While I have grown somewhat pessimistic with regard to the economic impact of COVID-19, I am still optimistic about the outcome of the COVID-19 crisis. The reason I am optimistic lies in the numbers. Everyday we see the latest case totals and death totals in the news, but are these the most important numbers to look at to get a sense of what is happening and may happen? I have found two websites I rely on to get accurate and up to date information on the numbers, worldometers.info and ourworldindata.org.
At worldometers.info you will find a chart with stats on total cases, new cases, total deaths and new deaths by country. This is much the same information you will find from any news program or source. They also show recovered cases, active cases and serious/critical cases. The latter being of significance to help understand future deaths. The last two pieces of data were added after I suggested to them it would be of value to see total cases and total deaths as a proportion of population.
Why is this important? It gives us an indication of what can be expected for future spread of the disease under various conditions. Almost every country has had a distinct approach to their combating of the disease. Different countries have different demographics with respect to age and gender. By comparing those countries with similar demographics it is possible to see how effective their control measures have been relative to other countries. There is however one caveat with this approach.
Not all countries are reporting on the same basis. First, I never look at the data from China because I find it totally implausible that from almost one day to the next their new cases and new deaths came to a halt or near halt. China was on a growth curve until Feb. 12th when they reported a huge spike they attributed to unreported cases. From that day on they were on a tapering curve until March 1st when they reported just over 80,000 total cases. After that both cases and deaths trickled in. Given what we have seen and are seeing in the rest of the world, this seems to be improbable.
Second, there is no standard reporting protocol. Each country reports as they see best suits their needs, whether these be domestic or international. Various countries have chosen to not report positive test results where the individual is asymptomatic. Others have chosen to report only hospitalizations. Some are only reporting those deaths they can attribute directly to COVID-19 and not those where there are underlying co-morbidity issues that may have contributed to the death. Any data we look at should take this into consideration no matter the reliability of the source.
On ourworldindata.org, there is much of the same information but they include thorough explanations of the data, its source and how it is used. They also include many, many interactive statistical graphs and charts, allowing one to play with the data to see it from different angles. One interesting graph they provide that I use to understand the direction of the crisis and its potential outcome is found scrolling down the page to the topic of growth rate. As you view this topic you find a chart showing the rate at which deaths are doubling in each country. The faster the number doubles the more serious the problem. Currently in the United States the number of deaths is doubling every four days. We currently have 6,000 deaths so in four days we could be looking at 12,000 deaths and four days after that 24,000. This is truly where the term flattening the curve comes in. If we can slow this rate to five days or six days or longer we significantly reduce the total number of deaths we can expect. So watch this number to see if the number of days increases or get smaller.
Now, why am I optimistic? If you go back to worldometers.info, to the chart I referred to earlier, and refer to the total deaths by population. This is shown as the number of deaths per million inhabitants. The United States currently has 18 deaths per million inhabitants. With a population of 330 million inhabitants if this rate were to grow to equal that of Italy and Spain, 232. We could expect 76,560 deaths, well below the pessimistic projection of the White-house task force of 240,000. To get to this pessimistic forecast the number would deaths per million would have to get to 727. No country in the world is experiencing this except San Marino, a small country completely surrounded by Italy and with a total population of under 35,000 and a death rate of 884 per million inhabitants. Because they are so small any death becomes a relatively large number on this basis.
Let us assume the death rate continues to climb in the United States, growing by 17 times the current deaths per million or 306 deaths per million. Even under this scenario, the total number of deaths is just over 100,000. In my estimation this would require a complete breakdown of the systems in place and a failure of our healthcare system. So, stay positive, keep safe, protect yourself and family by abiding by the guidelines in place and hope for the best possible outcome.
