Of the three most populous countries, as of April 16,2020, this site shows that there are over 600k Covid cases in the USA, China is around 80k and India is at roughly 12.5k.
Now if it’s true that China is lying, their numbers should be ignored as invalid. Which leaves the US and India to analyze.
Based on some Wiki research, in terms of population, India has appx 3x that of the US. In terms of land area, the US has appx 3x as much as India. These facts indicate that India is much more densely populated than the US, which should mean that it’s more prone to higher infection rates… Yet, according to the JHU site, the US has better than 50x the amount of infected people.
How is this possible? Is India lying as well? Are they just unable to actually test people? Have they done better at social distancing? Overall, why is there such a large disparity between the number of infected in the US vs pretty much anywhere else in the world?
A good starting point to answer your question would be to go to Worldometer. If you go to the table and then tap on the column heading ‘Total cases / 1M pop’ and ‘Total deaths / 1M pop’ it will show you how many cases or deaths per million people there are [tip - select ‘Yesterday’ at the top left of the graph to get a full 24 hours’ count].
Counting cases per million of population gives you some measure of comparison. However it also gives you some weird results - it sucks to be in San Marino, Andorra, the Faeroe Islands or the Vatican. Small countries with less than a few million population gives them abnormally high apparent rates. Ignore any country you can’t point to on a world map.
As of now the US cases is 1,947 per million of its population, India has 9, New Zealand has 2 per million. But before you conclude anything, you have to consider the following factors that influence these counts:
In some countries they have been in active pandemic mode since Christmas, others are only identifying their first definite cases just recently. Some figures will continue to keep rising, others are stable or declining.
Some countries like NZ have strictly maintained their shutdowns and are reaping the benefits. Others are claiming every day that ‘we may have seen the peak’. Others, like the US, have mainly had it break out in a few centres and there doesn’t seem to be any real reason it will not blossom across the rest of the country, because there is no central control or coherent plan except [mimes tapping forehead].
Gross population density is pretty meaningless. If there are five people on a football field, that’s great unless they are all clustered around one goal post, then its not any better than an over-crowded bus in Barcelona.
These are meant to be confirmed cases, which means testing, which means access to tests. Sucks to be poor and third-world. There is also a related issue about when you count deaths as Covid-related, especially if there are no hospitals for people to die in.
If China’s death rate increased by a factor of 10x (could they even conceal that level of impact, and enforced shut-downs to prevent it getting even higher without letting on?), then their figure would still only be 570 cases and 20 deaths per million, which is still a fraction of the US today.
I think you have to accept that regardless of any Chinese mismanagement and lying with figures that the US started badly, when there are no second chances given.
India has definitely not been testing as much as the US or China, but India is also not seeing a huge increase in the number of people accessing hospitals with symptoms of respiratory distress. Almost certainly the true case count is much higher, but the severely symptomatic population has been very small so far. Unlike China, India cannot (and will not) attempt to hide the severity of the situation if people start dying by the thousands and there are millions of symptomatic cases.
India’s lockdown has been very successful so far, and it is strongly enforced by police. But here in the US the “self-quarantine” has been a gentle request to the population and not a well-enforced order. I believe this has contributed to the magnitude of the crisis in the US.
Besides NYC is a huge melting pot of world cultures and has exposed it to infection carriers from all parts of the world. Not surprisingly Mumbai city in India, with the most number of active cases, is similarly a popular destination, though obviously not as much as NYC.
Overall I’d say that India has taken more effective steps and has willingly imposed a deep-freeze on the economy to limit the spread, and the disease numbers reflect that. Though for how long India can hold out is an open and worrying question.
Many more children as population share than the U.S. Death rates are age cohort related and kids seem to spread it less than adults do.
Deaths outside of hospital and untested are highly likely much larger numbers than elsewhere and won’t show up, if ever, until excess mortality stats are put together much later. And excess mortality rates may be tempered by the huge decreases in mortality with better air quality from the shut down there. Seriously.
And yes they are hardly testing. Tests per million there as of Worldometer current under 200. U.S. just under 10,000. Germany about 20,000. Iceland about 110,000.
Low tests number would explain missing cases which are asymptomatic and or minor symptoms. Not so mild*, severe or critical cases. Absolutely not deaths. Sure a particular death or deaths may slip through, but people are postulating thousands or even tens of thousands of deaths that the system does not know about. Which seems unlikely.
*By all accounts even ostensibly mild cases mean several days of being bed ridden.
In India? Average daily death rate in India is over 22K. A thousand or so a day one way from COVID, another the other from fewer traffic accidents and pollution-related deaths easily lost in the noise and not counted. I don’t think you appreciate how many of the world’s very poor die without hospital care or any health system interaction, and not only because they cannot pay for it. Sometimes they are better off without what care they would get.
Absolutely deaths too.
I believe that India is having a lower death rate due to demographics and to BCG use maybe. But I do not accept the data they report as at all likely reflecting reality, so I have little evidence to support the belief.
Compare New York(591 deaths per million) with Texas(13 deaths per million population)
It’s no coincidence. Colder places are bearing the brunt, Pakistan will be spared and I think eventually India will have to look at Pakistan results as India is having tougher lockdown and Pakistan lighter.
Demographics are mixed factor actually, we have only 12% population over the age of 55 but even below 55 age we have a lot many diabetic and high BP patients… Also there is more than sufficient testing. Do you know we are testing very very specific cases where there are high chances but even then only 3% are testing positive? You may safely discard the possibility of high number of unreported covid-19 deaths.
One interesting thing we’re learning about this virus is that it’s spreading international far slower than we naively thought it was. By using genetic sequencing data, we can trace the path of viral infections.
For example, even though the first cases on the West Coast were linked to a single introduction at the end of January, cases in New York came from multiple introductions from Europe in mid-late February. Despite tons of people travelling between the East Coast and West Coast every day for over a month, none of them appear to have been a vector for a significant enough outbreak.
Similarly, in the early days, everyone was fearing that Chinese migrant workers returning back to Africa for Chinese New Year would cause huge, undetected spread over the continent before monitoring systems were set up in place but genetic analysis of Africa also shows that the bulk of the infection was seeded by a European strain, not a Chinese one and we’ve yet to see an outbreak in Africa on the level of what we saw in Iran for instance.
Unfortunately, Nextstrain doesn’t have any genetic sequences from India yet but it’s entirely plausible that it simply took a long time to hit the subcontinent which is why we’re seeing such limited impact.
Another thing we’re learning is that there really is a crucial couple of weeks where the decision to lock down makes the real difference. Contrast California with New York for instance. Both were on roughly the same growth trajectory and California basically decided to lock down 3 weeks earlier than New York and it’s resulted in a 40x difference in deaths. Google is publishing mobility reports of different countries and you can compare The US to India. On the scale of the rough effectiveness of lockdown, you can see India is doing a much better job than the US and even states like New York.
To me, trying to delve through all the numbers is far too complicated and confusing because of the differences in test rates, reporting, political systems etc. What’s been a far more reliable source of information is to just look at what policies were enacted when in what countries and at what stage of the outbreak. Countries you naively thought wouldn’t have done well like Vietnam or Russia actually rolled out a bunch of pretty common sense policies. I think at the end of this, we’re going to be quite surprised by the ultimate impact COVID has on different counties and the correlations are going to be very different from what people thought would be the case before the virus.
The Mediterranean climate of places like Barcelona in Spain didn’t spare them; Louisiana has so far had 237 deaths per million, and they are immediately adjacent to Texas and have a warm climate.
Pneumonia can be caused by any number of bacterial and viral infections. Many of these underlying infections, such as influenza, are seasonal, but there is nothing at all that prevents a non-seasonal infection from killing via pneumonia in high summer, and we just don’t have enough information yet to say that COVID-19 is only seasonal and will die out with warm weather. (In March 2020, the city of New Orleans in Louisiana never dipped below 49 degrees Fahrenheit, and the highs most days were in the 80s; it’s still a viral hotspot.)
Barcelona is cold. But Louisiana is not. honestly it is the first example I am seeing of a place which is not cold and yet 200 Plus deaths per million population. I want to analyse it further. Thanks for sharing.
Also it has 4-5 million population, won’t be sure how we could use it against 1.75 billion population of the subcontinent( or against all other non-cold places.) which is presenting a different picture and
Also, 200 per million is 0.02% . We don’t know the extent of population infected in Louisiana but If deaths Don’t go up in future (say most have antibodies by now) ,then this death percentage is also not very bad compared to Europe hotspots or to New York. What I mean is we don’t have complete picture.
I know about the region since I live in it. So I know how the systems operate. And no. A 1000 extra deaths will be identified quickly by the authorities. This is a region where the authorities are always on the lookout for disease outbreaks since they happen with depressing regularity. The chances of there being excess deaths due to COVID19 during the most well publicized health crises in history are basically non existent.
My sisters father in law is a doctor in Lahore (just across the border in Pakistan) and he says that the biggest problem is not deaths being hidden it’s the relatives of the newly deceased being certain that their terminal cancer patient Dad really died of Covid.
I was reading that they’re thinking that the real deciding factor in New York was two things- they had nearly 100 separate introductions of the virus from European sources in the beginning, and one guy in particular in New Rochelle was a “super-spreader”, meaning that for some reason he was particularly effective at being a one-man pandemic in his own right.
Contrast this with say… California, where they had about eight(8) initial introductions before flights were cancelled and lockdowns began.
My suspicion is that India got the jump on the case introductions much like California did, and that’s why we’re not seeing quite the explosion we would have expected to. Something similar in Louisiana vs. Texas- although the lockdown dates were similar, Texas didn’t have anything like Mardi Gras to draw people from all over the nation and world and cluster them together tightly right beforehand.
I think it (covid19) is overhyped in context of subcontinent… that’s just me, but we will find out. India is under a strict lockdown. Quite inconvenient, my guess is it is becoming too much now and should gradually be relaxed…but they are airing old epics Ramayan, Mahabharat etc. on tv, 90s redux. A lot less pollution, getting more time with family, so a few positives also.
It’s likely that the fatality rate for covid-19 is about 1%.
At the moment, India is tracking as having a fatality rate of 3.3%. That would imply that they’ve tested under 1/3rd of the infected (and you have to test several people to find one infected).
They do seem to have had a delay of a few weeks before the disease made its way to the country, on the other hand, so they’re just catching up now.
The state of things in China is a mystery. Most likely, they’ve weathered it and gotten to herd immunity. We should expect their population count to stall out for a few years.
Good. Just one difference on fatality rate, I would think arnd 40-50% Italians would be having antibodies making fatality rate 0.1%.
My guess is that people are grossly underestimating the R-naught , covid19 is much more contagious and much less deadly and even lesser deadly in hotter climate.
