[Trudy Rubin] Virus lessons from Korea, Germany

As US fatalities from COVID-19 rise, Germany‘s death rate from the virus is roughly half that of America’s.

As America‘s front-line health workers still struggle to obtain face masks, South Korea has a smooth system to distribute masks to its health workers and its entire population.

Both countries are democracies and US allies, not authoritarian regimes like China. So shouldn’t we be looking at what these countries are doing right, and whether their methods are applicable here?

The German case is particularly interesting because relatively few people seem to be dying. Their fatality rate from virus cases as of early this week stood at less than half the nearly 3 percent rate in the US.

Three key factors deserve the credit: strong leadership, early and persistent testing and a robust health system that works.

“Germany is doing more testing than other countries, but still not enough,” I was told by Anna Sauerbrey, deputy editor-in-chief of Der Tagesspiegel, by phone from Berlin.

Despite US President Donald Trump’s false claim that the United States is now doing more per capita tests than any other country, several countries are doing better. Germany, as of late last week, was testing 1 in 90 citizens, compared to 1 in every 273 people in the United States.

These numbers enable German officials to find infections early, even among asymptomatic patients, isolate them and contain the disease from spreading.

And only widespread testing will permit scientists to amass the data required to get a clear picture of the disease, including how many people have had it and shown no symptoms, which means they can return to work.

Moreover, widespread testing is vital to figuring out the real death rate from COVID-19, and for finding a response to blunt the virus if it returns in a second wave.

So here are the two key important reasons Germany has been able to conduct widespread testing -- while the United States has faltered until now.

First, political leadership. “Germany and the United States both have federal systems,” says Sauerbrey, “but the polarization is not that great here.” Germany’s minister presidents (the equivalent of elected state governors) come from different parties, but were “able to cooperate and create a common set of rules,” she explains. Despite upcoming state elections, they dropped partisan rhetoric.

“They didn‘t use this for political show,” Sauerbrey adds.

Equally important, Chancellor Angela Merkel -- who had appeared to be fading before the crisis -- rose to the challenge, inspiring the public and working with state governments. “She did a great job communicating to the public how dangerous the virus was and how important solidarity is,” says Sauerbrey. “Her first speech was intense and emotional, and people understood the need to change their behavior.”

But lastly, Germany was able to administer tests and avoid overwhelming its health system because that system is so solid. “What can really drive death rates is if you don’t have enough intensive care beds,” says Sauerbrey, and Germany had them. Germans have a universal health care system, but with private doctors and a dual public-private system that guarantees coverage to all. “In Germany, you don‘t have to be afraid to call in sick,” says Sauerbrey.

National and state leadership, a solid health system and widespread ongoing testing -- unburdened by shortages, partisan politics and a chaotic health system.

Need I say more?

And then there is the case of Korea, which has become the global gold standard on testing and keeping COVID-19 in check. But what I want to write about here is Seoul’s success at solving its face mask shortage.

After an initial mask crisis, the central government decided to intervene in production and distribution, writes E. Tammy Kim in the New York Times. By early March, the government was purchasing 80 percent of the national production of KF-94 masks, the equivalent of the American N95, from the nation’s 130 or so manufacturers (for comparison, think how the US mask crisis might have been avoided if Trump had made robust use of the Defense Production Act).

The masks were shipped at a discounted price, first to hospitals and health providers, and then to pharmacies all over the country. No first responders washing masks or improvising bandanas in Seoul. No long lines at pharmacies, and everyone on the street is wearing masks (as CDC guidance now recommends for the US).

I asked Alexander Vershbow, former US ambassador to South Korea and distinguished visiting fellow at the University of Pennsylvania’s Perry World House, what the keys were to this process.

He replied that there is close trust between the government and chaebol. Businesses are more mindful of the national interest, so they worked together to bend regulations on tests, and have competed to produce the best tests and accelerate production.

“There was much more of a consensus on what needed to be done, and almost a worship of science and innovation. An educated public understood that a science-based approach was needed.”

What Germany and Korea have done is totally within the capacity of the US. In theory. If this crisis forces Americans to face up to why we are falling behind.


Trudy Rubin
Trudy Rubin is a columnist and editorial board member for the Philadelphia Inquirer. -- Ed.

(The Philadelphia Inquirer/Tribune Content Agency)