Timon is a medical student who just finished his Staatsexamen. Whereas the exam got cancelled in Italy, it took place in Germany under police supervision. During the exam he was a little afraid to fail by accidentally coughing, but luckily he made it through and can now assist those doctors treating COVID-19 patients.
“We are well prepared!” claimed Jens Spahn, German Secretary of State for Health in repeating in January and February 2020 before Covid-19 really hit Europe. Even though the case numbers were still very low at this time and most health care workers did not encounter the virus yet, this sentence quickly became a running gag between doctors and nurses in German hospitals.
We are still learning how to live with Covid-19. In Spahn’s defense, just a few weeks ago most people around the world did not really believe that the looming global pandemic was indeed global. But still, every person working in healthcare could see we were, in fact, not ready for it: You just had to count the amount of protective gowns and masks stored in the hospitals, the intensive care beds, isolation wards and employed doctors and nurses and compare it with the number of patients to be treated if just 10 percent of the population became infected in a short period of time.
While at first people were joking and being cynical about politicians, saying we were prepared while we were actually not, the perception rapidly changed when numbers skyrocketed in Italy. The government responded by closing borders, enforcing social distancing and the public life was largely shut down. Alerted by the overcrowded Italian hospitals, the medical system was finally geared up for an actual pandemic. General wards and entire hospitals were transformed into isolation wards for treating Covid-19 patients. Such elective operations were delayed to free up intensive care capacities. But these operations are not dispensable, they may be less urgent than emergency operations, yet you can only delay them for a short period of time. Doctors, nurses and medical students were called into hospitals, and finally politicians like Jens Spahn tried to allocate reasonable amounts of protective gear.
These first days of this panic mode became a dire moment for European solidarity as every country was putting their own interest first instead of working together to help the ones most in need. China tried to portray themselves as a generous sponsor by sending doctors and selling face masks to Italy. However, one should remember that just weeks before European countries donated tons of medical equipment to China which had contributed to the shortage of material in Europe in the first place.
Whereas this first period of the pandemic saw a surge of nationalistic thinking, there are some glimpses of a potential comeback of European solidarity. After all member states realized they were equally hit by the pandemic, it became clear that the spatial understanding of the disease could not be mapped along national borders but rather by outlining local infection hotspots everywhere in the European Union.
Many less affected countries sent money and medical equipment to the heavily hit regions in Italy and countries like Germany even flew patients from Italy or France to German hospitals to treat them there. On a bigger economic stage, the EU managed to arrange a 500-billion program to help its member countries with business loans, securing employment by short-time work and stabilizing struggling health services.
To circle back: Germany, Europe and probably the whole world were not prepared for the Covid-19 pandemic. But what if there was at least a little bit of truth in the statement of the German Secretary for Health: If you look at the numbers from the Johns Hopkins University there seems to be a conspicuous difference in the death toll between Germany and the other big European countries. While Italy (207.000), the UK (178.000), France (167.000) and Germany (164.000) have a roughly similar amount of positively tested people, in Germany (6.700) relatively fewer people died than in the other three countries (Italy: 28.200, UK: 27.500, France 26.500, all numbers from the 02.05.2020).
Since these countries are comparable in respect of wealth, technical and structural potential and demographics – Does that mean Germany was better prepared than its neighbors?
If you talk to healthcare workers in Germany nobody actually believes that, but there is a widespread notion that the German healthcare system in general is, despite its flaws, one of the best in the world. One aspect that is widely discussed as a reason for the reduced mortality is the robust intensive care capacity, tripling the numbers of ICU beds and ventilators per inhabitants compared to the other three European countries. Thus, preemptively emptying the hospitals led to the strange phenomenon that the German hospitals, expecting a much bigger wave of Covid-19 patients, have more spare capacities right now than ever before and made it possible to fly in patients from other European nations.
Experts and politicians are also claiming another reason for the seemingly lower mortality: The public health service in Germany, being less centralized than e.g. in France, allowed for quicker and regional on the spot measures, preventing the virus from spreading quietly across the whole country. It is highly likely that estimated number of unreported cases is much smaller in Germany.
As we managed to flatten the curve at least for now politicians across Europe are putting their focus on overcoming the shutdown and looking for a path back to normal. One must keep in mind that the infection numbers can quickly rise to out of control again; this is not a sprint but a marathon. The situation in the hospitals which may be relaxed for now can quickly flip in any area of the world. We will have to expect continuous local outbreaks of Covid-19 until there is a vaccine. To keep the death rate of this Coronavirus as low as possible we should establish a system of European solidarity beyond national borders to deliver help to regional hotspots as timely as possible – be it in Italy, Germany or the Netherlands. In order to distribute patients across the continent we should use all of our capacities or send medical personnel into these areas. At the moment the health care system in Germany seems to be robust, but with exponential growth every country will be in trouble if it is on its own, we can only hope to manage this pandemic successfully by working together and we should do it more. Europe did not give its best performance in the handling of this crisis. Nevertheless, there are some silver linings since we are still at a crossroads where it is possible that we not only learn how to live with the virus but also become better at showing solidarity.