Covid-19 Statistics: Reality and Illusion
Lack of testing kits, governmental commitment, politics all play a role
Given the remarkable disparity between infection and death rates in countries across the world, it is questionable how believable the data is about the Covid-19 coronavirus, which is sourced from national governments and put out by the World Health Organization. Many of the statistics, whether published regularly or not at all, are of varying quality and detail and thus probably give a very inaccurate picture of the reality on the ground.
But the overall picture is that the virus has escaped. It is no longer possible to keep it corralled. Some countries, particularly high-export economies like China, may decide that the penalty from quarantines and blockades is too high to pay if the virus becomes endemic. China's January-February exports were minus 17.35 percent year-on-year after a December gain of 7.6 percent. January-February imports fell from 16.5 percent previously to minus 4 percent. Hong Kong is seeking to return to some version of normality based on hand sanitizer, masks and a lot of caution.
As that plays itself out, however, even China’s data begins to look suspicious when, for instance, on March 8 the WHO reported that almost every province other than Hubei, the original epicentre, had zero new cases. This included major coastal provinces Shandong, Jiangsu and Guangdong which have close trade and other links with Korea and Japan. Korea for instance now has 7,134 cases including 367 new ones on March 8.
As for nations in Southeast Asia that experienced early cases through tourist links to China, the disease might seem as well as dead everywhere except spotlessly clean Singapore. Indonesia now has a grand total of six cases, the Philippines just 10 and Cambodia only two as of this writing. (With the situation fluid, the numbers are liable to change from the ones we have recorded)
Meanwhile, countries in northern Europe are reporting vastly larger numbers than anywhere in Asia apart from China and Korea, and higher than anywhere except Korea and Iran relative to their populations. Italy leads with 5,883, including 1,247 on March 8 alone, and Germany and France now have over 700 each.
It may be that Southeast Asia’s low numbers are partly related to their warm, humid climates. There are suggestions that the virus does not thrive in those conditions. Nonetheless, Thailand has had several locally originated cases as well as imported ones, as has Singapore. North Korea, which has imposed strict restrictions and closed its borders to try to prevent an outbreak, insists it has had no cases.
Indeed, among Singapore’s 150 cases, 90 of whom have recovered and returned to their homes, the island republic has had at least two cases who arrived from Indonesia where they were probably infected, an indication of the lack of testing in Indonesia to determine the true picture.
There have been three cases of people arriving in Taiwan, Japan and Australia who were found infected. Two of them might have caught it elsewhere but the Australian arrival had only been in the Philippines.
There are three possible causes of under-reporting. The first is an unstated desire of governments to discourage testing so as either not to spread local alarm or deter tourists – Thailand and Indonesia are still promoting tourism as the epidemic rages. The virus could also be an issue in the Philippines on account of perceived links to the influx of Chinese, previously encouraged by President Duterte, to run gambling operations. Cases jumped sharply overnight on March 10 to 24, with schools and malls checking temperatures as students and customers entered.
A second reason for under-reporting is that some countries or regions have few test kits or sufficient skills personnel to administer the tests. Public health facilities in the likes of Korea, Singapore and Italy are so vastly superior to, for example, Indonesia and Cambodia, that the chance of identifying infected persons is much lower. According to Bloomberg News, there are only 2,000 kits in the whole of the Philippines, with a population of more than 100 million.
A third factor for all countries is the sheer number of tests done relative to population in infected countries/regions. Hong Kong, for example, has ramped up its testing from only about 200 per day for a population of 7 million to 2,000 per day and is urging clinics and hospitals to make full use of the tests. The number comprises those with apparent symptoms and those who have been in contact with confirmed cases.
Korea, on the other hand, has been testing many thousands a day, by far the highest ratio to population in the world. Not surprisingly medical authorities are finding cases of people who were infected but had no symptoms or ones too mild for the individual to bother reporting. In addition to tracking through IT the movements of people who had contacts with those who have been infected, Korean thoroughness has enabled anyone to get tested nor just individuals identified by the health authorities.
The widely varying rates for death as a percentage of cases – anywhere from 1 percent up to 5 percent – also probably reflect, at least in part, the intensity of testing. Death rates will be higher if testing is focused on those with already strong symptoms.
Testing intensity data is not available for many countries but as of March 2, Korea had tested 2,138 per million population – a total of about 110,000 tests of which 4 percent were positive. Italy tested 386 per million with 5 percent positive but Vietnam has tested only 18 per million for a total of 1,737 tests. The US lagged badly in testing with major hospitals crying out for supplies.
There are plenty of other unknowns about the virus and hence varying estimates as to its ease of spread, the longevity of this epidemic and whether the virus will become globally endemic at least until a vaccine is available.