Deaths and Recoveries

I’m not bothering with my usual Numbers section today, since the 1-day and 7-day rates of increase in deaths and cases haven’t changed at all, and the ratio of deaths to closed cases remains at 17%. The projected deaths numbers are close to what they were yesterday.

I haven’t discussed the ratio of deaths to closed cases for a while, although I’ve been reporting it. To refresh your memory, this is the ratio of total Covid-19 deaths so far to “closed cases”; closed cases is the sum of deaths so far and “recoveries” so far. The fact that the US rate is 17% means that, of all closed cases so far in the pandemic, 17% of them have resulted in death. This is down substantially from the initial value of 41%, in late March, when Worldometers started reporting recoveries. But it is still quite high – it seems to mean that, if you’re determined to have a “case” of Covid-19, the odds are close to 1 in 5 that you will die.

I’ve been periodically comparing the US performance in this area to those of the other six countries for which Worldometers publishes all of these numbers, but this is the first time I’m publishing the comparison. It’s quite interesting. Of course, I’ve been reporting the Total Covid Cases, Total Covid Deaths and Recoveries numbers for the US all along. The ratio of deaths to closed cases, which I just discussed, is in the last column.

The last time I did this comparison was on May 9. Then, France had the highest value in the last column, at 32%. The US was at 25% and Italy at 23%. Now, France is at 30%, Italy at 18% and the US at 17%. This is an improvement, but the US still compares unfavorably with South Korea, China and even Iran. This could mean that a lot more people are dying, relative to total people with the disease, in the US than in those three countries. But it could also mean that we’re lagging behind the others in declaring people to have recovered (since recoveries are by far the bigger component of total cases).

I’ve been theorizing for a while (with my friend Kevin Perry) that recoveries are lagging because of the relative unavailability of tests. Since many hospitals don’t want to declare a person to be recovered until they’ve tested negative twice, and since the hospital would be reluctant to “burn” two scarce tests on someone who is clearly feeling fine now (and has most likely already left the hospital), they just won’t bother to try to determine whether or not they’re really recovered. As tests become more available, they will do this, which will bring the ratio down further.

But another theory is that the US hospital system has been overwhelmed (at least in hard-hit cities like New York and New Orleans), resulting in a greater number of deaths. This means we didn’t “flatten the curve” nearly enough in those cities, even though we have hopefully flattened it everywhere by now (although that idea will be tested as we get more outbreaks in smaller cities and rural areas, as is happening now). I don’t think it can be disputed that New York’s hospitals were overwhelmed during the height of their outbreak, but whether that would account for the whole difference between us and say South Korea is certainly debatable.

I see some other interesting indications in these numbers, but I’ll leave that discussion for tomorrow.

Country	Total Covid Cases	Total Covid Deaths	Ratio of Deaths to Cases	Recoveries	Ratio of Deaths to Closed Cases
S. Korea	11,441	269	2.35%	10,398	3%
China	82,999	4,634	5.58%	78,302	6%
Italy	232,248	32,999	14.21%	152,844	18%
France	186,835	28,714	15.37%	67,803	30%
Spain	285,644	27,121	9.49%	196,958	12%
Iran	148,950	7,734	5.19%	116,827	6%
US	1,794,153	104,550	5.83%	519,611	17%

5/31:My friend Kevin Perry just wrote in to say that he doesn't trust the recoveries numbers, which might throw doubt on whether the US ratio of deaths to closed cases has really fallen as much as it appears. Kevin says: 

It has become clear that many states are just not counting and reporting recoveries.  And the means for determining recovery is inconsistent.  Do you declare recovery by two consecutive negative tests, at least 24 hours apart?  Do you do, like Arkansas, simply assume recovery if the COVID-19 patient isn't still hospitalized 14 days after onset of symptoms?  How do you count the significant number of infected people who were either asymptomatic or whose illness was so mild that they never sought medical attention?

Testing for infection and testing for post-infection anti-bodies is also problematic.  There are instances where the nasal swab produced a negative result because the virus was centered in the lungs, not the nasal cavities.  And the anti-body test is now appearing to have as much as a 50 percent failure rate.

The “recovered” statistics are, in my mind, no longer meaningful.  Just as we have no idea how many people have been infected, we have no idea how many infected people have really recovered.

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com