The German Paradox

Germany now has 14,325 laboratory confirmed cases of the new H1N1 virus. That makes it the country with the 4th most infections in the world. However, no deaths have been reported in Germany. Among the top 10 countries for H1N1 cases, Germany is the only one with no deaths. For comparison, Thailand has 13,019 cases and 111 reported deaths. The United Kingdom, with 12,957 cases, has reported 61 deaths.

How have Germans escaped the deaths visited upon other countries? One possibility is that the government has simply decided not to report their deaths. However, Germany is number 16 on the list of most honest countries (out of 179). So, this appears to be an unlikely possibility. A more likely explanation, in my opinion, is that the German health care system is doing a particularly good job of identifying H1N1 patients and treating them promptly with Tamiflu or Relenza.

It would be worth studying how German public health authorities are identifying patients and delivering treatment so that other countries could emulate them.

Of course, those other countries would have to have the Tamiflu to deliver.


4 thoughts on “The German Paradox

  1. Is there a difference in availability/reliability of testing? At this point in the pandemic I would think most countries have enough antivirals for the job but our inability to quickly and correctly identify cases has left it largely on the shelves.

  2. Bilp, I do think identifying patients for treatment may be one of the key variables. But I don’t know enough about what the Germans are doing to know if this is the explanation. Although many rich countries have enough Tamiflu to treat the early cases, some of them, including the US, have hesitated to prescribe it to everyone with the virus. I think this is primarily due to fear that they will run out later in the pandemic. The result is that some people die needlessly, imo.

  3. Am I remembering correctly that Switzerland had prophylactic stockpiles of Tamiflu (vs. treatment stockpiles). It would be very interesting to know how they and the Germans are using anti-virals.

    I think it depends on whether we’ve had “millions” of H1N1 cases in the US or tens of thousands to know if given timely/accurate testing TPTB would have withheld Tamiflu. If the answer is millions then no, but I don’t think the answer is millions.

    Keep up the good work Monotreme.

  4. Yes, I think Switzerland had enough Tamiflu for their entire population. But then again, Roche is a Swiss company.

    Thanks, Billp.

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