> I've not heard a convincing explanation for Germany's relative success based only on the quality of its healthcare system and interventions. That isn't to deny that they played an important role, just that they may not have been the whole story.
Of course "its healthcare system" is not the whole story alone. "Its healthcare system and interventions" is a good enough precondition, combined with the timing: it was since long obvious that the difference in timing of introducing the interventions immensely changes the number of deaths in the first peak: first order approximation: if the doubling time is 3 days, interventions of 2 weeks earlier compared to some other country could result in 2 ^ 4 = 16 times less deaths per capita. It's very primitive approximation but good enough to make such an argument (even if it's significantly off, it is to show how little time result in big changes). For more detailed elaboration there was recently a paper calculating the difference with more exact models, I believe for the UK. (edit: found one for the US https://www.medrxiv.org/content/10.1101/2020.05.15.20103655v... )
So the story for Germany is: luck, in having the early warning and the capability to act on it: Italy have had its spread earlier and it gave Germany enough of "early warning" which was effectively used. The bigger story is the failure of other countries who also practically had the same "early warning" and remained blind to it, until they recognized that they had do "do something" but with the resulting cost of more deaths.
Europe is a good enough field where a lot of effects could be clearly observed, all countries having in some important aspects significantly more sane health system than the U.S. We also know for sure that the excess deaths due to the all causes together can't be hidden in these countries (see https://euromomo.eu/graphs-and-maps/ ), so we now know exactly how bad which country was hit. Comparing the rich European countries and knowing how they function all the differences among them are indeed very explainable, I don't see any surprises: it's the interventions and learning from the experience of other countries that consistently worked.
U.S. was of course much less ready to learn from anybody. In spite of that, the deaths per million in the U.S. is still 362 while it's 500 in Sweden -- so we all have a good "negative example" from Sweden. Note also that Sweden did close universities and older classes in schools, and suggested everybody who can to work from home, and still got to be that bad -- only because their interventions were by design less strong compared to other European countries.
Reported daily deaths per million in USA, Sweden, Germany and Italy, "by number of days since 0.1 average deaths (per million) first recorded" compared:
Note that "it lasted longer in Italy" for almost 20 days -- that was the early warning available to other countries. Some used it. Pity that FT doesn't display simply all the curves based only on the dates. Also, too big entities like the whole USA or China aren't a good comparison, the big less infected areas (due to them being simply less reachable) move the averages down too much -- a better base for comparison would be the entities on the order of 10 millions. E.g. in the USA, NY is definitely a phenomenon that is worth observing separately etc.
Of course "its healthcare system" is not the whole story alone. "Its healthcare system and interventions" is a good enough precondition, combined with the timing: it was since long obvious that the difference in timing of introducing the interventions immensely changes the number of deaths in the first peak: first order approximation: if the doubling time is 3 days, interventions of 2 weeks earlier compared to some other country could result in 2 ^ 4 = 16 times less deaths per capita. It's very primitive approximation but good enough to make such an argument (even if it's significantly off, it is to show how little time result in big changes). For more detailed elaboration there was recently a paper calculating the difference with more exact models, I believe for the UK. (edit: found one for the US https://www.medrxiv.org/content/10.1101/2020.05.15.20103655v... )
So the story for Germany is: luck, in having the early warning and the capability to act on it: Italy have had its spread earlier and it gave Germany enough of "early warning" which was effectively used. The bigger story is the failure of other countries who also practically had the same "early warning" and remained blind to it, until they recognized that they had do "do something" but with the resulting cost of more deaths.
Europe is a good enough field where a lot of effects could be clearly observed, all countries having in some important aspects significantly more sane health system than the U.S. We also know for sure that the excess deaths due to the all causes together can't be hidden in these countries (see https://euromomo.eu/graphs-and-maps/ ), so we now know exactly how bad which country was hit. Comparing the rich European countries and knowing how they function all the differences among them are indeed very explainable, I don't see any surprises: it's the interventions and learning from the experience of other countries that consistently worked.
U.S. was of course much less ready to learn from anybody. In spite of that, the deaths per million in the U.S. is still 362 while it's 500 in Sweden -- so we all have a good "negative example" from Sweden. Note also that Sweden did close universities and older classes in schools, and suggested everybody who can to work from home, and still got to be that bad -- only because their interventions were by design less strong compared to other European countries.
Reported daily deaths per million in USA, Sweden, Germany and Italy, "by number of days since 0.1 average deaths (per million) first recorded" compared:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=swe&are...
Note that "it lasted longer in Italy" for almost 20 days -- that was the early warning available to other countries. Some used it. Pity that FT doesn't display simply all the curves based only on the dates. Also, too big entities like the whole USA or China aren't a good comparison, the big less infected areas (due to them being simply less reachable) move the averages down too much -- a better base for comparison would be the entities on the order of 10 millions. E.g. in the USA, NY is definitely a phenomenon that is worth observing separately etc.