This chart has been uninteresting for a long time because it has shown some variation of US, Italy, Spain, and UK dwarfing all the other countries. The US is still in this position, of course, but there are a number of new countries in the top ten now. The fact that Russia has only started confirming large numbers of cases is very interesting. They’re a large country, so 5000 new cases is a small number when divided by their population. Still, the fact that they’re releasing large numbers now is a sign that perhaps things are getting worse. They seem to have avoided case growth up to this point somehow. We also see Brazil and Mexico creeping up the list. Brazil is also showing around 5K new cases but is also seeing an increase in deaths. Mexico’s numbers are lower, but up until recently, their cases and deaths numbers have tracked with Arizona’s, something that seemed very curious. Their reporting may have caught up to their cases, however, because they have had steep jumps in the last few days.
Sweden barely makes this list, but they have received a lot of press (bad press?) about their strategy to build herd immunity more quickly. As a result, they are only doing targeted social distancing. People who are not in high risk groups are going about their lives and businesses. This seems to make a lot of media people mad. I read a bunch of health department materials and statistics published in Swedish trying to understand what they’re doing (thanks again Google Translate). Essentially, I think I can summarize it this way. First, they ask people with high Body Mass Index and/or who are 70 and over to self-quarantine. Second, they provide instructions on what responses to take to symptoms. If you have lost your sense of taste or smell, then you are asked to quarantine for 7 days and then perform some set of actions with the health department before leaving quarantine, third, they have a network of people who are tracking cases and contacts and providing assistance to those in quarantine. Finally, they are conducting “symptom surveys” to understand where breakouts might be starting and find places to start contact tracking.
The net affect of this is that their strong communications and planning are resulting in a sense of confidence in the citizenry. This is impacting the number of people who are needing hospitalization for COVID-19 to quite a degree. Below I’ve pasted their hospitalization numbers per day. You can see that the numbers are already tapering off, but never reached much higher than 40 cases per day. This is manageable and keeping people out of the hospitals seems to be one of the key factors in keeping the death rate low. Their cases continue to increase, but remember, that’s the strategy! Get the population quickly immune and strongly mitigate symptoms along the way.
Singapore continues to be interesting to me, not least because I’ve seen a number of articles that are expressing shock that Singapore continues to see COVID-19 cases. Here’s one from CNN and one from Bloomberg. The Bloomberg article’s title is kind of irritating, “How Singapore Flipped from Virus Hero to Cautionary Tale.” What that title doesn’t tell you is how Singapore has done such a good job managing their cases. Yes, they are seeing case growth and at one point we were excited that they were one of the first countries to “flatten the curve.” But if you look at the charts below, you can see that any flattening that happened was probably premature. However, despite their numbers of cases, they still have only 12 deaths! They are doing similar things to Sweden and Iceland, and seem to be managing cases outside hospitals and addressing symptoms early.
Finally, back to the theme of strong communications. I was listening to the Peter Attia – Drive podcast the other day and heard his interview of John Barry, who wrote the most important book about the Spanish Flu. I listened to this 2+ hr podcast twice because it was so compelling. One big takeaway from John was that one of the main lessons from the Spanish Flu was the importance of trust in leadership that was established by truthful communications. He also showed cases where the media’s not telling the truth led to larger outbreaks and greater fear. Apparently the Philadelphia media were still saying “nothing to see here” after over 14K people died in 3 weeks. So, in general, then, honest, direct, unbiased communications are critical in a time of uncertainty like this. This is why I continue to try to write about what I see in the data. Hopefully it’s helpful to someone.