International Covid Comparisons: Making the Numbers Work for You | John Power
International comparisons are an important means by which to determine the efficacy of different government approaches towards the Covid crisis. Our perspectives about the success of our own government, and the government of others, is informed by these statistics. In the first part of this three part series, I will be discussing some of the complications which occur when trying to draw international comparisons.
One international leader has received attention more than any other, for his handling of the pandemic. Donald Trump, supposedly, did not ‘take the virus seriously’ enough, because he refused to use federal authority to mandate a nationwide shutdown.
The evidence provided in support of this claim refers to the baseline figure of 300,000+ Covid related deaths, which means that America has the highest number of deaths for any country. To present the total number of deaths without the context of population size is unfair, to say the least.
What happens when we add this context? The percentage of the American population that has died from Coronavirus is 0.093% (14/12/2020: Statista). This would put Mr Trump, in terms of performance, between Emmanuel Macron of France (0.89%) and Pedro Sánchez of Spain (0.103%), and exactly the same as Andrej Babišàk of the Czech Republic (0.093%). His performance should be compared very favourably to that of Sophia Wilmes, and later Alexander de Croo, in managing Belgium’s response to the disease (0.159%).
It would also be too simplistic to use this as evidence that Donald Trump has performed well during the pandemic. The United States is a Union of States, and Donald Trump has decided to allow different states to pursue different strategies. South Dakota’s governor, Kristi Noem, has consistently resisted calls to implement restrictions, contrasting wildly with Andrew Cuomo, who mandated masks and lockdowns early in the pandemic. Every country across the world takes a different approach to public health. Senior global health officials, Fauci, Whitty and Tegnell, all have varying degrees of influence over strategies.
The main thing missing from our attempts to draw international comparisons is an in-depth evaluation of countries based on, what I will describe as pre-existing conditions. To establish the effectiveness of a governments response to the pandemic, it is crucial to understand the interplay between these pre-existing conditions, and the severity of the restrictions which different governments imposed.
Most governments have presented government interventions, like lockdowns and mask wearing, as being effective instruments of lowering infection rates and saving lives. They have selectively presented scientific evidence in favour of this perspective, while denouncing opinions against it, as a means to justify unprecedented state power.
Most of our understanding of the pandemic is rooted within this framework. A high death count in America, is interpreted as a failure on behalf of Mr Trump to intervene aggressively enough, since governments are supposed to be entirely capable of protecting populations from the disease.
If this understanding of the pandemic was accurate, of course, we would find that there is a consistent correlation between government action, and the severity of the pandemic.
There are many instances where a correlation between severer restrictions and deaths does not seem to exist. The best example of this is within the United Kingdom. Nicola Sturgeon has defined herself as a harsh enforced of lockdown, and yet the death rate of Scotland (0.108%) is higher than that of the UK overall (0.096%). There are multiple examples of countries who adopted fairly loose restrictions, particularly early on, which have come out better than countries that enforced touch restrictions. Jair Bolsonaro was roundly criticised for his lax approach in the international media, and yet Brazil’s death rate is not especially egregious (0.087%), less than that of France (0.089%) where a letter of intention was required to leave the house in April. Dramatically confounding expectations is Belarus (0.013%), where Alexander Lukashenko refused to close down sporting events at the height of the pandemic.
But international comparisons do sometimes produce results which indicates that restrictions can have a positive impact on the number of deaths. Sweden (0.075%), a country now far less lauded by skeptics than in previous months, does have a far higher rate of death than neighbouring Finland (0.008%) or Norway (0.007%), both of whom have adopted a more restrictive approach.
When we talk about government restrictions, it is hard to quantify what we mean. One of the more confounding countries, when the data is analysed, is Japan. Japan has had an incredible pandemic (0.002%), with almost no restrictions on meeting in public. However, there is in most East-Asian countries a pre-existing cultural practice of mask-wearing, and some mask-enthusiasts suggest that this may account for the difference. The problem that Japan highlights for international comparison is this: How can you quantifiably compare the severity of two countries responses to a pandemic? We can say with relative confidence that Sweden has had a more liberal approach than say, Australia, but it is difficult to quantify this mathematically. Governments lock down for different lengths of time, and different periods, and lockdown can mean different things in different places.
The second problem is one of co-morbidities. Let’s revisit Scotland. How is Scotland different to the rest of the country? Recent data suggests that Scotland has a completely out of control drug epidemic, one of the worst in Europe. Glasgow has one of the lowest life expectancies for a city in Europe. Scotland a far higher obesity rate than the rest of the country. Its poverty is worse than the rest of the country. This is a problem which is difficult to quantify mathematically.
These two issues, of co-morbidities and quantifying restrictions, need to be addressed in order for us to accurately conceptualise how different countries, and leaders, have performed during the pandemic. In the next two parts of this discussion, I will be explore solutions to help improve assessments of different countries responses to the virus.