Volume 45 - Article 45 | Pages 1355–1372
COVID-19 fatality in Germany: Demographic determinants of variation in case-fatality rates across and within German federal states during the first and second waves
|Date received:||17 May 2021|
|Date published:||22 Dec 2021|
|Keywords:||case fatality rate, COVID-19, decomposition, demographic composition, Germany|
Background: Germany experienced one of the lowest COVID-19 case-fatality rates (CFRs) in Western Europe in the first pandemic wave, and further CFR decreases in the spring and summer of 2020. However, Germany’s CFR increased markedly during the second wave, becoming one of the highest in Western Europe. Furthermore, CFRs varied considerably across German federal states. The drivers of this CFR time trend and the state differences remain unclear.
Objective: We aim to identify the contribution to the CFR differences across and within German states of (1) the population age structure, (2) the age structure of confirmed infection rates, and (3) the age-specific fatality.
Methods: We use data documenting COVID-19 cases and deaths from the COVerAGE-DB, applying demographic decomposition methods proposed by Kitagawa and Horiuchi.
Results: The CFR decrease between spring and autumn 2020 in Germany resulted from a shift toward younger ages in confirmed infection rates and decreasing age-specific fatality. The CFR increase that followed was predominantly driven by a shift toward older ages in the age composition of confirmed infection rates. Although most of the CFR variation across German states resulted from differences in the population age distribution, differences in the age structure of detected infection rates contributed substantially to this variation.
Conclusions: Differences in German CFRs depended mainly on the age structure of the population and the confirmed infection rates. Age-specific fatality played a noteworthy role only in CFR changes over time.
Contribution: We provide previously undocumented information for Germany on the factors modulating differences in the COVID-19 fatality across states and over time.
Saskia Morwinsky - Universität Rostock, Germany
Natalie Nitsche - Max-Planck-Institut für Demografische Forschung, Germany
Enrique Acosta - Max-Planck-Institut für Demografische Forschung, Germany
Other articles by the same author/authors in Demographic Research
APC curvature plots: Displaying nonlinear age-period-cohort patterns on Lexis plots
Volume 41 - Article 42
Most recent similar articles in Demographic Research
Delayed first births and completed fertility across the 1940–1969 birth cohorts
Volume 48 - Article 15 | Keywords: decomposition
Differential impact of the COVID-19 pandemic on excess mortality and life expectancy loss within the Hispanic population
Volume 48 - Article 12 | Keywords: COVID-19
The COVID-19 pandemic’s unequal socioeconomic impacts on minority groups in the United States
Volume 47 - Article 33 | Keywords: COVID-19
Do the consequences of parental separation for children’s educational success vary by parental education? The role of educational thresholds
Volume 47 - Article 28 | Keywords: Germany
Life expectancy loss among Native Americans during the COVID-19 pandemic
Volume 47 - Article 9 | Keywords: COVID-19
Cited References: 25
»View the references of this article
Download to Citation Manager