by Frank Schnittger
Tue Apr 7th, 2020 at 10:18:47 PM EST
The data above for the 30 countries with most deaths is taken from RealClearPolitics at c. 21.00hrs GMT on 7/4/2020. For the first time, Realclearpolitics has added an additional column for the number of tests carried out. I have added three additional calculated columns- % positive tests, tests per million population, and population to identify how intensively each country is testing for Covid-19. Some of the numbers are surprising...
Since the start of the pandemic, different countries have pursued different testing strategies. Some tested only on admission to hospital. Some included testing of symptomatic health care professionals (although the UK originally had a quota of testing only 15% of symptomatic health care professionals, and I personally know a UK mid-wife who was symptomatic but never tested). Some tested widely in the community. Others attempted to test widely but had difficulty sourcing enough test kits and reagents for analysis.
Some followed up positive tests with contact tracing and others did not. Because of delays in testing and getting back test results Ireland did contact tracing on symptomatic cases even before a positive or negative result had been returned. Some countries didn't even test those that had died outside hospital, meaning that their deaths weren't necessarily recorded as Covid-19 related. Some countries didn't count deaths outside of hospital even if the deceased had tested positive. The deaths column in the table needs to be treated with some caution, therefore. Not all the figures are directly comparable.
The issue of testing and contact tracing became controversial in Ireland because of differences in the approach being taken between the UK (including Northern Ireland) and Ireland. Ireland went for the full WHO recommendation of testing and contact tracing as much as possible (constrained only by the availability of test kits and reagent for analysis) while the UK initially only tested on hospital admission and 15% of symptomatic health care staff and made no attempt at contact tracing.
While testing in the GB and N. Ireland has caught up somewhat since, it is still less than half the Irish rate - 4011 per Million population vs. 8754 per million. Deaths in the UK have also been over double the Irish rate, 92.6 per million vs. 43.3 per million population. As a result there is a danger that even if Ireland succeeds in suppressing the pandemic, reinfections could recur on an ongoing basis via |N. Ireland. There is not a lot of point in one country pursuing a very active suppression strategy, if your nearest neighbours don't...
Hence my letters to the editor published by of the Irish Independent and Belfast Telegraph to the effect that whereas N. Ireland in the person of Ian Paisley had pushed for an all-Ireland quarantine zone during the 2001 bovine foot and mouth disease epidemic, they didn't appear to be prepared to return the favour to the people of Ireland threatened by the higher rates of infection in the UK.
Thankfully the Chief Medical Officers of Ireland and Northern Ireland (and their respective administrations) have now agreed a Memorandum of understanding whereby their respective Covid-10 mitigation strategies will be subject to "greater cooperation" in the future. That agreement is not legally binding however, and comes a little late in the day. Nevertheless it is to be hoped that the issue will become less politicised in the future, especially when it comes to mooted tests on all travellers entering the island.
The larger issues stands however between other near neighbours in Europe. Germany and the Netherlands have similar overall death numbers despite having massively different populations. Germany has conducted 11075 tests per million population whereas the Netherlands has conducted only 5025. France, with a more than 6 times higher death rate that Germany, has conducted only 3348 tests per million. What is the point of Germany pursuing a massively greater testing regime if it could be subject to ongoing re-infections introduced via their neighbours once travel restrictions are lifted?
I will leave it to readers here to point out many other anomalies in the table above in the comments below, but two overall points need to be made:
- Countries which have followed the WHO mandated policy of widespread testing and contact tracing have been more successful in suppressing the pandemic. Although the findings are controversial, a University of Washington study has projected that the pandemic will cost 150,000 lives in Europe during the first wave of the pandemic, with 66,000 lives to be lost in the UK, 19,000 in Spain, 20,000 in Italy, 15,000 in France, and only 400 in Ireland. These are not trivial differences.
- We need to learn from what worked and didn't work in this pandemic and ensure there is a more coordinated response within the EU, and hopefully on the whole island of Ireland, in the future. EU member states badly need a centralised and harmonised EU public health policy and response capability so that future pandemics can be suppressed more effectively and consistently throughout the Union. Viruses do not respect borders. Public Health care, or at least pandemic avoidance and control must become an EU competency.
