Six months into the pandemic, where are we?

I haven’t posted for a while, partly because we went away on a staycation holiday, but also because I felt like we were all caught in a Groundhog Day loop, where numbers in certain parts of the US and the UK continued to climb, a certain segment of society was ignoring scientific fact while another segment was planning to lock down forever, and I was repeating “socially distance—wear masks—wash your hands” to the point that I was boring myself. But in the past few days, several things have happened. The UK, facing an increase in numbers while their testing and tracing system is still not “world-beating,” is (finally) putting some teeth into its regulations, Dr Fauci has had to waste time debunking yet another conspiracy theory advanced by Fox News’s willful misunderstanding of a CDC report and repeated by the president, and then, as the death toll in the US passed the 190,000 mark, there was this tweet from Donald J. Trump:

It seems like it’s time for another look at the numbers. Who, other than Fox News, the Washington Times, and the president himself might be assigning these VERY high marks? Where does the US stand compared to other countries, including the UK? According to Oxford’s Our World in Data, on September 7, the US lay between Brazil and India in daily cases, with 120.52 daily cases per million compared to Brazil’s 184.96 and India’s 60.39. But most of the rest of the world is significantly below that number. The United Kingdom reported 26.69, Germany reported 14.35, and New Zealand, which President Trump recently characterized as having a “tremendous increase,” reported 1.13. But wait, couldn’t that be because of better testing in the US? It’s doubtful that the numbers are entirely attributable to better testing, especially since countries like Germany and New Zealand have long had better testing than the US. But certainly it could be a factor in the UK, where we’ve had a number of problems with testing capacity.

Perhaps daily deaths would be a better measure? Certainly, if we look at cumulative deaths, the US slides down the table a bit, with the UK retaining first place at 612.07 deaths per million. Italy is also ahead of the US at 587.83. But the US is not that far behind, at 570.81 deaths per million. And Germany has had only one fifth of the US total, with 111.30. New Zealand is all the way down at 4.98 deaths per million:

But if you remember your algebra, you might be a little concerned about the slopes of those lines. The UK had flattened the curve around the middle of June, while Italy had done so sometime in May. Brazil, the US, and Mexico show no signs of flattening, which means that if everything continues the way it has been going, the US is likely to overtake the UK by sometime in October. This becomes even clearer when we look at the current daily COVID deaths. On September 7, the US reported that over the past 7 days, 838.9 people had died every day from COVID-19. For that same period, Italy reported an average daily rate of 9.1 people, the UK reported 7.4 people, and our old friend New Zealand, with its “terrible surge,” reported 0.3 people. (For those of you who hate math and are now confused by fractions of people, they are the result of a 7-day average. New Zealand, for example, had 2 people die in 7 days, which gave it 0.3 deaths per day.) Adjusting these numbers for the differing populations, the US trails Mexico and Brazil, with 2.53 daily deaths per million compared to Brazil’s 3.91. But Italy is currently reporting 0.15 daily deaths per million, the UK has 0.11, New Zealand has 0.06 and Germany is reporting 0.05 daily deaths per million. So adjusted for their populations, the US has a daily death rate that is 50 times that of Germany:

But what about the justifications? First, let’s look at that CDC report and the subsequent QAnon interpretation that suggests that US COVID-19 cases are vastly over-reported. The statistics in the report show that only about 6% of the deaths due to COVID-19 list only COVID-19 on the death certificate. The other 94% list other, generally secondary, causes. Mel Q, the QAnon tweeter who first called attention to that fact, has interpreted it to mean that only the 6% have actually died of COVID-19. This, of course, is hogwash. If you have Type 2 diabetes, yes, you have an underlying condition that makes you more susceptible to the worst form of the illness, but you would not have died had you not contracted COVID-19. But it’s not just pre-existing conditions. Perhaps a person died of COVID-19 with pneumonia. The pneumonia was caused by the COVID-19. According to Mel Q, this isn’t a legitimate COVID-19 death. But even in a world where we wanted to just count pure COVID-19 deaths, silly though that may be, we’d have to do the same in every other country. And given that Italy and the UK have a much higher median age than does the US, if anything, their proportion of “pure” COVID deaths would be lower. So the US is still near the top of the world for COVID deaths, even if the entire world got it wrong and listed a proportion of deaths as COVID when they shouldn’t have been.

Another argument that’s been floated is that the US is keeping people alive longer, so they’re dying at a more consistent rate than in, say, Italy, where they died all at once early on. I think with the numbers I’ve already discussed, we have enough proof that that’s not the case. If it were, the US wouldn’t still be reporting far higher new case numbers than most of the rest of the world. And if the US were keeping people in ICU units longer and they died anyway, it would hardly be a high mark for US care. But there’s no evidence that that’s the case. The biggest argument against this idea is that in a few weeks, the US will still have surpassed most of the rest of the world in per capita COVID deaths, whether they’ve been in the hospital for 2 weeks or 4 months.

The most plausible of the excuses for the US’s currently experiencing more per capita COVID deaths than the rest of the world is that in many places in the US, the costs of preventing the spread of the virus were deemed too high. Sweden is mentioned as a sort of model of an economy that kept open, weathered more infection and deaths, but still did less damage overall than if they’d closed the economy. So where is Sweden is this mix right now? Well, if we add it to the countries we’ve been looking at, the number of new cases per million fall somewhere between Italy and Germany:

Could that be because Sweden has reached herd immunity? If so, we’d expect Sweden’s cumulative infection rate to be significantly higher than its European neighbors in lockdown. And it is somewhat higher, but the difference in cumulative infections between Sweden and the United Kingdom, for example, is far less than the difference in infection between Sweden and the United States, with the United States having over 19 thousand infections per million people, Sweden reporting 8.5 thousand per million people, and the United Kingdom reporting 5.3 thousand per million. So the US, with its state-by-state inconsistencies in policy and enforcement, has managed to combine the worst of keeping the economy open with the worst of closing it down.

And Sweden and the United States have almost identical cumulative death rates, at 579 per million for each country. But once again, when we look at new daily averages, the story shifts. As of September 11, Sweden was experiencing a seven-day average of 0.11 daily deaths per million people, putting it in between the UK and New Zealand, while the US had a seven-day daily average of 2.15 deaths per million people.

Of course, Sweden has maintained all along that it was relying on the good sense of its citizens to practice good hygiene and maintain a social distance, something that neither the US nor the UK could do. Not that Sweden’s approach has been completely without the usual political unwillingness to change course when new data comes in. Even as the evidence has bolstered the case for wearing masks, Anders Tegnell, the Swedish state epidemiologist, has refused to alter his position on them, asserting despite the data that there’s no evidence they work and they may give people a false sense of security.

Regardless of Tegnell’s intransigence on masks, it may very well be that when we look back at the pandemic, we come to the conclusion that Sweden’s combination of keeping open while taking precautions was the best way of handling the crisis. Perhaps when Donald Trump talks about “high marks,” he’s referring to the economy rather than the deaths. How, then, does the US economic recovery stack up against other countries? According to the Financial Times, it’s a mixed bag. It seems that US job vacancies are 20% below their 2019 rate, which puts the US far ahead of countries like Spain and France, which are down about 40%, and the UK, at about 50%. But Germany is equal to the US without ever having experienced the extremes the US experienced in the middle of the pandemic, and Japan and Italy, each now at about 25%, are quickly catching up. In Leisure spending, the US is at -14%, comparable to the UK, Spain, and Japan, but far below the recoveries of Greece, Sweden, the Netherlands, Germany, and France. Only the US stock market seems to be a clear success, with the S&P 500 and NASDAQ performing quite a bit better than many other indices. This is not trivial, since it’s not just the wealthy who benefit from the stock market, but it’s precarious. There has been a lot of volatility, and as many economists have argued, a second wave caused by opening the economy too early would probably have a negative effect on the stock market as well. At any rate, it does not seem that the US has seen any great financial benefit to offset its health failures.

Of course, it seems unlikely that relying entirely on voluntary good sense would work in places like the US and the UK, where everything has been politicized and good sense seems in short supply. But maybe keeping the economy open with some mandatory hygiene, distancing and mask practices would have been a better approach than, particularly, the current mess in the US. So the answer to the question that started this post—who, exactly, is giving the administration high marks for its handling of the pandemic?—the answer would have to be only people who are politically rather than scientifically or economically motivated. There is no measure by which the US has handled the pandemic better than the rest of the world. Luckily, there are pockets of the US that continue to try to govern using facts instead of feelings, but those successes have not made up for the continuing failures. What we have now is the worst of all possible worlds: One group of people who don’t believe in things they can’t see (until it’s too late, as it was for Herman Cain), and another group of people, appalled by the statistics, who are overly fearful of opening up because they quite rightly don’t trust their leaders to tell them the truth. And now it seems the last part of the president’s tweet is what he’s pinning all his hopes on: a vaccine. Luckily, even Big Pharma is concerned enough about safety to  pledge that they will not succumb to pressure to release a vaccine early. It’s unfortunate that they felt compelled to issue that statement in response to a president who wants the vaccine ready before we go to the polls.