Various people ask this question....no real solid solution/answer exists. I'll offer these observations:
1. Most non-Germans (Americans, Brits, New Zealanders, etc) will definitely say after two years in the country....that Germans are hyper about sanitation and hygiene. I might go and rate the Japanese slightly higher, but Germans are often consumed with good hygiene habits.
It's like discussing food poisoning in Germany and finding it's an extremely rare thing.
When you go and visit a German house for the first time....they kinda let you know where the WC is located, and on occasion even point at the soap dispenser in particular.
2. Distancing. Even before this topic came up in the past month....Germans often keep their distance. It was already a common practice except at sports events and fests. You step up to a line (say in 2018), and there was already half-a-meter or more of distance between you and most other Germans.
3. Older Germans reside in rest-homes. Unlike Italy or Spain....most Germans who are getting to a fragile point and not capable of much walking....went into rest-homes rather than the son's house. So they didn't hang out at cafes, grocery shops, etc....in their home town.
4. Germans and the short list of friends. Germans in general, will tell you that they have a very short list of 'good' friends (maybe less than three). When they socialize for the most part....one of those three will be in the social 'moment'. So if you asked a German about their contact list, and went to the friend....other than fellow train-passengers, office-coworkers, or the grocery shop personnel....it's a fairly small list of contacts.
5. When Germans get a 'whiff' of illness....they stay home. Unlike the normal American attitude of a cold being a 'joke'....with most of easily going into work, I would suggest that Germans hit that sick-leave 'button' pretty easily.
You can ask some Germans and they will suggest they use twenty-five days a year for sick-leave.
So there is no real answer to this fairly low .4 death rate. Most of the dead are over 70 years old, and most were either frail, with diabetes, CPD, asthma, blood pressure medication, etc. Maybe mathematically.....there are fewer Germans with this health situation, compared against the Italians or Spanish.
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