So, the current working theory about Africa is that they have really good contact-tracing systems (because they still have lots of infectious diseases) and people comply more with infection control measures (because they still have infectious diseases).
The trouble with the developed world is that public health has been so successful that people appear to have forgotten why we need it.
Among other factors, South America seems to show the strong winter seasonality pattern typical of coronavirus infections (not just SARS-CoV2). Much of Africa does not (the continent spans northern and southern hemispheres to a greater degree, and has far more population in a tropical belt), though South Africa seems to.
The majority of people in South America are partially or mostly of American Indian descent. It's been generally known for a long time that American Indians are hit harder by the flu. Some research papers on covid seem to indicate a similar trend. As such, it may not be so surprising to see worse numbers in a continent of people genetically susceptible to the disease.
Africa is also pretty easy. Median age in Africa is 19.7. Median age in Europe is 42.5. Median age in the US is 37.9.
We know that young people are very unlikely to die from covid, so a place that skews so young would have fewer deaths.
Likewise, given the large number of much more lethal diseases in Africa combined with young age and poor medical facilities, people with preexisting conditions are much less common and are much more likely to be killed by other, more lethal diseases.
This is not correct. If you adjust for population size, most of highly-developed Europe is doing much worse than the USA right now. That includes Germany, Switzerland, etc.
The US has had 34k cases and 760 deaths per million people. Germany has had 10k cases and 152 deaths per million people. So Germany has done 3 to 5 times better than the US so far. The only Western European country that has clearly worse numbers than the US is Belgium and in part that may be because they have a much broader definition of deaths with COVID19.
But it does show that you cherry-picked data that didn't give the full story. The follow up comment only made things more clear, which I think you should appreciate.
I didn't cherry pick, I was in fact exhaustive. I was looking for cases that supported "most of highly-developed Europe is doing much worse than the USA" and specifically mentioned Germany. I looked at the specific cases mentioned and any others that could be classified as "much worse".
I agree, I just wanted to make it extra clear for others how several large European countries seem to have numbers similar to the US (Ironically... I could have phrased it in a way that made that more clear to you.)
It seems to me that all remaining levels and sub-sectors of American society have responded reasonably competently, despite the grossly negligent and incompetent response (potentially even criminal?) from the administration.
How do you figure that? Taking the example of Germany, their numbers of new cases and new deaths from the same source are ~2x less than the US per population. By what metric is Germany doing much worse than the USA right now?
Germany is basically the best case for Europe and had 199 deaths today, with a quarter the population of the US (who had 485 deaths).
* 506 deaths in France (a fifth of the US population)
* 213 in the UK (equiv. to 1000/day in the US)
* Switzerland tracking at 100 deaths a day, equivalent to over 4000/day in the US
* 162 deaths in Czechia, equiv. to 5346/day in the US
EU cases started climbing earlier than the US, and new daily cases have peaked and are descending.
Plotted here, 1 September to present, are the largest EU states: France, Spain, UK, Germany, and Italy, vs. US. (The tool is capped at five comparisons). Shown are new daily cases, normed to population, 14 day smoothing (to clarify trend).
Substitute otheer countries as you prefer. Note that Poland, Czechia, and Switzerland have comparatively small populations (38m for Poland v. 84m for Germany).
US cases are still climbing, EU are falling. France peaked on 2 November, 14 days ago, deaths attributed to those cases are just now being reported, but willdecrease rapidly.
Meantime US cases are still growing exponentially, with over 1 million new cases (at a 3% CFR) in the past week alone.
Calling the US situation "better" than Europe is ignoring the inevitable tragedy facing the US. As with this past spring, a few weeks lag on the epidemic curve can not be represented as evidence of superior situation. The future is here, it's just distributed more in Europe than the US presently. The US will get what's due it within 2-3 weeks, possibly sooner.
We're just discussing different things. I'm talking about the number of deaths occurring right now in Europe, as a response to the original comment I replied to. You've added a lot of context about the number of cases and what's likely to happen in future. I don't disagree with any of that.
1. Cases today translate directly to deaths in the 2--4 week future, at a best-case rate of 0.5% CFR and far more plausibly 1.5--3% CFR, based on present reported cases.[1]
2. US new cases per capita are at least on par if not worse than Europes's.
3. EU daily case rates are trending at worst flat, and are generally decreasing.
4. US case rates are rising, at an acellerating rate.
The US today reports 158,363 new cases (7-day average), and a 3% CFR. In ~2--3 weeks, likely daily deaths will be 2,375--4,750, or 7.5--15 per million.[2]
Germany, to use your favoured example, reports 18,363 new cases (7-day average), and a 2% CFR. In ~2--3 weeks, likely daily deaths will be 367--550, 4.4--6.6 per million.[3]
All Europe reports ~220,000 new daily cases (16 Nov 2020, not smoothed). in ~2--3 weeks, likely daily deaths will be 3,300--6,600, 4.4--8.8 per million.[4]
To provide an analogy, you're laughing at Europe being in a ditch whilst the US is racing toward a cliff's edge. Assessments of present health or wealth must include obvious future consequences or risks. You entirely ignore these, and reframed the initial criterion to do so.
Your analysis suffers from presentism and risk blindness and is utterly flawed.
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Notes:
1. I'll ignore the fact that reported fatalities undercount true COVID-19 fatalities as demonstrated by overall excess deaths by about 30% per an August 2020 New York Times report and other independent studies and data.
2. Using 1.5--3% CFR.
3. Also using 1.5%--35 CFR, despite Germany's lower experienced CFR.
4. Again at 1.5--3% CFR. Based on reported values, whic undercounts recoveries, experienced CFR is ~4%.
I did not "redefine" or "reframe" anything. From the beginning I chose to use recent daily deaths per capita as my measure of how badly a country is being hit by COVID "right now". It is true that my first response did not make this explicit, and in retrospect I should have done so. Please read all my comments charitably, as I have done with yours.
I have already agreed that the measures you are using are also valid and that the trends are bad. However your points 1-4 are entirely about cases, trends, and the future, which has nothing to do with the point I made.
Accusing me of "laughing at Europe" is the sort of toxic rhetoric which doesn't belong on HN and frankly says more about you than it does about my argument. I live in one of the worst-hit yet most-developed countries, and some of our ICUs have run out of beds.
"Beginning" means from the moment I conceived the idea in my mind. Again, please try interpreting things charitably, otherwise you will make poor assumptions and end up arguing against your own imagination.
If you re-read this thread you will see that I am not arguing against the points you made, at all. I'm saying (over and over) that you have failed to address the extremely simple point that I made. I've replied to your other comment, so let's leave it there. All the best.
I did look it up myself. I used the 7 day moving average to get more stable results and Germany is 2x better than the US in new cases/deaths per million right now even while having 3 to 5x less cases/death in total since the start which means it also has a more vulnerable population at this point. I didn't pick Germany, you did, and claimed it was "much worse". And it's not the best case, there are several countries doing better or much better than Germany.
As for the other examples Europe is now having a second wave after successfully suppressing the first one. The US has never suppressed the pandemic, or at best is now at a third wave, and thus has a currently less susceptible population from all the cases and deaths it has already had. And even then it's still having more new cases and new deaths than the well managed countries in Europe (Germany, Norway, Finland, Denmark, etc). It's hardly in a better situation right now as you claim. The worst countries in Europe are at the US accumulated average, some are catching up but the US is also spiking right now.
Over the past few weeks (i.e. right now), the number of deaths per capita in the European country I live in is far higher than the number of deaths per capita in the USA. Some of the best hospitals on Earth are running out of ICU beds. My country is not alone in this, as you can see in the numbers I provided. This is the context for my response to the original commenter.
You have a different way of measuring the problem and you are extrapolating into the future, and that is also fine. We are just making different points.
I'm not measuring different things. I've used initially the definition that seemed most appropriate to me as you didn't provide any and then the definition you chose. You're now using as an example an unnamed country. With the examples you gave it wasn't true in either of the metrics.
I've already given you the numbers for Germany which was your other example. It is actually 2x better than the US. Your claim was "most of highly-developed Europe". Germany isn't even the best case and the total EU metric also says the opposite.
Germany is at 177 deaths per day with 84 million people, for 2.1 deaths per million per day. The US is at 1170 deaths per day with 332 million people, for 3.5 deaths per million per day. That's a factor of 1.7x worse by the US. In number of new cases it's worse.
You're doing math with the "Today" numbers that are not always reliable because not all US states have reported sometimes. The 7 day moving average numbers are more reliable.
It's also very easy to lookup countries like Denmark, Finland and Norway that are much much better. Picking individual small countries is not a great methodology, particularly Czechia that did extremely well in the first wave and thus has a much more susceptible population.
231 million people, 1807 deaths, more than 2x as bad as the USA. And that's before adding Switzerland, Czechia, and other countries where things are worse.
It's also irrelevant that Czechia did well in the first wave. This is about who is doing worse right now as measured by actual humans dying. The reasons don't matter.
So from "much worse" it's now "not materially worse". In reality the numbers say Germany is actually much better, and it's 84 million people that you are now excluding from the analysis.
Picking other individual countries is a poor analysis. Take the whole EU or another group that's comparable to the US. Otherwise the same can be done for US states. But you were also given numbers for those that showed the opposite and doubled down. You already have a conclusion are are making the data fit.
> It's also irrelevant that Czechia did well in the first wave. This is about who is doing worse right now as measured by actual humans dying. The reasons don't matter.
It's not irrelevant in the context I used it. Which was to explain how you were cherry-picking a very specific case.
Population - Country - Deaths
60,427,888 - Italy - 731
65,328,048 - France - 506
68,021,208 - UK - 213
37,831,020 - Poland - 357
8,678,393 - Switzerland - 72
83,783,942 - Germany - 257
11,608,351 - Belgium - 195
Look at the map. These are reasonable choices. I haven't cherry picked them, e.g. I included Germany and excluded Czechia.
This is 335M people and 2331 deaths.
That is AT LEAST DOUBLE the current daily death rate in the USA.
There are many other ways of grouping European countries to achieve the same outcome, which is to show that contrary to the original commenter's position, right now, the USA is not the worst hit place on Earth, if you measure the problem by the number of people who are currently dying every day. I live here and that is the number that matters the most.
Here is my original comment, which is totally consistent with the numbers above (with the exception of Germany as an individual nation, but this is irrelevant as it's now in the aggregate):
"This is not correct. If you adjust for population size, most of highly-developed Europe is doing much worse than the USA right now. That includes Germany, Switzerland, etc."
Of course you can select many other ways of grouping the data and many other ways of choosing the numbers to achieve the outcome you want. That is not relevant to the point I have been making.
At this writing, Europe as a whole has a population of 747.8 million, and 14.1 million COVID-19 cases, for a population-adjusted rate of 18,900 per million.
The US incidence rate is 34,400/1M, 182% of Europe's.
EU has 8.57m active cases for a 11,500/1M active case rate.
US has 4.23m active cases, for 12,800/1M active case rate.
Note that Spain, UK, Netherlands, and Sweden don't report on active or recovered cases. Nor does the US state of Oregon.
The margin is much thinner, though reported data still give the edge to the EU. Given that Spain and the UK represent large current EU outbreaks, that margin could shift to the advantage of the US.
I'll note that US cases are continuing to grow largely unhindered whilst several EU outbreaks (notably France) may have peaked as lockdowns' impacts are seen.
Only by the least charitable interpretation of the point I am making. There's nothing wrong with using the current death rate per capita as a proxy for the problems a country is experiencing "right now". Which is the context for this sub-thread.
Assertions aren't arguments, and I've already addressed that comment.
Switzerland had 142 deaths in the past 24 hours. That is FOUR OR FIVE TIMES the number of daily per capita deaths in the USA at the moment. It is perfectly reasonable to believe that on this basis, Switzerland is having a tougher time right now than the USA.
I don't know why you are so doggedly refusing to accept the very simple point I have made here, which relies on nothing more than public facts and basic arithmetic.
Thanks for the discussion, but I have to assume you're not here in good faith, so I'm done. All the best.
It is difficult but its not because of the price, although that's there too. It's that developing countries may not have the infrastructure to transport and store the vaccine at the recommended temperature of -70C.
The moderna vaccine does not need -70c, juste -20 to be stored indefinitely (regular freezer), and even higher than that if you can ship relatively quickly (i.e weeks)
Developed countries don't have infrastructure for -70C distribution. The US is going to struggle to actually distribute the Pfizer vaccine. It's not like your local CVS has a freezer that goes down to -70C. Dry ice is possible but there's a shortage of that, too. Nobody has ever distributed a vaccine that needs to be stored at -70C.
The Moderna one is much easier, you just need a normal freezer. Which is fine for developed countries, will still be a challenge elsewhere (but one they're used to, it's not the first vaccine that needs to be kept cold)
There is no shortage of dry ice. The input (CO2) is a byproduct of industrial processes (ethanol in particular) and so the market is completely glutted. It is also used for a number of industrial process so there is plenty of infrastructure to produce it in any city.
Poor countries might face a different issue even if they get hold of vaccines - some of them (not sure if just Pfizer's) need to be kept in really cold environments [1]. Thus some countries will struggle with distributing it.
Pfizer's is the worst, and they give you 5 days at more normal temperatures. It will be more much difficult logistically, but if needed anywhere in the world is 5 days from any place else if it is important enough.
It doesn't seem to be rich vs poor countries in this case. The Moderna vaccine is expensive. Too expensive, even for some developed countries that rejected it as an option.
If the US government is happy to hand out billions in funding and then pay a high price for the doses, why would a private company not take advantage of this?
Somehow the EU/UK convinced AstraZeneca to sell the Oxford vaccine at production cost.
> If the US government is happy to hand out billions in funding and then pay a high price for the doses, why would a private company not take advantage of this?
The US government paid Moderna $1B to fund the development and $1.5B for 100 million doses. They are paying Pfizer $1.9B for 100 million doses of their vaccine. I don't consider $25/dose (maximum) or $19/dose to be "a high price".
It is a high price when you consider low income countries. For example, in Sudan the average monthly income is about ~$49. That's less than the cost of a 2 dose regime of this vaccine. That's a $2 billion price tag to vaccine all 40+ million Sudanese. Africa has 1.2 billion people. It is going to be extraordinarily expensive and difficult to eradicate COVID globally, so we are going to need cheaper vaccines to help us do that.
There is no reason other than political will stopping the WHO and developed nations from subsidizing the purchase of vaccines for places like Africa. In fact, I don't think there is any vaccine that a country like Sudan could afford to administer without such subsidies. Additionally, I suspect the cost of distributing and administering the SARS-CoV-2 vaccine in those areas is going to dwarf the raw cost of the doses anyway, considering the temperature sensitivities of the front runner candidates.
That said, the person I was replying to was claiming the price was too high for some developed nations.
> Moderna said it would charge other governments from $32 to $37 per dose. The charge to the United States, which has already committed about $2.5 billion to help develop Moderna’s vaccine and buy doses, comes out to about $24.80 a shot
Yes, they're expecting to profit to some degree, but those charges don't look to be particularly out of line for a newer vaccine from a quick skim of price data.
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I can't see how any developed country would choose to pass on it at that cost if available to them while others are still under development/not available in sufficient supply.
The economic damage this is causing is massive and anything that gets you past this even slightly faster is more than worth that price.
You could vaccinate the whole UK population for $2.3bn (in medication costs). The pandemic is causing vastly more economic damage than that to the UK.
Through only August, COVID has cost just the UK government (to say nothing of other economic damage) over $277bn (@current exchange rates). The vaccine could cost half, it could cost 5x as much, but it would still be absurd to do anything other than pay it and get it out to as much of your population as you can if it's available to distribute and other vaccines aren't.
Even if you've got something else in the works, if buying what you can of this gets you "reopened/normal" a month or two earlier than not, it's still an obvious economic win for any developed country.
The cost to manufacture is cheap as chips - governments pay $3-$10 per shot when they buy millions. Transporting and administering increases the price but not significantly.
Of course a country that could pay $1bn half a year ago in advance on the chance that the vaccine works will be ahead in the production queue in front of a poor country that only now puts in orders.
Bill Gates was there looking for answers as well. And he has been working with some companies for long enough to get ahead of the line just because he was there before this need.
