New International Covid-19 Data Revealing

Saturday, 22 August 2020, 5:42 pm
Article: Ian Powell

Since Covid-19 hit the shores of New Zealand in what seems an eternity ago I have faithfully accessed the World Health Organisation’s website for their daily country updates. This has been useful because you can see for each country the confirmed cases and deaths for both the (a) total numbers to date and (b) the numbers for the preceding 24 hours.

WHO has now changed its website reporting to weekly which evens out daily glitches such as technical difficulties and reporting delays. More significant though is the introduction of a new measurement of cumulative deaths per million. WHO can’t do much about the reliability of some of the data submitted (especially from countries without a universal health system). Nevertheless this new measurement provides more confidence in international comparisons. The deaths per million reveal some surprises and also provides an excellent context and perspective on the effectiveness of New Zealand’s elimination strategy.

Worst performers

From 30 December to 16 August the cumulative global total of cases was 21.1 million confirmed cases (including 761,000 deaths). For the week ended 16 August there were 1.8 million new confirmed cases and 39,000 new deaths. The Americas was the biggest affected region followed by south-east Asia.

The worst performing country is meaningless for comparative purposes. San Marino, a mountainous microstate locating within central and north Italy had 1,238 deaths per million. Scary? Perspective is required. San Marino had 42 deaths in total, has a population of around 35,000 (similar to the size of New Zealand’s West Coast) and is squeezed inside 61.2 square kilometres. Andorra has the third highest death rate (686) but, located in the Pyrenees, had 53 deaths out of a population of around 77,000. Both are tourist attractions.

Putting microstates aside, the highest per million death rate due to Covid-19 is Belgium (857), a small country but with a population of 11.5 million. Belgium had its first confirmed case on 4 February with a returnee from Wuhan. In early March cases escalated with a wave of school holiday returnees from northern Italy where the virus was rife. Belgium was hit early and responded slowly with a fragmented political distance. Initially social distancing was only recommended and decisions to close borders and use lockdown measures were far too late.

Eight other countries had death rates above 500 per million. There is some personal sadness with the next highest, Peru (784), as my grandson is half-Peruvian. He and I have a large extended family in Peru. In order, the remaining worst performing countries (over 500 per million) are Spain (612), United Kingdom (609), Italy (585), Sweden (573), Chile (544), United States (505) and Brazil (501).

Demolishing of Swedish alternative

It is astonishing (shocking is another applicable description) that some still see Sweden’s ‘herd immunity’ (that’s not allowed to be called ‘herd immunity’) approach as a model for New Zealand to seriously consider. The other Nordic countries rejected Sweden’s approach and instead have instead gone for their own forms of lockdown.

The contrast with Sweden’s 573 deaths per million is standout – Denmark (107), Finland (60), Norway (48) and Iceland (29). It is revealing that these other countries won’t include Sweden in developing an economic bubble because of the high risks to both the health of their populations and their economic recovery.

Good performers

On the other side of the ledger Vietnam rates at a remarkable less than 1 per million. Vietnam has learnt much from its earlier experience of influenza epidemics. As the country first hit by the virus and initially struggling with the Wuhan outbreak, through an effective whole-of-country approach including tough lockdowns and other effective public health measures, China impresses with 3 per million. Its data is something Donald Trump will never acknowledge.

Cuba is impressive given the intensified United States’ economic warfare whose targets include the Caribbean island’s health system – 8 per million. Other good performers include Singapore (5), South Korea (6) and Japan (9). Even Australia, even despite currently going through its largely Melbourne outbreak, still compares well with the above 500 brigade at 15 per million.

What about New Zealand

So where does this leave New Zealand performance internationally which is currently under attack from the venal and incompetent Donald Trump. The border security and testing lapses have been demoralising for many of those supporting the elimination objective. There is justification for much of the criticism, but context and perspective are required.

The Government’s response to the recent outbreak has been quick and firm. It appears to be under control and diminishing. Further, the fight against a pandemic that is still raging in much of the rest of the world is massive and unprecedented.

So what is New Zealand’s Covid-19 death rate per 1 million? If you believe Trump and the rabid domestic critics we must be soaring towards 500 or worse. But, according to WHO, it is 5. As good as Singapore, 3 times better than Australia and 100 times better that the United States. If this is failure then let’s have more of it!

The first moral of the story is by all means be critical when criticism is deserved (and it has been). But keep it in context. Perspective is required. Internationally the current outbreak is miniscule compared with 5 deaths per million.

The second is that if you want a quick guide to the truth on something go, to what Trump says on it and the truth will be the opposite.

© Scoop Media

Ian Powell

Otaihanga Second Opinion is a regular health systems blog in New Zealand.

Ian Powell is the editor of the health systems blog 'Otaihanga Second Opinion.' He is also a columnist for New Zealand Doctor, occasional columnist for the Sunday Star Times, and contributor to the Victoria University hosted Democracy Project. For over 30 years , until December 2019, he was the Executive Director of Association of Salaried Medical Specialists, the union representing senior doctors and dentists in New Zealand.

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