IDEAS home Printed from https://ideas.repec.org/a/dem/demres/v45y2021i45.html
   My bibliography  Save this article

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

Author

Listed:
  • Saskia Morwinsky

    (Universität Rostock)

  • Natalie Nitsche

    (Australian National University)

  • Enrique Acosta

    (Max-Planck-Institut für Demografische Forschung)

Abstract

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.

Suggested Citation

  • Saskia Morwinsky & Natalie Nitsche & Enrique Acosta, 2021. "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," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(45), pages 1355-1372.
    • Handle: RePEc:dem:demres:v:45:y:2021:i:45
    DOI: 10.4054/DemRes.2021.45.45
    as

    Download full text from publisher

    File URL: https://www.demographic-research.org/volumes/vol45/45/45-45.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.4054/DemRes.2021.45.45?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Shiro Horiuchi & John Wilmoth & Scott Pletcher, 2008. "A decomposition method based on a model of continuous change," Demography, Springer;Population Association of America (PAA), vol. 45(4), pages 785-801, November.
    2. Andrew T. Levin & William P. Hanage & Nana Owusu-Boaitey & Kensington B. Cochran & Seamus P. Walsh & Gideon Meyerowitz-Katz, 2020. "Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications," NBER Working Papers 27597, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    2. José M. Aburto & Alyson A. van Raalte, 2017. "Lifespan dispersion in times of life expectancy fluctuation: the case of Central and Eastern Europe," MPIDR Working Papers WP-2017-018, Max Planck Institute for Demographic Research, Rostock, Germany.
    3. Lin Ma & Gil Shapira & Damien de Walque & Quy‐Toan Do & Jed Friedman & Andrei A. Levchenko, 2022. "The Intergenerational Mortality Trade‐Off Of Covid‐19 Lockdown Policies," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(3), pages 1427-1468, August.
    4. Paul Labonne & Leif Anders Thorsrud, 2023. "Risky news and credit market sentiment," Working Papers No 14/2023, Centre for Applied Macro- and Petroleum economics (CAMP), BI Norwegian Business School.
    5. Jan Krzysztof Solarz & Krzysztof Waliszewski, 2020. "Holistic Framework for COVID-19 Pandemic as Systemic Risk," European Research Studies Journal, European Research Studies Journal, vol. 0(Special 2), pages 340-351.
    6. Miguel Casares & Paul Gomme & Hashmat Khan, 2022. "COVID‐19 pandemic and economic scenarios for Ontario," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(S1), pages 503-539, February.
    7. Andrew Perrault & Marie Charpignon & Jonathan Gruber & Milind Tambe & Maimuna Majumder, 2020. "Designing Efficient Contact Tracing Through Risk-Based Quarantining," NBER Working Papers 28135, National Bureau of Economic Research, Inc.
    8. Tara McKay & Rachel Sullivan Robinson & Serena Musungu & Nana Addo Padi‐Adjirackor & Nicole Angotti, 2024. "The Missing Millions: Uncovering the Burden of Covid‐19 Cases and Deaths in the African Region," Population and Development Review, The Population Council, Inc., vol. 50(1), pages 7-58, March.
    9. Alyson Raalte & Hal Caswell, 2013. "Perturbation Analysis of Indices of Lifespan Variability," Demography, Springer;Population Association of America (PAA), vol. 50(5), pages 1615-1640, October.
    10. Quang Dang Nguyen & Mikhail Prokopenko, 2022. "A general framework for optimising cost-effectiveness of pandemic response under partial intervention measures," Papers 2205.08996, arXiv.org, revised Nov 2022.
    11. Dmitri A. Jdanov & Vladimir M. Shkolnikov & Alyson A. van Raalte & Evgeny M. Andreev, 2017. "Decomposing Current Mortality Differences Into Initial Differences and Differences in Trends: The Contour Decomposition Method," Demography, Springer;Population Association of America (PAA), vol. 54(4), pages 1579-1602, August.
    12. Kathryn Grace & Stuart Sweeney, 2016. "Ethnic Dimensions of Guatemala’s Stalled Transition: A Parity-Specific Analysis of Ladino and Indigenous Fertility Regimes," Demography, Springer;Population Association of America (PAA), vol. 53(1), pages 117-137, February.
    13. Aburto, José Manuel & di Lego, Vanessa & Riffe, Tim & Kashyap, Ridhi & van Raalte, Alyson & Torrisi, Orsola, 2023. "A global assessment of the impact of violence on lifetime uncertainty," LSE Research Online Documents on Economics 118196, London School of Economics and Political Science, LSE Library.
    14. Ilya Kashnitsky & Jose Manuel Aburto, 2019. "Geofaceting: Aligning small-multiples for regions in a spatially meaningful way," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 41(17), pages 477-490.
    15. Seaman, Rosie & Riffe, Tim & Leyland, Alastair H. & Popham, Frank & van Raalte, Alyson, 2019. "The increasing lifespan variation gradient by area-level deprivation: A decomposition analysis of Scotland 1981–2011," Social Science & Medicine, Elsevier, vol. 230(C), pages 147-157.
    16. Christian Dudel & Timothy Riffe & Enrique Acosta & Alyson A. van Raalte & Cosmo Strozza & Mikko Myrskylä, 2020. "Monitoring trends and differences in COVID-19 case-fatality rates using decomposition methods: contributions of age structure and age-specific fatality," MPIDR Working Papers WP-2020-020, Max Planck Institute for Demographic Research, Rostock, Germany.
    17. Aburto, José Manuel & Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Black-white disparities during an epidemic: Life expectancy and lifespan disparity in the US, 1980–2000," Economics & Human Biology, Elsevier, vol. 40(C).
    18. Hazhir Rahmandad, 2022. "Behavioral responses to risk promote vaccinating high‐contact individuals first," System Dynamics Review, System Dynamics Society, vol. 38(3), pages 246-263, July.
    19. Marie-Pier Bergeron-Boucher & Marcus Ebeling & Vladimir Canudas-Romo, 2015. "Decomposing changes in life expectancy: Compression versus shifting mortality," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 33(14), pages 391-424.
    20. Giacomo De Nicola & Göran Kauermann & Michael Höhle, 2022. "On assessing excess mortality in Germany during the COVID-19 pandemic [Zur Berechnung der Übersterblichkeit in Deutschland während der COVID-19-Pandemie]," AStA Wirtschafts- und Sozialstatistisches Archiv, Springer;Deutsche Statistische Gesellschaft - German Statistical Society, vol. 16(1), pages 5-20, March.

    More about this item

    Keywords

    COVID-19; Germany; demographic composition; decomposition; case fatality rate;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:dem:demres:v:45:y:2021:i:45. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Editorial Office (email available below). General contact details of provider: https://www.demogr.mpg.de/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.