Today’s numbers are out and we see a new spiking (small) country, San Marino. San Marino (SMR) is a small micro-country fully surrounded by Italy. It shares much of it’s culture with Italy, and is also near the Northern part of Italy where the COVID-19 outbreak started.
It is a very small country, with a population just north of 33,000. To date, they have 187 cases and 21 deaths. This results in nearly 5 active cases per 1000 people and 0.6 deaths per thousand. Their death to confirmed case ratio is 12%, which is extremely high.
The above chart also brings to mind the case of Iceland (ISL), who has one of the larger numbers for COVID-19 cases per 1000. Part of this is because Iceland has created a strategic sampling approach for COVID-19 so they can find out where it is hitting hardest and triage quickly. This article gives us more of the story too…
Fifty-six individuals have recovered from COVID-19, 9,013 individuals are currently in quarantine (681 are in isolation), 2,096 individuals have completed quarantine, and 15 individuals are currently in the hospital diagnosed with COVID-19, two in intensive care, and one in a ventilator. A total of 11,727 tests have been administered. Of those diagnosed with COVID-19 in Iceland, two have died.
This is interesting in light of the chart below, which shows that Iceland’s Confirmed Cases are equal to 70% of the number of hospital beds in the country. But from the data above, only 15 of the ~700 diagnosed people are in the hospital. Because Iceland was randomly testing, they seem to have been able to keep people in quarantine and out of the hospital. This is basically the opposite of the Italy and San Marino experiences. According to the San Marino ministry of health (big kudos to Googles Italian to English translator!), 41% of their confirmed cases are hospitalized (0.2% of their entire population). For comparison, Iceland’s rate of hospitalization is just 2.3% of their confirmed cases and 0.004% of their total population.
Conclusion: This might confirm the strategy of America’s CDC (at least their recent strategy) of “flattening the curve” to spread the infection out and keep the numbers low in the hospitals. But it also makes the STRONG CASE for randomized testing to identify and mitigate more quickly.
A good friend of mine was recently diagnosed as COVID-19 positive in Orange County, CA. Her husband went to the local hospital to visit his sister, who was on her death bed. While there, he walked past a COVID-19 patient and that’s how he caught it, then passed it to his wife upon returning home. Best to take precautions and isolate those with it from the rest of the population to contain it. Good strategy to shelter in place to flatten the curve which is slowing the spread in the USA. Great analysis here, as always Tod!