COVID-19 virus SARS-CoV-2

Epidemiological Development in Germany


Epidemiological development of COVID-19 in Germany throughout the pandemic between March 1, 2020 and September 12, 2021. The Germany's epidemiological profile is somewhat atypical in that, while the COVID-19 incidence is lower than in most European countries throughout the entire second wave likely due to the implementation and maintenance of very strict social distancing measures, the individual incidence oscillations observed in other European countries in Germany fused into one single wave. In spite of this, notice the characteristic relatively sharp incidence peak around November 10, 2020, then again a third peak on January 10, 2021. The first peak is shared with a number of other European countries such as Spain, Czech Republic, Slovakia, Italy, France to mention a few. The latter was also observed in the UK, USA and Canada. The dip observed past the second peak on December 20, 2020 was suggested to reflect the testing and reporting slow down between the holidays. 

Due to the country's very strict non-pharmaceutical interventions the attainment of the nation's global herd immunity was substantially delayed. During the second peak of the second incidence wave on April 25, 2021 only 39% of the Germany's population (83,8 million) was exposed to the SARS-CoV-2 virus, and began mounting its natural global immune response. During the third wave peak on September 12, 2021 it was only 49% of Germans, who were exposed to the virus and began forming their resilience against it.
 
Correlation between Germany and Sweden

For unknown reasons Germany shares its characteristic COVID-19 epidemiological profile with Sweden despite of the implementation of vastly different non-pharmaceutical intervention measures. The second wave in both countries is highly positively correlated r=0.904.

In addition Germany's second wave epidemiological profile highly positively correlated with a number of other countries: 
Countries Correlation coefficient "r" Statistical probability "P"
Germany/USA 0.906 P < 0.001
Germany/Canada 0.924 P < 0.001
Germany/Italy 0.819 P < 0.001
Germany/UK 0.764 P < 0.001
Germany/Iran 0.766 P < 0.001
Germany/Slovakia 0.833 P < 0.001
Germany/Sweden 0.904 P < 0.001
Germany/Norway 0.877 P < 0.001
Germany/Finland 0.701 P < 0.001

The German COVID-19 incidence between March 22, 2020 and June 6, 2021 plotted together with its corresponding infection fatality ratio (IFR).

At the beginning of the pandemic (here before July 2020) the apparent COVID-19 mortalities appeared to be very high due to a number of unrelated factors such as, the unfamiliarity with the novel disease resulting in late diagnosis or misdiagnosis, lack of initial testing (artificially inflating the equation numerator resulting in large mortality value), in addition to some initial mishandling of severe cases due to overwhelming of the medical system. This region of the graph (blue dots) by no means reflects the true morbidity of COVID-19. However, the prevalent German COVID-19 mortalities tend to be higher than IFR in many other European countries despite very strict social distancing measures adopted by the German government. One possible explanation for the apparently high mortalities might be, hardly surprising, reluctance of the German population having themselves tested. This would result in artificially reduced incidence inflating the German mortality numbers. Other explanations might be older more vulnerable German population structure, or different case handling procedures in clinical settings (more frequent intubation of critically ill patients, for example) resulting in increase of COVID-19 linked mortalities.

For unknown reasons the German COVID-19 IFR profile appears to be higher than fatalities calculated for many other countries. 

Data: WHO weekly reported SARS-CoV-2 virus positive cases.