Why the broad disparity in death rates from COVID-19? The variation in health care systems cannot account for this vast (four and even fivefold) difference. The worst performing countries (double digit deaths as a percentage of reported cases) are all modernized. Is there a problem in the number of reported cases? Perhaps someone with a better understanding than I of the data (as of 10 April: [worldometers.info] ) can provide an explanation?
It comes from a number of things.
Do you test people in hospital, but not elsewhere? In that case the actual infection rate will be higher than your tests indicate, and the number of deaths as a proportion of that figure lower.
Is the pandemic rapidly engulfing your nation? It might take three weeks for someone to actually die - so the DEATHS are from the level of infection THREE WEEKS AGO. If infection rates are rapidly climing, this will lessen the apparent death percentage (which is actually people who fell ill three weeks ago) as a proportion of the CURRENT infection rate.
And so on.
In short, there's a hell of a lot going on that make these figures largely fictional unless you know and fully understand ALL THE BACKGROUND.
The amount of overall testing is one big factor. The more widespread the testing, the more likely the lower death rate because there will likely be more cases that are not as severe counted in the total case number. If a country is only testing people with more severe symptoms, the death rate will appear to be higher. The way deaths are counted varies by area. How many people died of something else while they were infected with CoVid-19? Some countries may not even list CoVid-19 as a cause of death and may instead list pneumonia. I heard that some states in the US do not test for coronavirus if the patient died at home. Some countries have a higher average age (Italy for example). REliability of reported data varies by country.Just some possible reasons.
The raw data is virtually useless.
No country really knows
1 how many people in total have caught the virus
2 how many in total have died because of the virus
3 how many survived the virus and have antibody immunity
4 How long lasting or effective is the antibodu immunity
for example... here in the UK only those actually entering hospital and some key workers are automatically tested for the virus ... and only deaths in hospital are counted as 'death by covid' despite some care homes etc being ravaged and experiencing multiple deaths.
Seems other countries, for political / morale / mass manipulation are using the data to propagate their own message to their own populace.
Not true, Germany and South Korea both have excellent data. They each tested a huge swath of their respective populations.
In America politicians restricted my ability to test the population. They actually threatened to sanction my medical license if we did not comply.
This is pointless data, and therefore meaningless. Unless every citizen in every country was tested we have no idea how many people anywhere actually have been infected. Some countries are fairly comprehensive in their testing, others have tested virtually nobody. Then there is the question of how early on the curve of the wave of the virus is your country...some countries such as China started as early as last December and are now well past the peak infection, whilst others are still in the early stages. It is only when this pandemic is over, and when all the analysts agree on a standard way of compiling data, will we be able get a true picture of the statistics.
@Matias As usual...Germany is more efficient and forward thinking than other countries,
@Silvertongue I wouldn’t single out the Chinese figures as being inaccurate, they are possibly more likely to be accurate than some of the others, because the WHO have actually done a report on the outbreak and the measures taken by the Chinese authorities. They undoubtedly tried to keep it hidden in the beginning, but very quickly realised that was impossible and then changed tack. The WHO have been on the whole very supportive of how the Chinese have dealt with this pandemic.
@Matias how about if we just count the body bags?
You’re correct
Except the Chinese are down playing their rates grossly
@darthfaja Yes..possibly so, but a lot of the other figures from other countries are grossly inaccurate too, even if not deliberately so, but due to lack of testing and data collection. That is why I think it’s somewhat meaningless to compare the statistics until they are accurate.
SHOUT OUT to all you "death rate deniers", maybe this chart will wake you the hell up! Minimizing this thing is Not helping! Just today 2 people on here were babbling away about ".04% death rates, why worry?"
@Silvertongue so you think # of hospital patients & recorded deaths mean nothing........
@AnneWimsey he is a UFO nut and ghost chaser @Silvertongue is also a xenophobe low information fool
@Veteran229 but I can infer if these are the numbers they are admitting to, things are FAR worse........
I live in the UK and come from Greece. Greece had it's first outbreak two to three weeks before the UK. Our death toll so far is less than a hundred people. Here in the UK, well check the table I can verify from this small sample that the differences are: better NHS in Greece (oh yes), a firm government that shut down everything very early on before the death toll was too high, banned social gatherings including the religious ones (that is a bold move for Greek standards), a very strict system in super markets where people enter one by one, with masks and gloves etc. On the other hand, in the UK the government was very slow in implementing half-measures talking about herd immunity etc. Now it's too late and we have around 800 deaths per day, a very sad number. Needles to say that all businesses are operating as usual... The NHS is unable to cope with the herd immunity attempt as people get infected uncontrollably... So sad. I have been living here since 2012 and love the country. Overall, it's a very well organized and nice country to be part of. It is the only time though I wish I were in Greece...
@Silvertongue First and foremost I don't appreciate the language. Secondly, all my friends and family continue to work as normal (in different sectors).
I love these tables! They contain the real data but not explanations. I could have hours of fun creating reasons why the numbers come out as they do:
countries where people hug each other upon meeting.
Countries where people live very close together;
Counties with large mountain ranges, etc., etc.
Hey, it would be more educational if we could see these data on a real map. We could use it to teach ourselves and our kids where all these countries are. That would be useful!
I think we had one posted in "Tales from the Lockdown" that updates daily.
Both WHO (international maps) and the CDC (USA ) have maps such as you describe, updated daily.
@FrayedBear The only one I follow daily is the one for my county in New York. We have 42 cases right now, out of a total population of 89,900, but no death yet.
Two most likely causes:
Applause! Yes. I would agree and add to this answer:
Some of people who have it haven't died yet. And some will die of other complications. How those deaths are recorded are key.
Testing and isolation is also key. Once a population starts havinging community spread, it's a lot harder to get back under control. Nearly impossible.
So in that overly wordy way, yeah, what BD66 said.
POVERTY, POVERTY. POVERTY, POVERTY.
Most of us do not see poverty on a regular basis. We do not travel into the neighborhoods that are impoverished on purpose. They are not part of our experience. We do not think about them. America is so rich with material goods that most of us automatically assume that everybody gets what they need. Some have more or better material goods, but we all have what we need.. WRONG.
Some of us work in impoverished communities. We see it daily. Here are things that those of us see that contributes to a higher incidence of Covid deaths are as follows:
Poverty is not always a matter of choice or hard work. Many people in this condition work two or three jobs, and are incredibly hard workers. Meritocracy and social vertical ascent is a myth for these people. Social stratification in society is normal. The way poverty is handled tells one how enlightened that society is.
So in closing, it is no surprise that there exists a disparity in Covid-19. White privilege and economic privilege allows a large part of the society to ignore, or otherwise overlook those in society that live in poverty.
It would be helpful if we had access socioeconomic data for the COVID-19 deaths in the countries in question, but I have yet to see such. When looking at the European countries on this list, poverty levels do not appear to be a factor. In Germany and Portugal, 15% and 25% of their respective citizens live below the poverty level, whereas The Netherlands and Italy are each hovering at about 8%. The poverty rate in the US is (or was) about 14%.
[borgenproject.org]
In some European countries economic disparity has become a problem. Since the Syria refugee began, there is a lost of distrust by refugees regarding particular governments I've heard.
This disease has no economic biased currently
So Belgians, death rate 11.3%, are more impoverished than residents of Turkey, death rate 2.1%?
This is all very complex. Its posdible that Belgium is more densely populated in a smaller area. Turkey being more rural, with exception of a few urban centers are more spread out. A virus like Covid needs a closely packed host population
@t1nick I stick by my statement that apparent discrepancies in the reported results in the table have mostly to do with differences in testing and reporting. You can see my full comment below if interested but I think, at this point in time, the data in the table is hardly useful and doesn't ell us much about the actual death rates. Eventually we will have cleaner data.
True on many levels. It is too early, but it's also possible to look at the nature of the population's distributions in each area and make some early inferences.
@darthfaja What data are you using to support that assumption? I would argue that poverty leads to people living in more crowded conditions, because they can't afford to live in more suburban environments. People who are poor tend to live in neighborhoods that are "fresh food deserts," where it's difficult to buy fresh fruits, vegetables, or meats. That means a diet that may be restricted to foods that are higher in sodium and sugar, at a minimum. Urban environments are neighborhoods where it is not safe to take a healthy walk every evening, so the lifestyle of the urban poor may lead to underlying conditions that make these individuals more likely to succumb to the virus. And those living in poverty may not be able to afford medical care, so they rely on public clinics or simply do without. They may not get tested for the virus at all, or until it's too late to make any difference. I think it's highly likely that economic status plays a role.
What I see is the USA as having the most infections because we listen the least. This is also why we have the highest number of deaths. As for percent of deaths most of the rest of the world has a lower healthcare technology. We do not lead in healthcare but we have better technologies generally speaking.
This epidemic tends to expose the weaknesses in a federated public health system. We have 50 independent decisionmakers who must act on behalf of their state first and foremost. And within each state we have county and city health commissioners and mayors who, while considering the big picture, are focused on their local issues.
Fighting an epidemic begins with consistent practices, policies and data collection, without which we will, as a nation, remain in reaction mode. I have lived in Europe and benefitted from health care there, and am surprised by the death rate disparity, particularly between Germany and the other 6 double digit countries, all of which have modernized health care.
@p-nullifidian
The difference is the rate of testing
Germany and South Korea tested more aggressively allowing them to identify the sick so they could be isolated
They both utilized private industry to do so
This is just the fist wave!!!
Every Pandemic has has two to three waves of infection!
The 1917-1918 pandemic had two confirmed waves.
In 1917 there were only 1.5 Billion individuals on this planet!
It took 14 months to encircle this planet!!!
Now we have over 6.78 Billion individuals living on this planet!!!
It took less than four months to encircle this planet!!!
The same thing happen in 1917-1918 Pandemic the so called modern countries have high mortality, simply they were overwhelmed by shear numbers!!!
The Cities and Towns that instituted social distancing, shelter at home and use face masks had far fewer deaths!!!
Just like 1917-1918 Pandemic the governments and Healthcare systems were not prepared and overwhelmed!!!
The true lesson is we can never be fully prepared for the future, the future does not reveal the events to come, the planet is bigger than any thing we can throw at it!
We can not conquer nature, nature will always conquer us!!!
There are plenty of ways to skew the proportions. One is state misinformation or cover-ups (think China, Iran, N Korea). Another is how much you test - if you test a lot you will identify cases that would otherwise never have made it into the stats. Another is whether you test post mortem - people haven't stopped dying of regular pneumonia, so if you don't check for Covid-19 then they will not appear as a coronavirus death but if you do, then they might. Different health services have different practices - in the UK, for instance, you are not registered as a case unless you have been admitted to hospital, so if you die quietly at home you will not be included in the corona figures.
One problem, at least in the U.S., is that if a person dies before they have been diagnosed, they are NOT counted in the tallies. In the U.S. we are still short on test kits and medical supplies needed to make a proper diagnosis (even if the Trump administration is doing their best to hide that).
Another problem is poor record keeping in many countries. The efforts are (mostly) being expended on keeping people from getting sick or helping those who are sick to get well. That takes so much effort, that keeping a proper count just isnt' a priority.
I suspect the countries with the highest death counts are keeping the best and most accurate records.
"I suspect the countries with the highest death counts are keeping the best and most accurate records."
Perhaps, but that would imply that those with lower death counts are undercounting their dead by a factor of 3-4x. Germany and the US couldn't miss the mark by that much if they tried. There's got to be another explanation for this disparity.
This is the state of our data, and it's pretty primitive. Rates per 100,000 for infection and death would be more revealing. So would the number of deaths at home that are actually due to covid-19. Last I heard from NY deaths at home were way up, and often the cause was never confirmed (makes some sense, they're already dead). Gathering good data is critical. We don't know the real breadth of the infection, true number of dead, or who has been infected and recovered or is an asymptomatic carrier. Little better than walking around blind without a cane.
It's all related to testing or in some cases under reporting. For example, the US is not testing many of the people who die and are not hospitalized due to a severe lack of testing kits despite what Trump tells on his daily lies, we have only tested about 1% of the population; so all these are not reported. Some countries, especially those ran by despots or tyrants like China, Russia and others, heavily under report deaths and even contagion cases for propaganda purposes. Like Trump tries to do here but there's free press, at least for now. These countries control everything, including internet, press, etcetera so whatever they decide to give you one must accept, take it or leave it. In some cases the death rate is low due to drastic actions by the governments since these found out this was an airborne flu type of epidemic. If you check google you will see that Obama started an international task force to combat potential pandemics like the Spanish flu. The countries that took these drastic actions have very low numbers in general, like Taiwan, New Zealand, etcetera. It also helps that these countries like many islands are precisely islands much easier to isolate (the term isolate comes from usland by the way). These are some of the reasons. And in some cases, having population that is scarce geographically speaking, like Canada for exanple, or in our case, states like Alaska, Montana, the Dakotas, etc. that have vast territory but sparse population with not hugely populated cities, also reduces the spread of contagion.
There are plenty of testing kits available. At my clinic I could test every citizen of my county.
@Mofo1953 excuse me?
Now why on earth would you say that to me?
I’m a selfish prick Because I informed you that there are plenty of test kits available?
Available test kits have nothing to do with what’s happening in New York and they have the same access to kits the same way I do.
I’ll remember how selfish I am when I go back to work today treating my covid patients.
@darthfaja if you, as you say, are in the health care profession, shiw a little empathy and less selfishness with your fellow professionals from other states. Just because your tiny county has enough kits doesn't mean all counties from all states, many with heavy population, that haven't had the luck your clinic has and have not tested even 1% of the state's population. That is why I xalled you a selfish prick. Not because of what you say but because your lack of soludarity with less fortunate Americans.
I’ll send you a cake, my college transcripts, and medical degree when this is over So I can be accepted by you.
@darthfaja right? I make the news up! This from 5 days ago: [phys.org]
In case you don't want to open your eyes to your selfishness, here is the relevant part of that article:
Why is there still a shortage in the supply of COVID-19 test kits in the U.S.?
At the start of the outbreak in the U.S., there was a lot of concern about there not being enough test kits. Due to recent efforts and the easing of federal regulations, the test kit itself may no longer be the problem.
Now, there are other bottlenecks in the testing supply chain, with shortages of the physical components needed to carry out the tests. As reported in a recent New Yorker article, these bottlenecks include the viral transport media used to stabilize a specimen as it's transported to a lab, extraction kits used to isolate viral RNA from specimens once they're at the lab, and the reagents that actually determine whether the specimen is positive.
This phenomenon of "shifting bottlenecks" is not a surprise to supply chain experts. When you have a multi-tiered supply chain that operates in several stages, once you correctly identify and expend resources to alleviate a bottleneck, the next weakest link becomes the bottleneck. Bottlenecks shift as resources are expended on one but not the other.
But in times like this, it is hard to know which resources will emerge as the next area of concern and we will have to continue putting out fires as they come up to deal with supply shortages throughout the duration of this pandemic. There is no rulebook for a disruption of this scale and scope.
@Mofo1953
No you didn’t make it up
You just didn’t read the article well enough and you’re being a jerk
“ At the start of the outbreak in the U.S., there was a lot of concern about there not being enough test kits. Due to recent efforts and the easing of federal regulations, the test kit itself may no longer be the problem.”
Also this ‘viral medium’ that everyone keeps talking about is essentially saline.
You need 4 things for this test
A sterile swab
A sterile container
Sterile saline
A lab order
We have endless amounts of each of these things
I’m happy to explain all of this to you if you can decide to be civil, but I’m not going to sit here and continue to have you badger me and be rude to me.
We get enough of that at work.
The information out there is not accurate.
I’m doing this everyday and my tests are being read by national lab organizations.
I spent weeks doing research to find other ways of testing and I’ve been successful at that. We’ve informed the press, our governor, state board, local and state government.
What else would you have me do?
If you would like to continue civilly I’m
Happy u to o answer any questions you have.
If you want to continue with your sources then please do so. I’m doing my job for my community and we’ve informed everyone we know to inform.
The big issue right now is space for the sick
Equipment and care providers
We don’t have enough of those
That’s the sad and unfortunate reality
Had we been able to test freely in the beginning and had Americans stayed home when they were told to the situation might not have been as bad
But there’s no way to know and nothing we can do about that now
@darthfaja What else? Show some empathy for one? This is a chart of people tested in the USA in order of tests per 1,000 inhabitants as of yesterday. Not sure where your clinic or county ranks, but America ranks as #42, oh well, we beat the Cayman Islands. Woo Hoo!. I guess that shows me not to make things up, right?
@SeaGreenEyez
“I’m into Chinese medicine”
That’s not accurate. I trained as a naturopath and Chinese medicine over 20 years ago. For the most part I did not find the people practicing this kind of medicine safe or knowledgeable.
So I switched to western medicine.
I don’t believe I’ve been ‘deliberately evasive’
I’ve answered what I can perhaps you’ve missed some replies or have chosen not to believe them
You can study or learn a subject that doesn’t mean you are ‘into’ them
I also have read the Bible and studied world religions
That doesn’t mean I’m ‘into them’
And as I’ve said there are enough tests
Now there isn’t man power
I’ve stated this above 2 times I believe
My county’s health department approached our clinic because of our work and we’ve arranged and perform testing for our community.
You’ve made decisions about me that are inaccurate and only based of your conjecture.
My colleagues and I are here in the front lines taking care of these very sick people exposing ourselves everyday. I’m here isolated from my family and friends so I don’t get them sick. It’s been like this for four weeks as we continue to try and help.
I would be happy to try and explain what I know and a more accurate picture, but I would prefer it be without you being shitty to me.
You can believe the people actually in the mess or continue to believe your news sources.
That’s up to you, but I’m not going to sit here trying to explain while you decide to be rude.
Best of wishes and health to all of us.
@Mofo1953
Empathy?
This conversation here has nothing to do with how I care for my patients or my ability to show empathy.
That’s an interesting leap you’ve made. I don’t believe we discussed empathy and patient care before.
I’m just trying to explain there are tests available.
That has nothing to do with empathy.
Until last Friday the government restricted our ability to test patients. As of Friday in my state I am allowed to test freely. That is likely the representation of your graph.
You’ve already decided your information is More accurate then my experience.
That’s understandable as you don’t know me enough to trust my information.
Good luck to us all.
This may be a better place to get data [coronavirus.jhu.edu] you can see where in the cycle the people are, maybe the deaths relate to how many people were infected at once and the health care systems ability to deal with the crisis. The people who got infected old vs young how accurately is the country reporting the results, how many people are they testing? I believe in Sweden if you do not need hospital care then you are not tested you are told to stay at home isolate and treat yourself as needed. So they may only be testing the ones that come to hospital ie the one having problems and in the higher risk bracket. The number crunching can only come when this is over and final figures are in and then to compare it to all different factors. It is a complex problem that a simple table is not able to display.
The UK is only testing health workers and people who are hospitalised with symptoms. Hence the huge death rate.
Maybe there are several strains of this virus and some strains are more deadly than others. Or maybe some countries are lying about the numbers....
Chart is now quite old; deaths in the USA are now in the 60 thousand range; Belgium, as a medically advanced country claims it counts undiagnosed Corona virus like cases which did not have medical testing, in order to be as complete as possible. In developing countries, the majority of virus deaths die without ever having seen a doctor. Many countries keep their statistics artificially low to avoid negative PR impact.There are many variables which must first be understood (and computerized in value) to draw any conclusions at this time.
Stale data, to be sure ... and so much more to learn about this disease. In just the past few weeks we've learned how the Coronavirus can attack heart tissue as well as contribute to strokes in relatively healthy, younger persons, even as it appears from antibody tests to have infected many more people than previously known.
The niumbers are skewed from the uncertainty of people actually dying from the virus.
Plus it was allowed to spread to make that possible. Anything else is just a waste of time, unless youre in position to change something.
All deaths reported were from positive COVID-19 victims. So the cause of death is pretty certain. Have there been additional deaths, such as at one's own home, that were undiagnosed and unreported? Most likely, but that would only increase the percentages. I'm not looking to change anything, other than my understanding, which is why I was hoping to hear from folks with an in-depth understanding of the factors that contribute to the disparities.
Yes I can
I’m working on the frontlines of this mess
There are many reasons why top of my list would be age in relation to population density
Allegation of supplies
And most importantly unlimited testing in the community
Look at Germany and South Korea
Allocation of supplies?
Each state is differently reporting tests .... positives ....hospitalized ....recoveries sent home and deaths....rwo horrific examples S Carolina has no state crime laboratory to save money and not prove prisoners innocent of framed crimes....takes 5 days to get tested and know the results.....Iowa has state of the art crime lab 1000 tests per day capacity 24 hour results known