With 400 public health offices forging ahead with testing, the country is a model for others to emulate

As the coronavirus crisis tests the resilience of democracies around the globe, Germany has gone from cursing its lead-footed, decentralised political system to wondering if federalism’s tortoise versus hare logic puts it in a better position to brave the pandemic than most.

Under German federalism – which has roots going back to the Holy Roman Empire but was entrenched after the Nazi era to weaken centralised rule – key policy areas, such as health, education and cultural affairs, fall under the jurisdiction of the country’s 16 states, or Länder.

At the start of the Covid-19 outbreak, such a highly devolved system of governance made the woman nominally in charge of the country look oddly powerless: even when Angela Merkel announced the first raft of social-distancing measures, she could only make recommendations that the federal states were free to implement or ignore.

As social-distancing measures came into effect, there were howls of frustration over how wildly the lockdowns varied between the states: in Berlin, for example, buying a book from a shop is still allowed but having a picnic in the park is not. In Baden-Württemberg, it’s the other way around.

Federalism is useful for creating a dynamic business environment between different regions, but it can make it hard for an entire country to move in sync.

I don’t have to wait to get a call from the health minister before I can go ahead with a test. Matthias Orth, Marienhospital Stuttgart

States in the formerly socialist east, less severely hit by the virus, were reluctant to close their schools, drawing ire from southern states who feared their students would then be put at a disadvantage.

A week and a half into the de facto lockdown, however, Germany is beginning to discover the upsides of a system which distributes, rather than centralises, power.

The country suddenly finds itself being held up as the model to be emulated for its high rates of testing – seen by many as the only strategy for being able to navigate a route out of lockdown measures.

German public health services are provided not by one central authority but by approximately 400 public health offices, run by municipality and rural district administrations.

Such an environment allows for a variety of laboratories – some attached to universities or hospitals, others privately run, medium-sized businesses – which act largely autonomously of central control.

“I don’t have to wait to get a call from the health minister before I can go ahead with a test,” said Matthias Orth, of the Institute of Laboratory Medicine at Stuttgart’s Marienhospital.

Some private labs started offering tests for the Covid-19 virus long before statutory health insurers were offering to pay for the tests, giving Germany a head start. Now around 250 laboratories are carrying out between 300,000 and 500,000 tests for Covid-19 every week.

Not bad for a lead-footed tortoise.