Most of Europe has been experiencing a huge COVID-19 outbreak in recent weeks.  If the EU was considered as a single country it would have a population 40% more than the US.  If we take just the top 9 most infected EU countries that we track it would closely match the population of the US.  These countries already have over 30,000 confirmed cases and the US is headed there before the end of this month.  These countries also have over 1,700 reported deaths.  Hopefully the US will not match this death count soon since the aggregated number include the tragedy unfolding in Italy. 

There are no winners in this global tragedy but there are definitely countries that are suffering more than others.  Clearly Italy is a big loser with 1266 deaths to date, increasing rapidly.  There also appears to be other countries such those in Scandinavia that appear to have very low mortality rates but the count is too low to be statistically significant yet.  But there are two countries, neither bordering  Italy, whose confirmed cases are both rising rapidly but who are experiencing very different mortality rates: Spain and Germany.  Spain and Germany are both headed on parallel exponential paths toward full on contagion with Germany expecting the majority of its citizens will contract the disease before it’s over without quick, concerted intervention.  

Spain  1376.3911953.1%15.5%
Germany554,599    90.2%0.4%
95% confidence low0.1%0.2%
95% confidence high0.4%0.8%

Germany has a coincident mortality rate of 0.2% that is statistically very significantly different than Spain’s 3.1%.  Out best guess of the real underlying mortality rate (comparing to the confirmed cases an average of 5 days earlier) is 0.4% for Germany versus 15.5% for Spain, with Spain suffering 40 times worse.  The table only gives the 95% confidence levels for Germany for clarity but the confidence interval for Spain is tighter than for Germany due its higher number count.  Our best guess is that Spain will be another Italy if they don’t take drastic actions to stop the spread of the virus.

What makes them so different?  It is not median population age which is a significant contributor to the fortunes of the Scandinavian countries since Spain’s median age at 44.9 yrs is actually lower than that of Germany’s at 45.7 yrs.  It may be the speed with which each country has responded to the pandemic.  For Germany the difference may be Angela Merkel who has been taking this virus very seriously.  If politics and egos were not factors, Trump could do well to examine Germany’s approach carefully and see if anything could be learned from them.  Will the fate of the US follow Italy and Spain or will it follow Germany?  The death rate could be a difference between thousands versus tens of thousands of dead Americans.