, ranging from 200-5000 euros per violation. Fortunately, there was no wide-scale panic buying in the days leading up to the shutdown. There were shortages of toilet paper, baking flour and hand-hygiene products; the rest seemed to be more or less normal. The initial public hygiene message, which began in the primary schools, was highly publicized and was largely successful.
Effect of the shutdown
The shutdown meant that intercity and cross-border travel was discouraged. The latter had an effect that was previously unseen. For instance, on March 19, the border closure resulted in massive traffic jams of over 60 km on the highway leading to Poland. The travel restrictions had a big impact on the seasonal agriculture activity, especially on the strawberry and asparagus farms that depend heavily on workforce from the Eastern borders. Some of the harvest was possible with so-called ‘Kurzarbeiters’ and volunteers.2 This came in handy for the agricultural sector, as a small fraction of the workforce could be retrained quickly. It was, however, far from ideal, and some of its effects may be felt in the long run. For instance, inadequate training in the asparagus harvest may result in damage to the next harvest. Some businesses were open though – DIY stores, supermarkets and service providers, like handymen. Modest building activity could also continue, which is, in general, highly mechanized.
While the shutdown was in effect, it did not prevent some being adventurous! For instance, one astrophysicist went so far as to boldly predict the progression of the COVID-19 in Germany.3 As one can imagine, this was not met with great enthusiasm within the astronomy circles, because it was best for us, non-experts on COVID-19 to refrain using our toy models to talk about it. The virus is a matter of life and death for people, and toy models may actually do more harm than good – on similar lines to some online discussions.4
The official shutdown was announced by the German Chancellor, Angela Merkel on Sunday, March 22, with effect from the same night. From the announcement of the school-closing on March 13, the intervening 9 days allowed for some preparations. Figure 1 shows how the number of infections started reducing soon after. While the shutdown was nearly two weeks later than Italy, Spain or France, there were ample public communications. This happened at all levels of the government starting at the municipalities to the highest levels in Berlin.
The public could rely on the federal agency, Robert-Koch Institute, which provided daily reports on the country’s public health. It was also helpful to listen to the experts, some of who were advising the federal government. One of them, a well-respected Virologist, Dr Christian Drosten, gave in-depth interviews to a public broadcaster every week. These interviews were available to the public in the form of podcasts to help it digest the details at its own pace.5 It also helped that Dr Drosten is a world-leading authority on SARS viruses, who also developed the first Corona virus test kit.6
Figure 1. Progression of COVID-19 infections from 01 March 2020. The number of reported cases are in yellow, while the blue bars represent the number of cases with actual infections. Image courtesy - Robert-Koch Institute
There is a debate on whether Germany wasted some precious time to respond. China communicated to the world on December 31, about a new virus and the first German case was reported on January 27 in Munich. While the chance of a pandemic was discussed in the Parliament in the last week of January, the severity of COVID-19 seems to have been underestimated. This, despite a very visionary study published in 2012 that assessed the country’s preparedness for a hypothetical epidemic or pandemic, which, in some sense, was a blueprint in existence for a shutdown. The 2012 study laid down the protocol – to close schools, child-care facilities and ban large gatherings.
As for COVID-19, the wake-up call really was the Heinsberg outbreak towards the end of February, when a cluster of infections emerged after people gathered in the town for the yearly Carnival celebrations. A shutdown at this stage was deemed unnecessary. In retrospect, the number of infections could have been much lower had the Carnival celebrations were cancelled in February. Despite the missed chance, the somewhat early realization from the Italian experience made a good case for quick action. This was further reinforced by the spike of COVID-19 cases after young Skiers got back to the country after their winter vacation in the Italian Alps. Even if somewhat late, the concerted action did help. This reduced the number of cases at the peak of infection, well within the country’s healthcare system capacity.
In the days leading up to the shutdown, there were some reassuring messages that the intensive care beds have been ramped up from 10000 to a total of 40000; and, the non-essential surgeries were to be put on hold. This did convince the public that the system is geared to deal with COVID-19 infections. Hospital occupancy was transparent and could be looked up readily.7 The shutdown had an immediate and noticeable effect, and, in the end, it did receive good support from the public.
There were some positive sides of the shutdown, as this helped families spend more time together and to undertake walks and biking trips. Since schools were closed, and work commute was absent, there seemed to be less time-related pressure. Aiding all of the outings was an extended period of favourable weather in early April. Home-office and home-schooling though were not devoid of frictions. As the novelty wore out in about a week into the shutdown, there was a phase of getting adjusted to the new situation. The kids were distributed homework electronically, living room exercises for kids were guided by television and office meetings moved to the virtual space in a different part of the home. Needless to say, this was a bit stressful for working parents as the days were interlaced with telemeetings, guiding children with homework, preparing meals and finally, the office work. Fortunately, many employers accommodated such special cases by redrawing meeting and work schedules.
Germany – a success story?
What made Germany relatively successful in minimizing the effects of COVID-19? There are several factors. Germany is a nation that is consistently among the countries that invest heavily in their healthcare systems. This, nearly, universal public healthcare system is more than 11% of the country’s GDP and is primarily funded by compulsory salary deductions. The healthcare is of excellent quality — one can visit the doctors or hospitals without the fear of a hefty bill and it is accessible to all sections of the society. There is little stigma in reporting illnesses, as well. The political leadership enjoys a significantly higher level of public trust. When the Chancellor has something to say, it is on the very independent public broadcast service and never on social media. It also helps when politicians rely on experts for the advice, with the experts themselves giving prime time interviews in television and radio.
The 2012 blueprint for a pandemic is also typical of the German approach – well-thought-out and planned in advance. Added to the trust in leaders, the largely rule-based society has a definite advantage. One can think of a rule for almost anything imaginable in this country. For instance, after the shutdown was announced a list containing no less than 40 categories of law infringements were drawn up, all related to the shutdown! Another feature of the society is that multi-generational living arrangements are quite rare. Youngsters often become independent when they turn 18 and leave the nest. The concept of personal space is more dominant in Germany than in Italy or Spain. It is not uncommon to see in public transport that only after all seats are taken, does someone sit next to another. The combination of these factors has had a huge impact on the pandemic spread here. One could also mention the role of the media in this crisis.
The public broadcast service is largely independent and provides reliable coverage of current affairs. This is made possible by the broadcast tax (the Rundfunkbeitrage) paid by every household. The resulting 8 billion euros annual budget serves to fund the high-quality news and programs while being largely free of influences. This combination of a well-functioning public debate and conversation with a strong and mostly impartial media have greatly aided the success of the shutdown. The German preparedness was also exemplary – ramping up ICU beds and testing capacity, and vigorous contact tracing have all helped fight the virus. In some ways, Germany had certain advantages as it the number of hospital beds are increased before the onset of flu season every year. This year the annual ramp-up of beds came in as a distinct advantage. In the month of March, the testing capacity was increased from 84,000 a week to 7,00,000 paving the way to extensive testing. Anyone displaying the mildest of symptoms was eligible for testing.
Social movement was slowly reintroduced towards the end of May, ending nearly three-months of vastly reduced activity. Childcare facilities and schools were opened by mid-June and so were the borders to neighbouring countries. Early June also saw the government action on stimulating the economy with a 130-billion-euro package. The German welfare system was adjusted to extend the financial support (called Kurzarbeit) to provide up to 40% of the salary to 7 million citizens in both employed and small business sectors. The number of cases is now quite manageable, but there can be no room for complacency, as evident from the emergence of some clusters recently. Two local outbreaks have surfaced around June 15 (see Figure 1) and local shutdown is being imposed on these cities. This highlights the fact that until a vaccination is found, the country can only resort to localized shutdowns.
Analogues for India
Is there a message that one can draw from the German experience for India? Any elaborate effort in that direction is bound to fail given the size and complexity of India, the cultural setting and the level of public knowledge. Given India’s population and diversity, one can only commend the low mortality rate of 3.1%. However, the recent easing of the lockdown has sent the number of infections soaring. While the benefits of testing cannot be overemphasized, what can be carried forward from the German experience to the Indian setting? In terms of immediate action, the country can make the tests widely available and provide it free of cost. Multiple tests costing Rs 30008 are not affordable for large sections of the society. The country needs to find the resources to foot the testing expenses. But testing, by itself, is half the battle won – it helps prevent the spread and serves as an early warning system; medical resources can be focused to areas where it is needed the most. If the infection does end up in complications, the treatment costs run into lakhs of rupees – which most Indians cannot bear. Therefore, more pressing and highly challenging is the mobilization of medical resources for the economically weak. This could perhaps lay the foundations of a future universal healthcare system in India. The public communications could be better and more transparent. This could have defused the exodus of migrant workers at the start of lockdown. Greater devolution of powers to the districts or even to towns and municipalities will be useful in the days ahead. For instance, moving some decisions to local panchayats or municipalities will allow the system to be move quickly and communicate better. This will become more important now, as the country has to thaw the economical deep-freeze inevitably resulting in localised COVID-19 hotspots. These can be managed by micro lockdowns if the local governing bodies are empowered. However, this can only work if there is better coordination at the district and state levels.
AUTHOR
Ramesh Karuppusamy is a staff scientist at the Max-Planck Institute for Radio Astronomy (MPIfR) in Bonn, Germany.
Views expressed are the author’s and do not represent the Max Plank Society or the MPIfR.
Disclaimer: The views and opinions expressed in this article are those of the author/s and do not necessarily reflect the official policy or position of Azim Premji University or Foundation.
