by Frank Schnittger
Mon Mar 23rd, 2020 at 11:53:13 AM EST
Update [2020-3-23 23:40:41 by Frank Schnittger]:Table updated
You can find the table above constantly updated here, where you can also sort it by each column header.
A number of factors can influence the spread and mortality rate of the pandemic in different countries:
- Timing - the number of days since the first case in a region
- Preparedness - the ability of local hospital facilities to cope with rapidly elevating demand
- Timing and effectiveness of counter-measures taken - principally non-pharmaceutical interventions like the closure of schools, pubs, restaurants, non essential business contacts, sporting events, and the practice of self isolation, physical distancing and personal hygiene.
- Level of testing and contact tracing
- Demographics - older people (and men), especially with pre-existing serious medical conditions, are disproportionately at risk
All countries can be criticised for being too slow to take effective counter-measures, but some were slower than others. China, as the first in the front line, can be forgiven for taking some time to identify the threat, but acted most effectively thereafter, driven by their SARS experience. They are also the first and only country to have effectively contained the outbreak, and yet other countries were slow to take their advice.
Some countries, principally the USA, were in effective denial, and thought the outbreak could be contained by PR, bluff and bluster, their standard response to any threat. Others, principally the UK and Holland, flirted with herd immunity theories, more appropriate in the context of vaccination drives, and recanted only when presented with evidence of the high mortality rates implied by that strategy. In practice, they may still be following that approach, but cannot say so openly as that would involve taking responsibility for those deaths.
Other countries are limiting the amount of testing they are doing to hospital admissions only, resulting in a gross overall case under-count, and eliminating contact tracing as a possible counter-measure despite the fact that this was central to the ultimately successful Chinese containment strategy. This results in the "Confirmed case fatality rate" column in the table above becoming much elevated as the denominator - "Confirmed cases" is a gross under-estimate. The USA, UK, and Holland may be in that camp, although the relatively early stage of their pandemics has yet to be translated into a much higher than average fatality rate.
Germany has a remarkably low Confirmed Case Fatality Rate of 0.42%, probably because of a more rigorous testing regime and a health service not yet overwhelmed by case numbers concentrated in a particular area. Other demographic factors, such as an ageing population, are similar to Italy, and are less likely to be a cause of the discrepancy between that low rate and Italy's catastrophic 9.26% fatality rate.
Those countries that were slow to take radical action because of their political cultures or social norms are now paying a terrible price. Spain, in particular, was slow to close its cafes and now is proceeding rapidly up the deaths table column. Ireland, despite being led by a small minority caretaker government recently resoundingly defeated at the polls took radical action quite early in the pandemic, and may now be starting to reap the benefit with new case numbers stabilising despite a massive increase in testing:
(Update [2020-3-23 22:33:3 by Frank Schnittger]:Since this diary was written, there has been a record 219 increase in cases in Ireland on 23/03/2020 as shown above). Further update: 204 new cases were confirmed for 24/03/2020, 235 cases for 25/03/2020, 255 for 26/3, 302 cases for 27/3, 294 cases for 28/3,and 200 cases for 29/3.
It is too early to say whether Ireland has turned the corner, however, because there is a massive backlog of 40,000 people waiting to be tested, and those tests would only have been ordered if there was some symptomatic reason for doing so. Additional testing sites are being opened all over the country, and so an additional surge of confirmed cases can be expected. So far the death rate, at 0.44%, is comparable to Germany's however, and the health system has not yet been overwhelmed. An increasing number of health workers are testing positive however, so staffing could soon become a problem.