COVID-19: Americas Report, Omnibus Edition

This is the second of my “omnibus” reports on the statistics of the COVID virus. Today, I’m going to tackle the Americas. That is, the geographical area comprising North America, Central America, South America and the islands off the coasts of North and South America. In this area, there are 35 countries reporting via Our World in Data, which I have divided into three groups:

North America	South America	West Indies
Belize	Argentina	Antigua and Barbuda
Canada	Bolivia	Bahamas
Costa Rica	Brazil	Barbados
El Salvador	Chile	Cuba
Guatemala	Colombia	Dominica
Honduras	Ecuador	Dominican Republic
Mexico	Guyana	Grenada
Nicaragua	Paraguay	Haiti
Panama	Peru	Jamaica
USA	Suriname	Saint Kitts and Nevis
	Uruguay	Saint Lucia
	Venezuela	Saint Vincent
		Trinidad and Tobago

Once again, the data sources are (for epidemic data) Our World in Data and (for lockdown regulations) the Blavatnik School of Government, both at Oxford University. The data I used included figures up to and including March 1^st.

The countries

Here are bar charts of the United Nations HDI (Human Development Index) ratings for the countries in each of the three groups.

It’s interesting that the lowest rated countries in Central America are lower than their counterparts in South America – even Venezuela! And, Haiti apart, the West Indian ratings are very comparable with the South American ones. I did lift my eyebrows at that rating of Cuba. But then, my criteria are not the United Nations’.

In the context of assessing lockdowns, I shall also be using the Freedom House rating. According to Wikipedia, it “measures the degree of civil liberties and political rights in every nation and significant related and disputed territories around the world.” Like the HDI rating, it is a percentage. I won’t show the bar charts here, but the Freedom House rating varies from Cuba (14), Venezuela (16), Nicaragua (31), Haiti (38) and Honduras (45), via the USA (86), to Canada and Uruguay at the top of the tree with 98.

Now, here are the population densities:

Look at those population density figures in South America! Way, way lower than Europe. How can metropolitan greenies live with themselves for endlessly repeating their mantra that the world is over-populated with human beings?

Cases

Again, I’ll start with cases. Here are the spaghetti graphs of total cases per million for each of the three groups:

Apart from the USA and Panama, all these cases per million totals are well below the corresponding figures for European countries. In both North and South America, the countries divide between a group with case numbers high, and another group with them much lower. The West Indies island countries are entirely in the latter group.

The daily cases per million graphs are much less “organized” and more “confused” than their European equivalents:

The epidemic profiles for different countries look to be independent of each other. This reflects that the countries in this area have tended to quarantine arrivals, ban arrivals from certain places, or even close borders altogether, far more than their European counterparts.

Now let’s have a look at a scatterplot of cumulative cases per million against HDI rating:

The slope of the trend line here is very much greater than in Europe. The countries with the higher development indices tend to get many more cases per million; perhaps because they have greater economic activity, and so mixing of people, than the lower rated countries.

Let’s have a look at cases per million versus population density.

Just as in Europe, this looks almost like two separate sets of data. I could almost draw a horizontal trend line for the countries with more than about 100 people per square kilometre, and a vertical one for those with less! This reinforces my view that population density at the national level isn’t a big factor in influencing cases per million.

Lastly for cases, here is a list of all the countries, ordered by cumulative cases per million:

Island nations seem to be generally better at keeping the virus down than continental ones. But they may face some problems, I suspect, once border restrictions have been eased. Controlling the virus in its early stages is one thing; controlling it when the world around is unlocking apace, may prove to be quite another. As the Swedish deputy prime minister said early in the epidemic, “This is a marathon, not a sprint.”

In fact, seven of the bottom 10 in the list are island countries. The other three are Venezuela, Haiti (which shares an island with the Dominican Republic) and Nicaragua. And all the bottom four in the Freedom House rankings – including these three – are also in the bottom seven in cases per million!

Case Growth and Lockdowns

In this area, the weekly case growth graphs don’t show anything of great interest. So, I’ll skip them, and go for the R-rates instead.

There’s an oddity there. That detached line at the bottom of the North American graph is Nicaragua. Geographically, it lies between Honduras and Costa Rica, both of whose R-rates are in the same ball-park as the other countries in its region. It has a president called Daniel Ortega, a former Sandinista; who just keeps on getting re-elected, much in the style of Vladimir Putin. I wonder, perhaps, whether the Nicaraguan figures actually mean anything at all? Let’s have a look at their basic cases and deaths graph:

That gentle curve down since June looks a bit suspicious to me. And where are they in the cases per million rankings, compared with their neighbours Costa Rica (eighth in the list out of 35) and Honduras (pretty much in the middle?) Second from bottom. Furthermore, as we’ll see, their average lockdown stringency is the lowest in the whole of the Americas. And they haven’t closed their borders, though they have at various times screened or quarantined incoming travellers. Curiouser and curiouser. If Mr Ortega and his pals are telling the truth, an awful lot of us in the West ought to be demanding our money back for all the lockdowns we have suffered.

OK, so let’s have a look at the lockdown stringency graphs:

There’s another oddity there. What are the Venezuelans doing? (Theirs is the black line with the bumps near the top of the second graph). Since late September, they have been going through alternate weeks of “Workplaces: Mandatory closed” and “Workplaces: Some closed.” They have also had face coverings required outside the home continuously since Halloween. Mr Ortega gets his low case count by sleight of hand; but Mr Maduro prefers to achieve it by stomping on what little economy and freedom the Venezuelans have got left.

Here’s the list of average lockdown stringencies:

Uruguay and Dominica stand out as having controlled the epidemic quite well to date, yet having a relatively relaxed lockdown régime. But, of the bottom five in the Freedom House ratings, two, Honduras and Venezuela, are right at the top in average stringency. Cuba is about a third of the way down. The other two, Haiti and Nicaragua, are near, and right at, the bottom. Haiti’s data, though, looks to my eye much more trustworthy than Nicaragua’s.

Let’s see what happens if we plot average lockdown stringency against Freedom House rating:

Inconclusive. But what if we take out Nicaragua (that point way below the others, near the far left), on the grounds that none of their data is at all believable?

Cherry-picking? Moi? But cut out the incredible Mr Ortega, and it looks as if governments with (supposedly) greater concern for the freedom of ordinary people have tended to lock down less hard. But not by all that much.

Tests

I won’t show the total numbers of tests per hundred thousand, as except for the USA and a brave attempt from Chile, these are all way below European levels. Cases per test, however, show a more interesting picture:

Generally, cases per test on the American mainland are considerably higher than in Europe. That suggests a persistent shortage of test kits in many countries in Central and South America. West Indian cases per test, for those few countries that report, are comparable with, or a bit higher than, Europe’s. Except for Cuba at the bottom. I wonder why?

Hospitalizations

This section will be a lot shorter than the corresponding one in the European report, because only Canada and the USA are actually reporting hospitalizations. I will, however, show the scatterplot of number of hospital beds per thousand versus UN HDI rating:

In contrast to Europe, in this area there is a positive correlation between HDI rating and provision of hospital beds.

Here are the hospitalizations per million plotted over time, for Canada and the USA:

This contrasts the three-peak epidemic in the USA with the two-peak Canadian one. Peak hospital bed occupancy by COVID patients has been 14.4% in the USA and 5.2% in Canada. I won’t bother with the ICU data, as they are almost in direct proportion to the hospitalizations.

Deaths

Total deaths per million in each region are as follows:

These graphs show how differently the epidemic has taken its course in different places. In North America, there are three groups: the very bad (those with over 1,000 deaths per million), the bad (the rest of the believable ones) and the ugly (Nicaragua). There are big gaps between these categories! In South America there’s a somewhat similar divide between bad and very bad; but the threshold between the two is lower, about 600 deaths per million. But both continents have, on average, less deaths per million than Europe. In the West Indies, deaths per million are generally lower yet than on the mainland.

Here’s the league table of deaths per million:

Deaths per million against HDI rating:

As with cases, the higher the HDI rating, the higher the deaths per million.

Now for cumulative deaths per case. As I’ve said before, if there is one COVID metric on which to judge a country’s health care system, this one is it. High means bad.

Ouch! Mexico comes out the worst, and by a long way. Its health care system is known to have been plagued with problems in the past; maybe they are there still. Ecuador and Bolivia have both had some nightmares, too. These three all show more deaths per case over the course of the epidemic than even the worst European country (Bulgaria).

And Cuba is right down there. This means either that they’re lying, or that the Cuban health care system is among the best in the world. Maybe that’s why the UN rates them so highly?

Vaccinations

Here are the equivalent graphs to the ones I gave for Europe last time round.

There are no figures for full vaccinations in the West Indies yet. Looking at the above graphs, the Chileans are making a brave attempt (and they are also adopting the UK strategy, of getting the first jab out to as many as possible as quickly as possible). But the USA is way out ahead of anyone else. If there is anywhere in the world where the effects of vaccination might be showing up already, it’s there. So, here’s their graph of weekly case growth, stringency and R-rate:

I find the evidence inconclusive. The drop in R-rate in the new year was too soon after the first vaccinations to have been caused by them. Give them another month, though, and we may be seeing either a drop in the R-rate and weekly case growth at a constant stringency, or a drop in stringency without an increase in the R-rate or in weekly case growth. There should be a significant drop in deaths per case, too. But the USA won’t be the easiest place to see these things. One, because it’s so big. And two, because it is in effect 50 disparate countries, each with their own rules.

To sum up

With the exceptions of the USA, Panama and perhaps Canada, countries in the Americas – particularly the island ones – are not yet as “far through” the epidemic as in Europe. One of the main reasons is that they have tended to close borders more stringently than the Europeans. If the vaccines work as advertised, these countries may end up with significantly lower deaths per million than the Europeans. If not, they will have a lot of work to do. No judgement is possible yet on whether or not the vaccines are positively affecting the virus statistics.

The countries with the lowest Freedom House ratings – such as Cuba, Venezuela, Nicaragua, Haiti, Honduras – tend to have either the very highest, or the very lowest, average lockdown stringencies. The Nicaraguans are, in my opinion, lying about the progress of the epidemic in their country. But the Haitians seem to have controlled the virus well with a relatively light lockdown régime; and if their data is a fabrication, it’s a very good one. Venezuela and Honduras are, very definitely, not places to be right now.