The United States and Germany are two high income nations with strong healthcare systems that differed quite significantly in pandemic outcomes. From the onset of the COVID-19 pandemic to March 1rst, 2021, The United States recorded nearly three times as many COVID cases per capita than Germany and nearly two times as many COVID deaths per capita. In my comparative analysis between the two countries, I examine differences in health demographics, healthcare delivery, mask mandates, testing strategy, PPE procurement, and social distancing policies between the two countries and analyze the degree to which these differences account for different infection and death rates. I found that the United States has significantly higher rates of comorbidities compared to Germany that increase the chance of hospitalization and death from COVID. Testing rates and percent positivity suggests that Germany was testing much more adequately for the virus. Although there was tremendous variation within both countries, Germany appeared to have a more unified approach in mask mandates and reopening plans between its federal states. Finally, both countries suffered widespread PPE shortages due to a lack of a domestic supply chains and over reliance on imports.