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The Tragedy of the Numbers

May 11, 2020 Coronavirus (Covid-19) No Comments Email Email

“All happy families are alike; each unhappy family is unhappy in its own way.”  (Leo Tolstoy, Anna Karenina).

The tragedies continue.  While new COVID-19 cases are starting to decline in some of the hardest-hit countries, the death toll continues to rise everywhere.  This is a story of how the response to the pandemic, and the results from that response, have played out differently from one country to another.  It’s a story that can be told with infographics like this one, which hopefully will help us to deal more effectively with the next pandemic:

This graph charts the progression of the pandemic in the six countries that have experienced the most COVID-19 cases.  It shows total cases along the horizontal axis and total deaths along the vertical axis.  To make the comparisons more meaningful, both metrics are per 1MM population, and each country’s curve starts on the day it reached a threshold number of 10 total cases per MM (i.e., about 3,300 cases in the U.S.).

Unlike most of the COVID-19 graphs we’ve seen, time is not one of the dimensions being graphed.  However, each marker along a country’s curve reflects one more day, so whether a trend is accelerating or decreasing can be seen by changes in the distance between markers – the horizontal difference for the number of new cases, and the vertical distance for additional deaths.  Also, the slope of each country’s curve gives you a sense of how deadly COVID-19 has been in each country; to aid that understanding, the broken gray lines emanating from the origin show all the points where the case fatality rate (CFR) – i.e., total deaths divided by total cases – equals 2%, 5%, 10%, or 15%.

Some observations that emerge from a quick glance:

  • Spain is a true tragedy.  Its total deaths and total cases far exceed the other five countries’.  Thankfully, both numbers are starting to decline significantly – you can see that by the shrinking gaps between the markers.
  • The U.S. does not score well, at least in terms of disease spread.  To better compare the U.S. to the other countries shown, we’ve drawn a circle around the point on each country’s curve showing its position 53 days into its case progression.  The U.S. has seen double the cases Germany had seen at the same point and nearly 40% more than the combined Italy/France/U.K. group.  The percentage of the population diagnosed with COVID-19 in the U.S. began to exceed Italy’s percentage four days ago, and may ultimately overtake Spain’s.
  • The U.K doesn’t score well, either.  A closer examination of the markers along each curve shows that the U.K. is the only country shown whose total cases are continuing to grow at a rate comparable to the U.S.’s.  Moreover, the U.K.’s case fatality rate of 15.0% is the second highest CFR in the world, exceeded only by Belgium’s 16.4%.
  • COVID-19 is lethal.  Three countries – Spain, Italy, and France – have CFRs at or approaching 15%, and Spain’s has hovered above 10% for the last month.  Even in the U.S. and Germany, the two countries with the lowest CFRs – 5.9% and 4.3%, respectively – the curves are showing an ominous upward bend.  By comparison, a frequently cited estimate of the common flu’s CFR in an average year is 0.1% – and some think even that estimate is high.  While it’s a virtual certainty that the COVID-19 CFRs shown are overstated because many asymptomatic or mild cases have gone unreported, after any reasonable adjustment for unreported cases COVID-19 is still much, much deadlier.
  • Germany is doing something right.  The picture tells that story.

Sometimes the numbers, and especially the visualizations of those numbers, tell a powerful story.  Unfortunately in this case, it’s a very sad story.  But the same pictures show glimmers of hope as well.

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