Friday, September 18, 2020

Is the United States Really the Worst When it Comes to Containing the Coronavirus?

The answer is not that simple to get to. While the United States does have, by far, the highest number of diagnosed COVID-19 cases, the United States is the third most populated country in the world. So let's look at the major statistics as totals and then let's look at them after adjusting for population. 

First, I selected all of the countries with at least 3,000,000 people. There are 134 of them. I decided to do this because, when we look at rates (San Marino with 34,000 population has the highest COVID-19 death rate), these smaller nations didn't seem comparable to the United States. Why 3,000,000? I played around with the cutoff number. With 5,000,000, I had 122 nations and left off some important ones like Ireland and Panama. So I stuck with 3,000,000.

The following figures are from September 18, 2020 and come from https://www.worldometers.info/coronavirus/.


Before Adjusting for Population. 

Cases.

The United States leads with the most cases: 6,925,941.

India is second with 5,305,475.

Brazil is third with 4,497,434.

Russia is the only other country with at least a million: 1,091,186.


India has been catching up with the United States, with approximately 40,000 to 60,000 more new cases per day. At this rate they could overtake the United States in about a month and a half. Of course the rates could change by then. 

Deaths.

The United States leads with the most deaths: 203,171.

Brazil is second with 135,857.

India is third with 85,625. 

Mexico is fourth with 72,179.

Although India has been averaging several hundred more new deaths per day than the United States, it would take about a half a year to catch up with the U.S. figures. A lot is likely to change over six months. 


Tests.

China leads with 160,000,000. The roundness of the number says it is an estimate.

The United States is second with 96,223,461.

India is third with 61,572,343.

Russia is fourth with 42,000,000. 


So, other than testing, the United States is first in total numbers. 


Adjusted for Population.


Cases per million population. Again, for countries with at least three million people.


Panama is first with 24,226.

Chile is second with 23,122.

Kuwait is third with 22,999.

Peru is fourth with 22,873.

Brazil is fifth with 21,126.

The United States is sixth with 20,897. 

The next country is Israel with 19,469.


India, which has the second most cases, has four times the population of the United States and a case rate per million of 3,836.


Deaths per million population: 

Peru is in first place with 946.

Belgium is in second place with 857.

Spain is in third place with 652.

Bolivia is in fourth place with 642.

Brazil is in fifth place with 638. 

Chile is in sixth place with 637.

Ecuador is in seventh place with 624. 

The UK is in eighth place with 614.

The United States is in ninth place with 613.

To round out tenth place, Italy has 590.


The United States is greatly outpacing the UK (958 new deaths on September 18th versus 27) so should move up a notch soon.


Tests per million:

United Arab Emirates is in first place 863,488.

Denmark is in second place with 560,039.

Singapore is in third place with 426,268.

Hong Kong is in fourth place with 370,582.

Israel is in fifth place with 318,753.

The United Kingdom is in sixth place with 314,407.

The United States is in seventh place with 290,332.

Russia is in eighth place with 287,773.

Australia is in ninth place with 282,596.

Belgium rounds out the top 10 with 238,673.


The United States case rates per million in comparison to the countries with similar testing rates.

United States: 20897

Israel: 19469

Russia: 7477

United Kingdom: 5679

Australia: 1051


New Cases.


Some countries experienced massive infection rates early on (Spain, Italy, the United States). To get a picture of what is happening now, a snapshot of the current status, this is how many new cases occurred on September 18th, adjusted for population.


New cases per million:


Israel has 414.78

Costa Rica has 304.85

Argentina has 263.77

Chile has 202.36

Czechia has 196.67

Peru has 190.93

Brazil has 187.85

Belgium has 174.82

Panama has 171.16

Moldova has 164.94

The United States has 154.92 (11th place)

(Note: Not too much emphasis should be placed on a single day's figures.)


The United States by total numbers or by population has been performing among the most poorly in limiting its infections and deaths. It performs a high rate of testing, seventh among nations when adjusted for population. Among those with a similar rate of testing or greater, it is doing the poorest among cases. 


In terms of new cases, a one-day figure is far from optimal, but nevertheless the United States is in eleventh place. In this case, those countries with more new cases also have a lower rate of testing.


Is the United States doing the poorest? Adjusted for population and considering the number of tests per million, Brazil, Chile, and Peru are doing more poorly. Israel is near the rate of the United States in terms of cases and is catching up. They have a similar testing rate. The death rate of Israel is 130 per million compared to 613 for the United States.


I'll try to follow this up in a week. New cases over the course of a week are much more meaningful than a single day. 


The United States for the Week Ending September 12. 

North Dakota and South Dakota are leading in terms of new cases per million population. Vermont continues to be in a league of its own.


 As for testing, Arizona lowered its testing rate to below 5,000 new tests per million population for the week. No state has performed at such a low rate since the week ending June 13th. Rhode Island officially reports testing encounters which bumps up their rates over people tested. Even with an adjustment, they would still be in first place.


Wyoming and Vermont had no deaths. Florida and Arizona, among the worst testers, were near the top in terms of death rates.




Positivity rates adjusts for those poor testing states.


Martin Hill Ortiz is a Professor of Pharmacology at Ponce Health Sciences University and has researched HIV for over thirty years.


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