COVID World Status Report: 2 – The Rest of Europe

This is the second in a series of status reports on the COVID situation as at May 23^rd, 2022. This report covers Eastern Europe, and those parts of Western Europe which were not included in the first report on my “core 14” European countries.

Vaccinations

Here’s the list of percentages of the population fully vaccinated:

The figure for Gibraltar is clearly overstated; unless, perhaps, they have been vaccinating non-Gibraltarians who wish to enter Gibraltar. Otherwise, there is a general trend that the further south and east the country, the less of the population are vaccinated.

Lockdowns

Here are the graphs of lockdown stringencies over the course of the epidemic, and the current lockdown status, in each of three groups of countries:

The stand-out at the top (black line in the graph) is Ukraine, whose data, for obvious reasons, cannot be trusted at this time. Otherwise, the general downward trend in recent months is similar to the trend in the core of Europe. If anything, stringencies in this region now tend to be a bit lower than further west.

These countries are a bit of a mixed bag. There is a group that are unlocking quickly, and another group (Greece, Cyprus, Bosnia and Herzegovina, Kosovo, Croatia) that have chosen to leave lockdown stringencies relatively high.

With the exception of San Marino (black line) and Finland (grey), all the countries which are reporting stringency data are well on the way towards a complete unlock.

Here is the ordered list of stringencies throughout Europe, re-cast in the form of my “harshness” metric, which only includes mandates, and aims to assess lockdown levels in terms of their impact on the population:

Among the countries being considered here, Iceland, Slovakia, Lithuania, Romania, Bulgaria, Norway, the Faeroes, Moldova, Liechtenstein and Finland now have no mandatory lockdown measures. At the other end of the scale, here are the lockdown mandates for the top four (excluding Ukraine):

Country	Measures
Greece	Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: Up to 11-100, Stay at home: Required with exceptions (Regional), International: Screening, Face covering: Required in some places
Kosovo	Schools: Some closed, Workplaces: Some closed, Events: Mandatory cancelled
San Marino	Events: Mandatory cancelled, Gatherings: Up to <=10
Cyprus	Gatherings: Up to >1000, International: Quarantine high-risk, Face covering: Required when with others

Cases

Here is the ordered list of cases per million throughout Europe:

The range is extreme, from more than 70% of the population diagnosed as cases in the Faeroe Islands, to under 10% in Albania, and only 3.6% for the Vatican.

And here is the same data, on a map:

Cases per million (darker is higher)

The further east you go, the lower the cases per million tend to become, except for Scandinavia and the Baltics.

Here are the daily cases per million spaghetti graphs:

All the countries’ case counts in this region seem now to be converging downwards. There have been brief recent sideways movements in Czechia, Slovakia, Hungary and Latvia. Might these, perhaps, have been due to the arrival of the BA.2 variant, which is now dominant in much of Western Europe? But no-one in these countries seems to have been worrying much.

In this region, the trend is also towards zero. But there have been definite recent bumps in cases in Cyprus, Greece and Slovenia. And this, while the first two are among the hardest locked down countries in Europe!

As these are mainly small countries, their case counts per million do tend to be volatile. There has been a monster omicron wave in the Faeroe Islands, and smaller ones in Greenland, Andorra and Iceland. There have been more recent waves in Liechtenstein and the Isle of Man – likely due to BA.2, I’d guess. And cases are trending upwards again in Andorra and San Marino – could this perhaps be BA.5, as in Portugal?

Hospital Occupancy

Here are the graphs of hospital occupancy by COVID patients, for those countries which report this:

The top five here are all core 14 countries. To my eyes, there don’t seem to be any real concerns here in any of the countries outside that core 14.

Only two of the countries being considered here, Iceland and Malta, have increasing COVID hospital occupancy. And Iceland is coming up from a very low base. While Malta has not, in fact, reported any hospital occupancy data since the end of March, so the figure shown here is rather out of date.

Intensive Care Unit Occupancy

Here are the ICU occupancy graphs for those countries which report them:

Again, no real cause for concern, since Slovenia, the worst affected country in this group, has less than 7% of its ICU beds occupied by COVID patients.

Even better, no country outside the core 14 has ICU occupancy growing.

Deaths

Here is the ordered list of deaths per million:

Eastern Europe, particularly the southern countries there, has been one of the hardest hit areas in the world in terms of deaths per million. As of May 29^th, eight of the top ten countries in COVID deaths per million are in this region.

Here is the same data, shown on a map:

Deaths per million (darker is higher)

You can clearly see the concentration of COVID deaths in the south-east of Europe. I am wondering whether latitude, and so climate, may affect the lethality of the virus? Or, perhaps, the degree (or not) of economic development?

Serbia, Kosovo and Albania seem to have performed better than others around them. As has Belarus. Albania and, even more, Kosovo have taken high lockdown strategies; but Serbia’s average lockdown has been relatively low. And Belarus’s has been minimalist. But when I checked these figures against the excess mortality figures, there were some big discrepancies. With the possible exception of Serbia, these data are not, I think, what they appear to be.

Next, deaths per case:

You have to hand it to those Nordics for exemplary performance against the virus! At the other end of the table, there is a concentration of deaths per case towards the south and east. Here is the same data, shown on a map:

Deaths per case (darker is higher)

This suggests a trend; from relatively good in the north and west, to relatively poor in the south and east. The very worst performers in deaths per case have been Bosnia and Herzegovina, Bulgaria and North Macedonia, in that order. Poland, Ukraine, Russia, Moldova, Romania and Hungary have also done quite poorly. This map also suggests that the UK and Belgium, and perhaps Spain, ought to have done better.

Another statistic to compare with cumulative deaths per million is average excess mortality over the course of the epidemic. Here’s the ordered list:

One difficulty here is that not all the countries which report excess mortality do so reliably. Some, notably Gibraltar and Belarus, stopped reporting excess mortality as soon as the going got tough. On the other hand, in the larger countries the mortality reporting is usually done by someone not directly connected to the COVID reporting, and may well be more trustworthy than the COVID reporting.

Let’s try putting these on a map…

Average excess mortality (darker is higher)

This shows a rather different picture from the deaths per million. There is still an increase in COVID deaths as you go south and east. But Albania and Kosovo, to name but two, have undercounted their COVID deaths. And, therefore, their cases too. And Belarus stopped reporting excess mortality in April 2021. Hmmm…

On a happier note, Ireland and Germany are added to the list of the “good guys,” with average excess mortality lower than about 5% over the epidemic.

To sum up

Eastern Europe, particularly in the south, has been one of the hardest hit areas in the world in terms of deaths per million. As of May 29^th, eight of the top ten countries in COVID deaths per million are in this region. And the further south and east you go, the worse the performance tends to have been. Nevertheless, the epidemic now seems to be dying down almost everywhere in the region. (Russia, because of its huge size, may be an exception).

The effects of the BA.5 variant, currently growing in Portugal, are not visible yet outside the core of Europe, except possibly in Andorra and San Marino.

Some of the COVID deaths data doesn’t tally with the excess mortality data; notably in Albania and Kosovo. Not to mention Belarus. This effect, I expect, is likely to be worse outside Europe. And in those parts of the world (most of them) which can’t (or won’t) supply excess mortality data, I won’t have anything to cross-check the deaths figures against. Oh, well.

COVID World Status Report: 1 – The Core of Europe

 

Cumulative deaths per case (darker is higher)

The COVID epidemic appears to be on the wane in most European countries. The fat lady hasn’t sung a note yet, but she’s gargling. So, I thought now would be a good time to take another look at the COVID data from around the world. This time, I’ll return to my original classification scheme, dividing the world into six “supergroups” of countries by geographical area: Europe, Americas, Middle East and North Africa, Australasia and Oceania, Sub-Saharan Africa and Rest of Asia. The final report will look at the world as a whole.

In this series of reports, I’ll focus on cases, hospital and ICU occupancy (where reported), and deaths. Vaccination and lockdown data, where available, will be included, but only for the purpose of putting the other figures into context. Testing will not even be mentioned in this series of reports, as it isn’t a big factor at this stage of the epidemic. That subject will be reserved, along with assessment of the effectiveness (or not) of lockdowns and vaccines, for a later series of “post-mortem” reports.

This time, I’ll divide the European report into two. The first part will address my “core 14” list of European countries, including individual data for the constituent nations of the UK. The second will deal with the remainder of Europe.

All the data in this series of reports was taken from the usual sources, Our World in Data and the Blavatnik School of Government, together with the UK government COVID dashboard for individual nations’ data within the UK. The data was taken on May 24^th 2022, and runs up to May 23^rd 2022.

Vaccinations

Here is the list of percentages of people fully vaccinated:

Not much difference between the highest and the lowest.

Lockdowns

Here is the spaghetti graph of lockdown stringency over the course of the epidemic:

A strong downward trend is evident in recent months. It looks as if most of the governments have decided that the epidemic is all but over in the core of Europe. For this summer, at least.

Here is the list of current lockdown stringencies, and the individual lockdowns which make them up:

As an aside, the UK-wide Blavatnik data shows a “schools closures recommended (regional)” lockdown, which isn’t to be found in any of the constituent countries’ data. I suspect that the UK’s actual lockdown stringency is now the same as Sweden, Portugal, Denmark and Ireland.

I’ll also show my measure of “harshness,” which only includes mandates not recommendations, includes face covering mandates, and weights lockdowns which affect everyone higher than those which affect only some:

Denmark, Ireland, Sweden, Portugal and the UK now have no mandatory lockdowns. Switzerland has only International: Ban some arrivals.

Spain is showing an incorrect, low harshness value. This is because its Blavatnik data since March 15^th has been mis-formatted. I don’t know what the true situation is there, but the record for March 15^th shows: Workplaces: Some closed (Regional), Events: Mandatory cancelled (Regional), Gatherings: Up to 11-100 (Regional), International: Ban some arrivals, Face covering: Required in some places. Germany has International: Screening, Face covering: Required in some places. The calculated harshness value as of March 15th was 34.375.

France, the Netherlands, Belgium and Luxembourg all have International: Ban some arrivals, Face covering: Required in some places. Austria has Schools: Some closed (Regional), Workplaces: Some closed, Gatherings: Up to 101-1000, Face covering: Required in some places. And Italy has Workplaces: Some closed, International: Quarantine high-risk, Face covering: Required in some places.

Cases

Here are the cases per million so far for the core 14 countries, and for the UK constituent nations:

The percentage of people diagnosed as cases varies between 25% (Sweden) and 54% (Denmark).

Here is a map, with cases per million shown by colour:

Cases per million in the core of Europe (darker is higher)

Here is the graph of daily cases per million (weekly averaged):

With one exception, the cases per million all seem to be gently settling down towards zero. That exception is Portugal (brown line), where there has been a recent surge in cases of a new variant called BA.5. This appears to be more transmissible than the currently dominant variant BA.2. See https://www.theguardian.com/world/2022/may/20/two-types-omicron-classified-covid-variants-concern-uk-ba4-ba5.

Data from South Africa, where this variant has been present for several months, suggest that BA.5 is not significantly different in hospitalization probability or lethality from other strains of omicron. So, there should be no great cause for alarm, unless and until the Portuguese new case count starts to approach its previous peak. Although, as of May 27^th, it was still rising. It's interesting, though, that this is happening in Portugal, which is fourth out of the 14 in cases per million, and highest of all in vaccinations!

BA.5 is already in several countries including the UK, but case numbers are small at the moment. My best guess is that there will be another peak in BA.5 cases in the UK, probably of similar size to the peak in March, when BA.2 took over from BA.1 as dominant variant. That ought not to be a big problem for any health care system. But this is the NHS, after all.

Hospital occupancy

Here are the hospital occupancies by COVID patients per million population. All the 14 countries except Germany provide this data. The percentages of available hospital beds which are occupied by COVID patients are also shown:

Here is the same data looked at in terms of weekly growth in hospital occupancy:

No cause for alarm at the moment, except in Portugal, and possibly in neighbouring Spain. But there is still a fair bit of slack in both, compared with the peaks earlier in the epidemic.

Intensive Care Unit occupancy

Here are the ICU occupancies by COVID patients per million population. The percentages of available ICU beds which are occupied by COVID patients are also shown:

That has to be a bit worrying for the Portuguese, whose ICU occupancy by COVID patients was amazingly high at the peak of the epidemic.

And here is the same data looked at in terms of weekly growth in ICU occupancy:

That has to be even more worrying for the Portuguese. But at least, when their cases peak out, we’ll know what BA.5 can do.

Deaths

Here are the deaths per million so far:

The percentage of the population who have died of COVID varies between 0.11% (Denmark) and 0.275% (Italy). The percentage of deaths in England is very close to that in Italy. And interestingly, the percentage of deaths in Northern Ireland (0.18%) is far closer to that in the Republic of Ireland (0.145%) than to that in the UK as a whole (0.26%). I wonder why?

Now here is a map, with deaths per million shown by colour:

Deaths per million (darker is higher)

That’s interesting. Relatively good performances by Denmark, the Netherlands, Luxembourg, Germany and Switzerland; as well as by the Irish. And Italy, Belgium and the UK are the three worst, in that order.

Looking at the data in terms of deaths per case:

Here is another map, with deaths per case shown by colour:

Cumulative deaths per case (darker is higher)

As this metric says a lot about the general state of a country’s health system, that map is very revealing. Italy and Spain are the worst, by far. Sweden, the UK and Belgium made major mistakes, and lost a lot more people than they ought to have. And Denmark and the Netherlands are outstanding on deaths per case, compared with the rest.

Here are the spaghetti graphs of daily deaths per million and excess mortality (relative to 2015 to 2019), for comparison:

If the two correlate well at a particular time in a particular country, that means that COVID was a major (or the major) cause of mortality in that country at that time. There is a qualitative similarity between the graphs, but the excess mortality is much higher at the first peak, compared with the COVID deaths, than at the second. In the case of the UK (pink lines), the first peak in excess mortality is about 166% of the peak of COVID deaths. Suggesting that a lot of early COVID cases (and so deaths) were missed. I suggest this will be a fruitful area to investigate when it comes to the “post-mortem” reports!

That being said, despite a few excursions – most recently in Denmark (grey line) in March, and the recent spike in Portugal – the COVID deaths per day counts do seem to be settling down towards zero.

To sum up

Five of the 14 core European countries, Denmark, Ireland, Sweden, Portugal and the UK, now have no mandatory lockdowns. And Switzerland has no mandatory lockdowns except at the border.

Daily cases, hospital and ICU occupancy, and deaths per million are still settling downwards in most of the countries. But Portugal is currently experiencing a surge of cases of variant BA.5, with consequent increases in these figures.

BA.5 is already in the UK and other countries, but is not yet dominant except in Portugal. My best guess is that in the UK it will lead to another peak in cases comparable with the March peak, when BA.2 took over dominance from BA.1.

The fat lady will have to put away her gargle for a few weeks or months yet. But there doesn’t seem to be any cause for alarm about COVID causing health care resources to run out again in the core of Europe.