Why is the COVID death rate surging in Germany?

In Germany, the COVID mortality rate is increasing much faster than last year around the same time. Since August 4, 2021, there has been a more or less steady increase in daily COVID-19 deaths relative to population in Germany, along with a clear acceleration since October 24.

According to information from Our World in Data, roughly the same COVID-19 mortality rate was noted on August 4, 2020. But since that same date this year, rates have diverged dramatically.

Last year, COVID-19 deaths did not dramatically increase until September 22, 2020. From that moment onward, the numbers steadily increased, with a dramatic spike from October 27, 2020, until peaking on January 14, 2021.

Strict lockdown from December 2020

Last year, a so-called "lockdown light" was announced in Germany on November 2. The contact restrictions were meant to significantly reduce the number of infections ahead of the Christmas holidays. This was not effective. As a result, measures were tightened further.

On December 13, 2020, the German government announced strict measures to control both the COVID-19 infection and mortality rates. The new restrictions were initially planned to last until January 10, 2021, but were extended several times until May 2021.

What is different this year?

Currently in Germany, the COVID mortality rate is almost as high as it was exactly a year ago. In contrast to last year, however, the numbers have been steadily increasing since August, and not since October.

One major point is that numbers of new infections are currently significantly higher altogether than in the comparable period of the previous year. The current seven-day incidence for new infections in Germany broke 400 for the first time on November 24, and continues to rise. 

An additional factor are how the current restrictions do not compare to those from last year. In the strict lockdown of last year, for example, clubs and bars were closed, and personal meetings were tightly restricted. Indoor events were also largely prohibited.

Restrictions currently in place, however, include allowing only those who are vaccinated or recovered (a rule known as "2G" in Germany, for geimpft/genesen) to enter public venues like restaurants and movie theaters. Nationwide, public transport is now "3G," also allowing people who present a negative COVID test (the third G stands for getestet). In some regions, also visiting stores is only allowed with 3G proof — so vaccination, recovery or a current test.

And in addition, at this point in time about 68% of Germans have been fully vaccinated against COVID-19, in comparison to virtually none last year.

This considerable proportion of the population who are not vaccinated (or not fully vaccinated) plays a major role, as the Robert Koch Institute (RKI), the government agency for infectious diseases, told DW: "This also applies to the elderly, who have the highest risk of death." Among people over 60, more than 3 million people have not yet been vaccinated.

Most of the deaths related to COVID-19 can be traced back to unvaccinated people, RKI statistics indicate. And according to intensive care medics, 90% of the COVID patients in ICUs in Germany are unvaccinated. The RKI says the chance of survival is only 53% for COVID patients in the ICU once they go on a ventilator, whether vaccinated or not.

So in essence, Germany is facing the same mortality rate as last year — but with many more times the number of infections, and for the great majority among the unvaccinated.

Who is dying now?

Last year, it was largely elderly people dying of COVID-19, particularly before the vaccine became available. Of all deaths reported since mid-March of 2020, after vaccines began to be rolled out for vulnerable populations, 86% were 70 and older, while the median age was 84. The median age of those with a fatal course of the coronavirus is currently at 83 years. So, the median age has only slightly dropped — but following current trends, it is expected to drop much more.

However, according to intensive care medics, the average age of COVID-19 patients in intensive care units now is significantly lower than in spring or even last autumn this year.

In an interview with the German news channel tagesschau24, intensive care doctor Uwe Janssens from the German Interdisciplinary Association for Intensive Care and Emergency Medicine warned about the dramatic situation facing German ICUs.

According to him, just fewer than half of COVID patients in intensive care units are under 60, which represents a break from past coronavirus surges.

"Many patients are 30 or 40 years old — and they're seriously ill. The majority of these people are not vaccinated. The mortality exceeds 50% — especially among the younger people," said Janssens.

How to reduce the death rate?

According to Germany's RKI, breakthrough cases — where someone who is vaccinated gets infected — are not significant in the mortality rate at the moment. Nevertheless, Germany's Standing Committee on Vaccination (StiKo) recommends a booster shot to help against the waning effect of vaccinations.

Janssens' urgent appeal is to get vaccinated, particularly for those 3 million people at higher risk over the age of 60 who have yet to receive a single shot. Beyond that, 13 to 14 million people in Germany between the ages of 18 and 59 have not yet been vaccinated. These people face a high risk of catching the more infectious delta variant of the virus.

Edited by: Sonya Diehn