Does Political Opinion Trump Data???
How is the United States really doing with regard to COVID-19?
I majored in math and statistics because the certainty of data has always appealed to me. The same correct solution to a math problem can be calculated by you, me, or someone in the middle of the Sahara desert. But 2020 and the COVID-19 situation have changed all that. I’ve never seen so many preposterous assumptions and ridiculous comparisons made so data can fit pre-determined political agendas.
What’s the real story? Many states in the US reopened to try and ignite the economy in mid-May, so now we have three full months of data. Let’s take a look at how it’s gone, starting with global observations and progressing to more specific. As always, we’ll let the pictures tell the story. If I remember my primary color combinations, red and blue make purple. I’ll switch text colors to reinforce that the focus is on data versus partisanship.
What in the world is going on?
Globally, there have been over 23 million reported cases of the COVID-19 virus, and it has killed over 800,000 people in 200+ countries. Below are the top ten in terms of case count. On the top is mid-May when the US began reopening, and underneath is the count as of mid-August. Countries are color coded by continent to illustrate geographic differences, and key points follow.
- The geography has definitely shifted. Europe (in green) was the primary battleground in May, with six of the top ten countries. And that doesn’t count Russia, which is 23% Europe and 77% Asia (had to look that up!). Today only Spain occupies a top ten position, and the last one at that. The point is that many European countries have been successful in slowing the spread. Meanwhile…
- Five of the current top ten- South America in yellow and Africa in grey– are countries below the equator. This could be a significant issue, as these countries are currently experiencing their winter months. One of the theories regarding the virus has been that it would not spread as easily in warmer weather. The data from cold weather countries may reinforce that- something to keep an eye on as it turns colder in the northern hemisphere.
- The United States dominates both graphs. This is partially due to population and geographic spread, which must be taken into account if comparing the US to the rest of the world. On this point, some comparative statistics are shown below.
What does it mean? With the usual disclaimers about differences in reporting…
- The United States has indeed done more testing than most other countries, even after normalizing for size of population- a little over 4X the global average. The * is to note that the global average isn’t going to be laser beam accurate due to variety of factors. So… I wouldn’t swear to it that the US is exactly 19th, but “top third” should be a safe estimate.
- The case count per million is 9th highest, which can no doubt partially be attributed to more testing and partially due to having more sick people. How do we know the latter? Because…
- The deaths per million is more than 5X the global average, which is obviously troubling. This is partially due to high death rates in New York / New Jersey when the virus was “new,” but this isn’t a Top Ten you want to be in… especially when two of the top ten are San Marino and Andorra, two countries that could be carpeted in a matter of hours. The US is actually 8th highest among countries of significant size.
- Is 532 deaths per million a lot? For reference, that would have made COVID-19 the third highest cause of death in the United States in 2019 behind heart disease (650,000) and cancer (600,000). COVID-19 has 180,000 deaths in about half a year so far. Of course, we didn’t shut down the economy for heart disease or cancer. And of course, we understand more about those diseases and they aren’t highly contagious. And now back to our regularly scheduled program…
On the National Level
The case count in the US was on a sharp increase in March, then tapered off right at the beginning of April. April 1 is the starting point for the graph below to provide proper historical context.
As the legend says, the red line denotes the time in which some of the larger states (like Florida, which we’ll look at in more detail shortly) began announcing their intention to reopen. The green line is June 18, when the case count started to rise. The point is that it took a month for the announcement of reopening to translate into an increasing case volume. (That had been a hotly debated topic.) The tail end of the graph is a good news / bad news thing- the US is headed in a downward direction, which is good. But the average case count per day is still around 49,000 (7-day moving average for August 18), which is not good. Here are the top ten states by case count:
States are color coded by region of the country (I avoided red and blue states!). This picture is dramatically different than even a month ago. New York and New Jersey had lapped the field in earlier blogs, but now the entire northeast has trailed off significantly- which is good. The southeast is the new hot spot, with five of the top ten states (and Tennessee is #11). Bar graphs do not show trends, so to get a better feel for current status we need to look at progression over time. To wit:
These are clearly two very different situations. New York peaked early, dropped, and has sustained a lower level. Texas came to the party later but (hopefully) has peaked and is now starting the downward progression. Most of the top ten states are closer to the Texas pattern- more recent surge, now tapering.
What about deaths? The top ten states are shown below.
Two key points to make here:
- New York and New Jersey continue to lead by a wide margin, at least partially because they were hit with COVID before medical staff knew what they were dealing with. The time-based death graphs for these two states have significantly dropped off. Ditto MA and PA from the northeast and IL and MI from the Midwest.
- The death counts in California and the southeast have predictably risen as the case counts have risen. A large increase in case count has translated to a rise in deaths about a month later.
With regard to trending over time, deaths are shown below in two formats- daily on the left and daily averages for each week on the right. The US does not report deaths as comprehensively on the weekends, so the count typically falls off for Saturday and Sunday and then sharply increases early in the week to account for the unreported weekend deaths. As an aside, almost every week one side claims victory over the virus on the weekend because the numbers are down and then the other agonizes about “the tidal wave of death” that inevitably follows two days later. It’s almost comical. To illustrate the reporting inconsistency, circles are drawn around weekend days on the left. The average daily count for the week on the right smooths out that phenomenon.
So what does it mean? A hotly debated topic in the six weeks following reopening was why the death count was going down (see red arrow). Had the virus been defeated? With the passage of time we now have a more definitive answer: sufficient time hadn’t elapsed for the deaths to happen. We were at 560 at the lowest point, saw a significant five-week increase (blue arrow), and are taxiing at around 1060 now- (yellow arrow). The good news is that the rebound in deaths has not taken us back to the levels of April, which may be evidence that we know how to treat the virus better now than when it was new. Having said that, is there economic justification for the additional lives lost? Let’s take a look.
Balancing Public Health and the Economy
COVID-19 is not exclusively a public health problem or an economic problem- it’s both. To get past this we must ask a horrible-but-necessary question: how many jobs is a life worth? I’ve used Florida as the sample state throughout this series of blogs, and it continues to be a great case study. To rehash stats: the tourism industry in Florida brings in an average of about $3 billion dollars per day and employs 750,000 people. When the state is shut down to visitors, that’s a lot of money / jobs left on the sidelines.
So on May 18 the governor was faced with certain economic disaster if staying closed, and probable public health implications of reopening. What do you do in that no-win situation? Florida decided to open. Here’s what happened next from a virus perspective:
Just like in the national graph, it took about a month for the cases to start spiking, and it took about another month for the deaths to start spiking. To be more specific- Florida was averaging around 40 deaths per day pre-reopening, and held that through July 8. In the 42 days July 8-August 18 they have averaged a little over 140 deaths per day, which is obviously 100 more than pre-reopening. So here’s the real question:
“Is $3 billion in revenue per day worth 100 lives per day?”
Oh sure, you can quibble with the numbers. One side can contend that the 100 deaths weren’t really all COVID-related, and the other that many actual COVID deaths were attributed to another cause. One side can contend 750,000 jobs is too high since many of the displaced would get jobs in other industries, and the other can contend 750,000 is low since other industries besides tourism are impacted. And so on, and so on… but when all the spin stops, the question that governors (and we as a people) have to answer is some version of
“Is $3 billion in revenue per day worth 100 lives per day?”
Too simplistic? Of course. On the economic front it isn’t just about job count, it’s about quality of work, GNP, etc. On the health front it’s not just about deaths- it’s about long-term health complications, social development, etc. Once we’re having that discussion then we’re looking at this like the complex problem it is. But just to get the ball rolling…
“Is $3 billion in revenue per day worth 100 lives per day?”
A lot of people would answer that question by saying “sure it’s worth it… as long as I don’t know any of the people.” I have empathy for governors faced with this decision. While I don’t know if the perfect answer exists, I do know that a perfect answer would not consist of ignoring either the economic or public health realities of the situation. If we’re going to get past this, we need to look at it through both lenses.
What decision would you make?
Data source = Worldometer