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1st or 2nd Wave? It’s Just a Semantic Issue

June 18, 2020 Coronavirus (Covid-19) No Comments Email Email

In the last few days, much has been written about the fact that U.S.’s COVID-19 new cases trend is not dropping the way it should.  These writers wonder whether we’re experiencing a second wave, or whether it’s just a continuation of the first wave.  Well, what I’m wondering is: WHO CARES?  The fact is that the U.S.’s new cases simply aren’t declining the way other western countries’ are, and we should be focusing on why that is and not on what to label it.

Any meaningful analysis must compare the U.S. to other countries; looking at the U.S. by itself is pointless.  The following graph compares the new COVID-19 cases trends for the U.S., Canada, and the seven nations of western Europe that have seen the most cases to-date.  To enable country-to-country comparisons, it shows new cases per 1MM population, and each country’s graph starts on the day it reached a threshold amount of 10 total cases per 1MM population (about 3,300 cases in the U.S).

First, the similarities in the nine country curves:  With the exception of Sweden (more on that below) all begin with a rapid acceleration in new cases, reach a peak at four to seven weeks, and then start to decline.  By now, thirteen to fifteen weeks along in each country’s pandemic, six of the countries have reduced new cases to less than 10 New Cases/MM/day.  Most of the curves somewhat resemble those stylized “flattening the curve” images that were ubiquitous early in the pandemic.

And now, the differences:  On a positive note, the curves for Germany and France show the lowest peaks and the rapidest declines.  Sadly, while the two countries’ curves are very similar, the death rate per reported case – a metric not presented here – is about four times higher for France than it is for Germany.  Canada’s peak is similarly low, with both an ascent and a descent slower than other countries – this is perhaps the best example shown of “flattening the curve”.

On a sadder note, Spain and Belgium saw equally rapid ramp-ups in new cases, peaking at rates much higher than the other countries shown.  Both countries have since brought new cases down to very low levels, but even more tragically, have suffered some of the highest death rates of any countries in the world.  The U.K.’s peak level of new cases was in the middle of the pack, but they are still struggling to bring that level down, and have experienced death rates comparable to Belgium’s and Spain’s.

Sweden is an outlier.  More than any other country in the wealthy world, Sweden chose a more laissez-fair approach, keeping schools and most businesses open.  Perhaps as a result, now 14 weeks into Sweden’s pandemic new cases are continuing to rise, to rates exceeded only by Spain and Belgium at their peaks.  The initial ramp-up in Sweden’s new cases per day was more moderate than any of the other countries shown, but that may be partly due to the fact that Sweden has done less testing than most other western countries, so mild or asymptomatic cases have gone unreported.

Which brings us to the U.S.  We saw the same sharp initial rise in new cases as the other countries did, reaching a peak rate that was one of the highest.  Like all the other countries except Sweden, we shut down our economy for several weeks in an effort to control the pandemic.  But there the similarity ends.  While the other countries dramatically reduced new cases, the spread of new cases in the U.S. has slowed only slightly, leaving us with precious little to show for the terrible economic cost of a shutdown.  Why the difference?  Entire books will be written about this, but possible contributors include:

  • We’re 50 states as much as we’re one nation.  Unlike most other western nations, the U.S.’s federal structure makes problematic a single, unified national response in most areas other than national defense.  In spite of some of the rhetoric, our federal government has done relatively little to coordinate a national plan of action, and sometimes even the rhetoric itself has worked against any national coordination.  Meanwhile, the pandemic has played whack-a-mole with the nation, popping up in new cities and states as we stymy it in others.
  • Testing.  This is essential to controlling a pandemic like COVID-19.  Compared to most other wealthy nations – and contrary to some of the rhetoric on the subject – the U.S. has simply not built up a strong testing capability.  This will have long-term consequences.
  • We simply haven’t complied well.  We are a nation of people who feel strongly about our right to do as we please.  That perspective has served us extremely well, but it’s not helpful in a pandemic.  Even worse, in some quarters noncompliance with good public health standards has been seen as a political statement.

There’s no question that the U.S.’s COVID-19 numbers and trends are very different from other nations in the wealthy west, and not in a good way.  But rather than putting a label on those differences, let’s focus on what brought us to that point, and how to use our national strengths to combat the pandemic.

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