A Defense of U.S. COVID Status

As I explained to my cousin when I disputed his take on recent coronavirus numbers: I’ve become a COVID stats junkie over the past five months. It started to snowball when I read in the Wall Street Journal about a kid, Avi Schiffmann, a high school student on Mercer Island, in Washington State. He was named “2020 Webby Person of the Year,” presumably for his Coronavirus Dashboard, a coronavirus tracking website. Some people follow the NY Times updates, some Johns Hopkins, some the CDC or Worldometer. But me, I stick with Avi.

Avi Schiffmann Linked In heading

Avi has the data I seek: a saved feature for the spots I want to watch closely (mostly where my family members—and we— live), a world panel to reveal who is better or worse off than you, and separate tables for the USA, Canada, Australia, Europe, Asia, South America, and so on.

This is how I came to take issue with my cousin’s Facebook post, which cited how Japan, Australia, France, and China recorded far fewer deaths than the US on a particular date. Following Avi’s dashboard, I saw that Japan rarely updated its stats. Many of the columns are marked unknown. The fact is we really did not know how Japan is doing. Likewise for China. By now we see that China’s reported data are ludicrous: a population of 1.4 billion has cases on a par with the state of Indiana, population 6.7 million? I don’t believe it. Deaths from COVID in China are pretty even with the state of Connecticut, population 3.6 million? Another suspicious factor: China never updates its number of tests. It’s been stuck at 90 million for months. Avi’s dashboard is a lesson in comparative transparency among the countries of planet Earth.

Why China’s statistics are not credible. Large blue-gray figure represents proportional size of China to the US

Naturally, comparing deaths for any single day is problematic. While France, for instance, may have had fewer deaths on a given day, their deaths per confirmed cases are about 11%, Belgium 12%, and Italy 13.6%. Considering this morbidity rate, even bad-boy Florida comes out relatively golden with a 1.7% deaths to cases ratio.

Comparative size of Australia and US, though Alaska and Hawaii are here omitted.

As for Australia—whose population amounts to 7.8% of the US population (that is 300 million-plus more people live in the US)—Australia is slightly smaller in geographic area. As a result, population density in Australia runs about 7 people per square mile, compared to 93 people per square mile in the US. Thus, a US-Australia comparison is tricky. How much viral spread can you expect if people are not in proximity with one another? In all, we can compare and contrast our numbers with others, but any conclusions depend on contextualizing cases and deaths over time according to population and population density.

The US has endured a global smack-down on its coronavirus status based on piece-meal analyses that shortchange the US health care establishment. Our trusty Avi has recently added columns showing cases per million and deaths per million globally, that is, per capita measures of coronavirus. Now we realize that the US deaths per million is 546, or 0.000546 deaths per US population. Who might have higher deaths per million? The state of New York for one, at 1,695. Mayor Bill DeBlasio of NYC and NY Governor Cuomo have some ‘splainin’ to do. New York and New Jersey are driving the US per capita death rate. Truth be told, the eastern US performs dismally in this statistical column, with New Jersey at rock bottom, meaning with the highest count of deaths per million, reflecting again the impact of population density. Yet looking at rates outside the US, we find higher deaths per million in Belgium, Peru, Chile, the UK, Spain, Italy, and Sweden, with France not far behind. So much for the US as global pariah.

Much has been made of the US lagging far behind in testing for coronavirus, with blame laid squarely at the feet of the sitting President of the United States. I’m no apologist for President Trump, but at this juncture the US must deserve some credit for its testing. Our health care community has gone all in, with drive-in clinics, rapid-test clinics, pharmacies, and free clinics (at our local fairgrounds for one), providing mass testing for anyone and everyone who wants to be tested. A nearby community went door to door to ramp up its testing.

The single country performing the most tests appears to be China, though we already have questioned the currency and veracity of their numbers. Even if China has tested 90 million people, as Avi shows in his dashboard, the US is close on China’s heels, at this writing with 77 million tests among a population smaller than one-fourth of China’s. I must note that China’s cases increase by several a day, but the testing number never changes—which makes one wonder how they can confirm new cases without having added tests.

Pandemic life in Sweden

As I say, the US is roundly shamed for being out of control regarding COVID19. Some say that people in France or New Zealand or Hong Kong admirably obey directions, compared to US free-wheelers. They lock down, wear masks, and dependably socially distance. (I also hear that the French would carry a baguette around when they went for walks in the lockdown phase. The gendarmes wouldn’t question your purpose or fine you if you were out with a baguette. After all, you needed bread.) So why is Sweden not shamed? Sweden, with higher deaths per million. Is it because they admittedly opted not to lockdown to minimize the spread of coronavirus? Sweden aimed for herd immunity, hang the costs in cases and lives. Do we know at this time whether more cases will result in herd immunity? Recent reports cite some experts claiming mission accomplished in Sweden.

So back to the US, which is far above any other single country in sheer numbers of tests and cases. Should a country be faulted for large numbers of cases? If we test more, we find more. Is the converse then true: If a country fails to meet a substantial testing threshold per population (Avi now provides populations), should they take pride in keeping their case number low? In some French départements (regions), they tout low cases per 100,000. The same pride surfaces in US counties, where they list cases per 100,000. Happily, in our Paciific Northwest, more confirmed cases have not translated into high death rates. For that matter, is low case count a good thing? Do we really believe that not exposing cases means the virus is not active? The virus will go where it will, right?

If we test, we know more about the movement of coronavirus in our area. Denmark has tested a remarkable 39% of its population. Singapore 29%. The US has tested 23%. New Zealand has tested 14%, Sweden and Hong Kong 10%, France 9%, Brazil 6%, and surprisingly COVID poster-child South Korea fewer than 4%. Globally the testing rate is 0.5% of population. Whether or not the US has an extraordinarily high number of cases, we know this because of the rigor of its testing. Truth be told, the numbers drive me crazy. But I don’t think the US status constitutes the worst coronavirus profile.

In the final analysis, I don’t want to be defensive about my country. I don’t want to suggest we’re far better or worse than anyone else. I remember a Brazilian saying when U.S. numbers went up that he was glad he lived in Brazil where such a thing wouldn’t happen. Now that man knows otherwise. We look at Brazil today differently than we did then. Still, they’re hanging in there with a deaths per million rate about equal to that of the US, doing a decent job with the curve they’ve been thrown.

COVID in India, from The Guardian

In March Italy locked down—too late some said—and now their children are back in school and they have moved way lower (in severity) on Avi’s dashboard. Last month France and Spain were down in numbers; today they’re surging again. The US had a super-surge through July, but in August it’s subsided. India, with 1.3 billion people, is seeing very high case numbers. They may need the help of all of us in the long run, but so far, they are doing an amazing job at keeping deaths at bay. Yes, in the end I don’t want to be a statistics junkie. I want to feel safe, neither shamed nor proud. I want to understand the reality and meaning of the coronavirus in our lives. All of our coronavirus data, after all, come with a caveat: so far, or at this point in time.

Avi Schiffmann’s site has a link you can click to buy him a cup of coffee. $3 donation. I bought him a coffee. By now he must have his college education paid for. I’m glad for him. I want us all to do well and to come out on the other side of this with some semblance of life as we knew it. That is to say God bless us everyone.