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Coronavirus: How US Stacks Up Against the World

In the July 28, 2020 Axios interview, the President brought some graphs to support his point that US is doing well in terms of handling the coronavirus, claiming we’re “the lowest.” He also said “number one mortality rate” on the Chris Wallace interview on June 19, 2020. This is an analysis of that assertion.

Trump Keeps Bragging About America's Covid-19 Death Rate. It's ...
Graph showing case fatality rates of three countries, including the US, and the world as a whole over time.

Notice that the President is using only two other countries for comparison and the world’s average. He is also using the case fatality rate, which is grossly inaccurate since it relies on the number of cases, which is a lot higher than the official count.

To be fair, US should only be compared to other developed countries, but here I will include both, developed countries and the rest of the world, for reference.

Note: I am going to use the Worldometer website as my source for the numbers, as of August 06, 2020.

What criteria do we use to compare the US? As it is the third most populous country, it doesn’t make sense to compare absolute numbers, like the case/death count. We will focus on ratios, such as deaths per 1,000,000 population. However, it is worth noting that the US has the highest number of deaths in the world (about 25% of all deaths) despite having 5% of the world’s population. Not surprisingly, then, that the death rate per capita is over five times that of the world’s average. This is the most startling statistic that belies all the talk of doing all that is possible to contain the virus.

Case fatality rate

(# deaths per 100,000 positive cases): this depends on how many people are diagnosed, which is grossly undercounted since “the number of people in the United States who have been infected with the coronavirus is likely to be 10 times as high as the 2.4 million confirmed cases” (CDC Director Robert Redfield, 6/23/2020). Also every country has a different rate of testing, for which I am not going to standardize in this exploration. I am, however, going to assume that the number of deaths figure is accurate, even though it is most likely an underestimate.

Regarding the case fatality rate, which the President said in the Axios interview as US being the lowest, US is actually 70th, slightly lower than the world average, but nowhere near the lowest. In any case, US (3.25%) is better than many European countries, but much worse than Japan, South Korea, Russia, and Israel. Again, this metric is very poor since the actual number of cases are probably much higher and there is wide variation in every country’s test rates and death measurement methods.

Case fatality rate

Testing rate

The President bemoaned that the reason US has more cases than other developed countries was because of high rates of testing. Paradoxically, a higher test rate drives down the case fatality rate, which the President brags about. The graph below shows that US is has the 8th highest testing rate among countries with populations over 2,000,000. This is comparable to Australia, Israel, and Russia, but it’s only 3/4 of the UK’s rate and about 1/3 of the UAE’s rate. It is also 20% more than Spain and Belgium, 50% more than Italy and Canada, about twice as much as Germany, and three times as much as China.

Total tests/1M population

Total cases

So the conclusion is that US is among the countries with the highest rates of testing, and therefore we also have among the highest rates of cases/1M pop, comparable to Brazil (we are essentially the highest in the world for developed countries. Even Israel has around half the rate of cases even though their testing rate is similar). This is another reason why comparing absolute case numbers is not as meaningful and using the death rate is a much more accurate metric.

Total Cases/1M population

Population fatality rate

(# deaths per 1,000,000 population). This is a more accurate representation of coronavirus’ spread, especially when comparing countries with similar healthcare resources which means the survival rate is similar, and which is why this is the best metric to use. Also, unlike cases, deaths are calculated by counting “likely deaths” calculated as additional deaths when to the same time over the past years, which captures more people than just those who have tested positive for the virus. At least this is the case in the US, many other countries are presumably underreporting their death toll, such as Mexico, whose death toll might be twice as high. This casts some doubt on the observation that the US is in the top 5% of countries (out of 215 countries) in terms of its death rate. Nevertheless, by no means is the fatality rate “the lowest.”

From the chart below we can see that the US has the 10th highest rate of deaths with respect to population in the world, with Belgium topping the chart at almost twice the rate of the US. It is similar to France, a little lower than Italy, Spain, and UK, and five times higher than Germany and Russia, 110 and 99, respectively.

Total Deaths / 1M population

We must also note that the European countries have had the virus more or less under control, while it is spinning out of control in the US.



The interview: