In previous posts, we had pointed out that certain countries such as South Korea, Singapore, Germany, Austria, and Scandinavian countries appeared to have done significantly better than other countries such as Italy, Spain, France, and the UK in the war against the COVID-19 pandemic.  This pattern of success has persisted through the last few weeks of exploding cases for many but not all of them.  It turns out that the Scandinavian success was a statistical fluke and short-lived except for Norway who continues to lead all European countries with the lowest coincident and estimated final mortality at 1.1% and 1.4% respectively.  This was initially attributed to the youth of its original infectees, skiers, but since more than 0.1% of the country’s population has now been infected we believe it may be more representative of the country as a whole.  Germany and Austria follow close behind with coincident and estimated final mortality rates near 1.5% and 2.0%, respectively.

Much has been made of Germany’s early testing and tracking.  But unlike South Korea and Singapore, they did not test as widely nor did they isolate or restrict the travel of their potential infectees as well as South Korea Singapore, and Taiwan.  This was partly because as members of the European Union they had tried to maintain open borders for as long as possible, but also because the Germans had initially underestimated the severity of the disease. So while South Korea was able to maintain both a low population infection rate of 196 per million and a low death count of 3.4 per million, Germany’s later imposition of international and domestic travel restrictions led to a cumulative infection rate of 1,148 per million and a current death rate of 17 per million that is sure to rise higher to perhaps 30.  But these numbers are or will still be nearly 10 times better than what we see and estimate for Italy, Spain, France, and the UK (whose current death count is just 64 only because their infection is still in the early stages). 

InfectionsDeathsMortality CoincidentMortality
Spain          2,697     126,16811,9479.5%13.6%255.4
Switzerland          2,397       20,505            6663.2%4.2%    77.8
Italy          2,056     124,63215,36212.3%15.1%  253.4
Austria          1,310       11,781          1861.6%2.0%    20.7
France          1,381       89,953  7,5608.4%16.3%  116.1
Germany          1,148       96,0921,4441.5%2.1%    17.3
Norway          1,026          5,550            621.1%1.4%    11.5
U.S.             943     311,357  8,4522.7%5.1%    25.6
Iran             666       55,743         3,4526.2%8.3%   41.3
UK             618       41,9034,31310.3%19.0%   63.6
Singapore             206          1,18960.5%0.7%     2.3
S. Korea             196       10,1561771.7%1.8%     3.4
Taiwan               16             355      51.4%1.4%     0.2
China               57       81,639   3,3264.1%4.1%    2.3

Again, the lessons to be learned from observing these countries’ results is that:

  1. Testing, tracking, and treating (3T) early and widely and thoroughly will help to lower both infection rate and mortality rate — as South Korea, Singapore and Taiwan have done.
  2. Some errors or delay in implementing the 3T can be ameliorated with early and stringent travel (the 4th T) restrictions or quarantines — like Germany, Austria, and Norway has done.  They have high infection rates but still reasonably low mortality rates.
  3. Failing to follow this 4T prescription until very late will lead to disasters like those we are seeing in Italy, Spain, France, and the UK.  The incremental loss in lives is at least 10–1000 times worse and totally unnecessary.
  4. The US is currently at an infection rate of 943 per million and a current death count of 25.6 per million.  It is projecting a final death count of 300–720 per million.  It can avoid the worst-case but it needs to act now to impose stringent domestic travel restrictions.