April 28, 2020

Comments on today’s report, Tuesday April 28, 2020.

REPORT CHANGES

  1. Changed the chart on Positivity Rate so it’s based on a 7 day moving average. Thanks to /u/sjj342 for the suggestion, and this reason for keeping it in the report: “it’s not great given the limitations of the testing, but more useful than cumulative case counts or other metrics that are too highly correlated to number of tests… ideally you’d have a high volume of random tests, and the trends would then be a good gauge of the prevalence in the community” So, for now it’s still in.
  2. Added 5 charts for today only, comparing various facets of the pandemic for Tijuana, Ecuador, Sweden, Brazil, Denmark, USA, and Canada. See #1 in the DATA section below for comments on what, if anything, this data tell us.

THE DATA

  1. 7 Country Comparison Charts: a couple of points before examining what these might tell us: a) The populations range from 1.4M for Tijuana to 330M for the US, so normalized, i.e. per capita, comparison is the only meaningful metric. b) all 4 charts should be taken as a whole; individually they don’t tell the story.

Some people have been touting Sweden as the success story of the pandemic. Sweden has fewer deaths than Spain or Italy, and no lockdown. Isn’t that the way to go?

Denmark had a lockdown. Sweden has 10M people; Denmark has 5M. Per capita daily new cases: Sweden is running steady at aroun 55; Denmark steady at just over 30. Cumulative cases: Sweden just over 1,750 per 1M; Denmark at 1,500. Cumulative Deaths: Sweden tops everyone at 214; Denmark at about 75. Finally, fatality rate: Sweden at 15%; Denmark at about 7%.

So, is Sweden a model of success for the US to emulate? The data don’t say so. Yes, Sweden has worse results than Denmark from almost every point of view, except the economic one. But I think the argument is largely irrelevant anyway. First of all, Sweden has a much higher rating on healthcare quality and access than the U.S. – 95.5 compared to 88.7 for the U.S. [healthsystemtracker.org] The Swedish government went into high gear on March 10, 5 days before California went into lockdown. Another factor is a cultural one – the tendency of Swedish citizens to trust their government and follow its advice, which was to practice physical distancing. Meanwhile, we have protesters waving signs shoulder to shoulder with no masks. Sweden’s hospitals were not in danger of getting overwhelmed. Ours were.

Tijuana, Ecuador and Brazil. Yes, I know TJ isn’t a country, but it’s representative of what experts fear will happen in the rest of Mexico. Obrador, the president of Mexico, and President Bolsonaro of Brazil ignored the virus until they couldn’t. President Moreno of Ecuador jumped into action in February. What they have in common is a healthcare budget that is around $950 per person, less than 1/4 of the OECD average of $3,973. Their economies are also fragile. Global disruptions of supply chains hit all of these places especially hard. That means they don’t have the resources to allocate to fight the pandemic.

Ecuador, particularly in the state of Guayaquil, had a relatively low rate of daily new cases until April 23, when more testing shot them above even the U.S. Brazil has a low rate so far, but if I had reliable data for Sao Paulo, it would probably look just like TJ and Ecuador. What is most worrisome is the steady upward climb of cumulative deaths. And remember, in all liklihood these are deaths that only happen in hospitals. There are probably thousands of “excess deaths” that don’t appear in the statistics. Even so, the case fatality rate in TJ is alarming.

Despite all our insular talk, what happens in the rest of the world affects us directly. TJ, Brazil, and Ecuador are in the beginning stages.

Lastly, the US vs. Canada – two wealthy nations with high quality healthcare systems (compared to Brazil), and right next to each other. Daily new cases in the US are double Canada’s. Per capita cumulative cases – US almost 3 times Canada’s. Same for per capita cumulative deaths. US only comes close to Canada in the case fatality rate, about 2% ahead of Canada’s.

Go back to the Cumulative cases chart and look at the US compared to every other country. This shows how a country with 4% of the world’s population has 31% of the world’s cases. This is not the definition of a good job.

Testing: People who love to brag typically compare apples to giraffes using absolute numbers. This is a deceptive statistical practice that hides the meaning of facts. When you normalize populations for all countries and then sort from highest testing per 1M to lowest, the U.S. is 43rd on the list. The 7 country tests chart shows the US behind Denmark and Canada.

This chart also shows one of the biggest problems in th developing world. If we thought we had a problem in the US, and we did, compare us to Ecuador, Brazil and Mexico. Mexico only has 563 tests per 1M, while Denmark has 28,737 – 51 times the level of Mexico, 18 times Brazil, and 8 times Ecuador.

2) Rats! Carlsbad broke is streak of no new cases, and is now at 51. Don’t jump to conclusions about protests — too early to tell, and 1 case could just be noise. On the other hand, the city added 80 cases and the county added 173, not one of the better days.

3) California state continues to hold at a little over 110 daily tests per 100K people. New York set a new record at 160. The US is at 80.

4) Per capita cumulative cases continue to rise at the same rate for the US, now at about 32, compared to San Diego city at about 11 and Encinitas at 5. The doubling rate based on a 3 day moving average went up for every locality by San Diego city and county. For the county, it’s around 17 days – not explosive growth, but nothing to be complacent about, either.

5) The test positivity rate passed 10% for San Diego, not a great sign, since it went up more than the per capita case rate decreased. No really significant changes in the states that are rushing to open up.

Last, a question for you about Twitter.

Do you think I should post these reports on Twitter? I’ve never been interested in Twitter, because nothing I do is that interesting to anyone outside my family. A while back, someone on r/sandiego suggested that I should post these on Twitter, and I dismissed the idea. Was a wrong? Would anything positive be accomplished? I’m retired, so I have no brand to push and don’t need any followers, and won’t spend time doing that. Is Twitter even worth it if you aren’t willing to do that?

Thanks for your input on this.

Stay well everyone!

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