What is clearer is that the first wave of covid-19 infections in Italy was predominantly among older people, who are far more likely to die than younger people, even with the best of care. The median age of those diagnosed with covid-19 in Italy is 63 years, compared with 47 in Germany. The two countries have a similar share of older people in the general population. But only 20% of cases reported in Germany are people aged over 60, compared with 56% of those in Italy. The early German cases seem to have contracted the disease at carnivals and ski-resorts, which explains why the initial profile is so young.
Another reason why Italy’s death rate looks much higher is that its epidemic began earlier. Covid-19 deaths lag behind infections by several weeks. That means that for quite a time the disease can spread unnoticed. Italy’s first deaths were on February 22nd, Germany’s two weeks later. So a large number of Germans who are already infected will become sicker and die in the coming days and weeks. That is starting to happen. On March 23rd Germany’s cumulative number of covid-19 deaths jumped by 56%; the next day’s increase was 33%.
Lastly, Italy’s deaths would not be so numerous if its covid-19 patients had not overwhelmed its hospitals. The country’s epidemic has been concentrated in the Lombardy region, whereas Germany’s cases have been distributed more broadly across several hotspots. As the disease spreads in both countries, it will become clearer whether the German health system really is so much better than Italy’s at keeping covid-19 patients alive. ■