COVID World Review, Part 6: Deaths per Case

This is the sixth of my review reports on COVID-19 worldwide as at August 20^th 2021. This report will cover deaths per case; calculable for all 191 reporting countries. And it is a good method, by which to judge a country’s performance against the virus. For a high deaths per case ratio may indicate a failure to find and record a significant fraction of the cases which have occurred; or a poor quality of treatment within the healthcare system; or both.

Europe

I’ll start, as before, in Europe. I’ll show two graphs for each group of countries. First, cumulative deaths per case as measured over the course of the epidemic. And second, the actual deaths per case ratios, with the numbers of cases always offset by 21 days, which is the mean length of time between a case being reported, and death supervening (if it does). At the end, I’ll show ordered lists of the percentage of cumulative deaths per case, and of the current deaths per case ratios among all the countries in the region.

The first graph shows convergence towards a roughly constant total of deaths per case for most countries (though the UK, and one or two others, have decreased). The second shows the peaks and troughs since October 2020; each peak maybe representing a new variant.

Here, in several of the countries, after the first trough the deaths per case have increased; particularly in Hungary, Slovakia and Romania. The cumulative deaths per case to date are both generally higher, and further apart from each other, than in countries to the west.

Here, the cumulative deaths per case are even wider spread, with Bosnia and Herzegovina at the top, and Cyprus as a significant outlier at the bottom.

In this group of mostly small countries, cumulative deaths per case to date are even lower than in most of the countries than in the other groups. They are all below 2%!

So, here is the ordered list of European countries by cumulative deaths per case:

All the countries near the top, except Italy, are in Eastern Europe. I’ll add Bosnia and Herzegovina, and Italy, to my list of countries deserving follow-up for their poor performance. For the other end of the scale, I’ll add Cyprus, Denmark and Finland. And the UK and Ireland, because of their significant recent improvements in cumulative deaths per case.

Here is the ordered list of current deaths per case in Europe:

There’s a strong east-to-west gradient in this list. And most of the major West and North European countries are near the bottom of the list. Iceland, Denmark, Norway, Sweden, and Finland are all Nordic countries; and Estonia is all but. Of the major non-Nordic countries, Ireland, the Netherlands, Belgium, Austria, Switzerland, the UK, Cyprus, Spain, Luxembourg, Portugal and France are all under 0.5%.

I’ll add North Macedonia to my follow-up list; that 35% ratio of current deaths per case is amazingly bad!

Americas

As I don’t find the deaths per case spaghetti graphs particularly informative, I’ll only show the cumulative deaths per case here (except for North/Central America). I’ll show the deaths per case (with a 21-day offset) in the report on the individual countries I pick for further study.

This looks much like Western Europe, except for the enormously high outlier of Mexico. Because of this outlier, I’ll show the deaths per case over time graph for this area:

Mexico (dark blue) has been way above the rest almost all the time since the very first wave!

A big spread; and big trouble in Peru and Ecuador. Venezuela is at the bottom; given the régime, I don’t believe that. I think they deserve to go on the “probable naughty boys” list!

In general, much like Eastern Europe, or South America except for Peru and Ecuador.

The top three in this list are all on my list for further follow-up. As is Grenada near the bottom, and (now) Venezuela, whose figures trigger my bullshit meter, just as Nicaragua’s and Egypt’s did in earlier reports.

Jamaica is worth adding to the follow-up list. Cuba, too: are their figures believable?

Middle East and North Africa

A wide spread, but comparable with other places; except for Syria, which is a war zone.

Except for Yemen, which is another war zone and excluded from the above graph altogether, there are far lower deaths per case here; these countries must be doing something right! Saudi Arabia is an outlier.

Comparable with other countries, except for Sudan and Egypt; both of which have had their problems in recent years.

Sudan deserves a closer look. So would Egypt, if I could believe its figures; but as I told in the previous report, I can’t do that. Qatar and Bahrain at the bottom are also worth another look.

Sub-Saharan Africa

These figures seem low in comparison to other countries, even to Western Europe. Not only does the virus seem to spread less easily in Central Africa than elsewhere; but it also seems to be less lethal per case.

Somalia is the high outlier; another war zone. Burundi, the Seychelles and Eritrea are low outliers. Otherwise, these figures are comparable with norms in other countries.

Here, Mauritius is the low outlier, and Zimbabwe the high one.

Not much to see here, except the recent upward trend in Guinea, which doesn’t look good.

Tanzania deserves another look, because its deaths per million are very low, yet its cumulative deaths per case are the second highest in Africa.

Rest of Asia

These countries divide into two subgroups: China and Taiwan, and the rest. China and Taiwan are quite close together in cumulative deaths per case. The Chinese figures are not credible, but I have no reason to believe that Taiwan’s are not. The other countries are low to middle in the “normal” range.

Two clusters here: Kazakhstan, Kyrgyzstan, Azerbaijan and Georgia the upper, Tajikistan, Uzbekistan and Mongolia the lower. Both are low by the standards of many other countries.

All are low by world standards, but Sri Lanka doesn’t look good at all.

These range from very low to middling in cumulative deaths per case to date. Again, there are recent upticks in Myanmar, Indonesia and Vietnam; probably the effect of the delta variant.

Taiwan certainly deserves another look, as does Sri Lanka. At the bottom, Laos deserves another look, as the second lowest after Singapore.

That weird figure for current deaths per case in Kazakhstan comes from an enormous negative adjustment (more than 59,000) in the number of new cases on July 24^th, which caused the weekly averaged number of cases for the week centred on July 27^th to go negative! At the other end of the table, Vietnam is worth adding to the list.

Australasia and Oceania

Vanuatu has had four cases and one death; which looks like sheer bad luck. All the others are within normal parameters, although I’m a bit surprised to find Australia, rather than Papua New Guinea or Fiji, in second place.

Nothing particularly remarkable here.

Top and bottom 20

Here are the lists of the top and bottom 20 countries in cumulative deaths per case:

After Vanuatu, a recipient of bad luck, I have most of the high scorers, war zones excepted, on my list already. Also the three lowest scorers, and Qatar.

There is no point showing the bottom 20, as there are many countries with no recent deaths at all.

Recent improvements in deaths per case

For deaths per case, I’ve done some calculations, like those I did for hospital and ICU occupancy per case in the fourth report of this set. For 32 countries which supplied data on hospital or ICU occupancy, I compared deaths per case (21-day offset) as at August 20^th with the same figure six months previously, on February 20^th. I calculated the ratio of deaths per new case now to the deaths per new case six months ago for each of these countries, then grouped the countries by this ratio, with the following results:

0%: Iceland (which had no deaths around either of the dates).

1-9%: Denmark, Ireland.

10-19%: Austria, Estonia, Germany, Netherlands, Norway, UK.

20-29%: Belgium, Hungary, Luxembourg, Slovakia, Sweden.

30-39%: France, Israel, Italy, Switzerland.

40-49%: Croatia, Czechia, Spain.

50-74%: Finland, Portugal, Poland.

75-99%: Cyprus, Lithuania, USA.

100-199%: Bulgaria, Canada, Latvia, Romania, Slovenia.

It seems that Nordic countries, and countries close to the core of Western Europe, have done best. The USA has not improved much in deaths per case over the course of six months, and Canada has got worse. In Eastern Europe, the northern countries have tended to do better than the southern ones.

The follow-up list

So, here’s the list of countries I plan to follow up on in a later report. It is culled from this report and the previous one.

Country	Reason
Peru	Highest deaths per million: Highest average excess mortality: Highest cumulative deaths per case
Hungary	High deaths per million
Brazil	High deaths per million
Bhutan	Low deaths per million
Singapore	Low deaths per million: Lowest cumulative deaths per case
Grenada	Low deaths per million: Low cumulative deaths per case
Georgia	Highest current daily deaths per million
Fiji	High current daily deaths per million
Sri Lanka	High current daily deaths per million: High cumulative deaths per case
Cuba	High current daily deaths per million: Figures may be suspect
Ecuador	High average excess mortality: High cumulative deaths per case
Mexico	High average excess mortality: High cumulative deaths per case
Norway	Lowest average excess mortality: Nordic
Iceland	Low average excess mortality: Low current excess mortality: Nordic
Finland	Low average excess mortality: Low cumulative deaths per case: Nordic
Denmark	Low average excess mortality: Low cumulative deaths per case: Nordic
Sweden	Low average excess mortality: Nordic
Japan	Low average excess mortality
Hong Kong	Low average excess mortality
Oman	Highest current excess mortality
Colombia	High current excess mortality
Liechtenstein	Lowest current excess mortality
Cyprus	Low current excess mortality: Low cumulative deaths per case: Low current deaths per case
Switzerland	Low current excess mortality: Low current deaths per case
Bosnia and Herzegovina	Highest cumulative deaths per case in region
Italy	Highest cumulative deaths per case in core of Europe
UK	Significant recent improvement in cumulative deaths per case: Low current deaths per case
Ireland	Significant recent improvement in cumulative deaths per case
North Macedonia	High current deaths per case
Venezuela	Low cumulative deaths per case: Figures may be suspect
Jamaica	Highest current deaths per case in region
Cuba	Low current deaths per case: Figures may be suspect?
Sudan	High current deaths per case
Qatar	Low current deaths per case
Bahrain	Low current deaths per case
Tanzania	High deaths per case for the region: Figures may be suspect
Taiwan	Highest cumulative deaths per case in region
Sri Lanka	High cumulative deaths per case for region
Laos	Low cumulative deaths per case
Vietnam	High current deaths per case

That’s 40 countries to be followed up in detail; more than a fifth of the 191. To this list, I’ll add any more countries which I find are worth another look because of their record on testing or lockdowns. My plan now is to report on the testing and lockdown data first, then to follow up on all the individual countries in a final report. That will also give me the opportunity to update the countries in my list with another month or so of data.