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What is your risk of death from COVID-19? — some relativity

The data at 8:30 on Tuesday 30 June is that the death rate of confirmed cases is 0.049. This is the global total.

I decided to look at the countries individually and there was a significant difference in the death rate. Paraguay in South America has a very low death rate of 0.0070. Australia is 0.013, the USA is 0.0497.  

People queue waiting for a meal offered by volunteers, amid the COVID-19 pandemic in Ita, Paraguay. (Photo by NORBERTO DUARTE / AFP)

Sweden has a rate that is higher than the global rate at 0.0810. I think this is interesting because they have not sheltered their population, so it is likely that a greater percentage of the population have been infected but not tested. 

The take away from this is that as with the community based infection rate studies carried out in the US, the infection rate is much greater than the reported tested rates of infection. The community studies in the US carried out in 2 different areas showed the number of the population carrying antibodies to the COVID-19 virus was up to 50x greater than the tested/infected rate. If you put those numbers through the equations we will get a much lower death rate. 

So the question that occurs to me is why is there such a significant difference in the numbers in different countries? 

Does Paraguay have a better health system than Australia and Sweden? The Russian federation also has a low death rate of 0.0142.

Association between mobility patterns and COVID-19 transmission in the USA

The WHO has put together reporting guidelines to help boost the quality of the numbers coming out of different countries. Interviews that I have heard have stated that the numbers from the US are likely highly inflated. There is CDC directive to count any death as a COVID-19 death if the patient tested positive to COVID-19. This will skew numbers as in some cases the infection was incidental rather than the cause of death. In addition, hospitals received additional payments for ventilator use and deaths from COVID-19. These incentives will boost the COVID-19 count.  

The next question which comes to mind is what is the background health status of the population in each country?

The disparity in the death rate is seemingly at odds with the level of health care and the prosperity of the country. This then leads me to wonder what the degree of chronic health conditions is, in the population at large. The US has the highest death rate. Canada and Sweden are on par at 0.0825 and 0.0810 respectively. 

A number of experts that I have listened to have suggested that when the virus has run through the population at large we will end up with a global death rate that is very similar to the rate of Sweden. Australia and New Zealand with our “lock down” policies are just delaying the spread and we will have to wait longer to discover what the final death rate is.

World Life Expectancy and Health Expenditure comparison

I spent some time on the WHO website which is a mine of information. Much of it is between 2012 and 2018 at the newest.

What is interesting is that the lower the spend on health the lower the COVID-19 numbers. That might seem odd, but there is some sense to it. The higher per capita health spend is usually associated with increased life expectancy, thus an older population and more likely to be on medications, which seem to be associated with an increase in mortality.  

Paraguay is the obvious contradiction or not. They have the lowest fatality rate with a low number of cases. There is an argument when you look at the rest of the statistics, that if you survive to 50yrs of age you are pretty hardy and will likely recover from most illnesses. 

An eminent epidemiologist that I was listening to was talking about excess deaths – the deaths from COVID-19 that were in excess of the normal deaths that occur during a measured period. It is likely in the countries where the probability of dying between 15 and 60 is low, that the excess deaths from an illness will show up more than, say, the Russian Federation where the deaths for men between 15 and 60 is more than twice that of the USA! 

I have found this period of focus on health and what factors give a higher chance of survival, has largely ignored the factors that cause resilient health. 

A surprising predictor of a good survival rate of COVID-19 seems to be a low average income. 

The countries that I picked from the sea of data that had the lowest rates of death from COVID-19 also had a lowest per capita average income and the lowest health spend per head.  

This may bring us back to a theme that I have talked about in previous blogs. The poor countries with poor populations do not spend on medications. These individuals would seem to be more hardy and able to fight off infections.

Fighting off viruses with a healthy immune system

The physiology of the prosperous countries is largely supported with technology and medications, which would seem to leave those individuals vulnerable when challenged.