EU Coronavirus comparisons

The number of infections in European countries is still very uncertain. This means that the only hard numbers we have for comparison are total deaths recorded. This is  usually shown as a logarithmic plot for each country, but this fails to take into account differences in population. Therefore I have simply plotted the normalised deaths in each country per million citizens. This shows some interesting comparisons.

Comparison of accumulated deaths in several EU countries as of 26th April  (click to expand)

On this measure the actions of the UK government and NHS healthcare have been really quite successful. Germany has been the most effective at limiting the number of deaths, followed by Sweden.  Belgium is clearly experiencing a dangerous increase in the death rate which means it has not yet got the outbreak under control. It is currently Europe’s hot spot.

There are regional differences in population density and distribution which partly explain some of these differences. The UK population is concentrated in London, the South East, West Midlands and Northern Cities. Germany has a more evenly distributed population with more  towns and cities of smaller populations. Sweden has deliberately avoided a full lockdown and restaurants and shops remain open, but this is also probably helped by a low population density and a strong sense of social responsibility. Their policy does indeed seem to be working and it  will be interesting to see how this plays out in the future.

One of the consequences of reducing the reproduction rate R is that the epidemic slows down. If the unabated value of R is 2.4 the epidemic would all be over  in about 2 months although at a heavy price. If R=1 the “epidemic” would continue indefinitely. So R has to be kept as low as possible until all cases are eliminated, which is probably impossible for the whole world, unless a vaccine is found.

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29 Responses to EU Coronavirus comparisons

  1. Steve Gouldstone says:

    I wonder if these figures are directly comparable? It depends entirely on how different countries compile and report the figures.

    In the UK at least, the deaths are under-reported as they only count deaths in hospitals as far as I understand. The death toll in care homes is significant but the number of deaths due to Covid 19 is unknown as the deceased are not being tested. (A care home I know of has had 18 deaths in the last two weeks but only two of them were attributed to Covid 19, the 16 others weren’t tested although the symptoms were the same as the two [untested] victims attributed to it).

    It is a shambles, due more to incompetence and disorganisation than a deliberate attempt to cover up the figures (I hope).

    • Clive Best says:

      Yes you’re right. Deaths in care homes are not included in the official figures. Nor is it clear whether they are included in other countries. I believe that the visible peak in France around mid-April was when they added in the care home deaths.

      I agree it is a bit of a shambles but that won’t change until all persons showing symptoms get tested and isolated. They only way to end this other through than herd immunity or a vaccine is to test and track all cases in the UK.

  2. Olga says:

    You can’t compare the number of deaths in different EU countries because counting method differs from country to country.

    • Clive Best says:

      The problem is that everyone does compare deaths from different countries. The daily press conferences do just that.

      • Olga says:

        Belgium counts deaths in the hospitals, care homes and suspected death from coronavirus, while UK counts only deaths in hospitals. So, those figures differ quite a lot, I suspect.
        Another thing, the number of deaths only tells how lethal this virus is, the number of cases points out on whether or not the outbreak is under control. Also number of deaths lag the number of cases by 10-12 days. So, to draw the conclusion that “Belgium is clearly experiencing a dangerous increase in the death rate which means it has not yet got the outbreak under control.” is just wrong.

        • Clive Best says:

          The number of cases depends on the number of tests. In the UK we have no idea of the total number of people who have been infected. Most of them self-isolate for a week and then go back to work. They do not appear in any statistics. UK only tests people sick enough to go into hospital This makes the death rate look artificially high ~ 10%.

          I agree with your comments about deaths though. Probably UK deaths should be increased by ~ 20-30%.

  3. MarkR says:

    Euro MOMO has updated through April 20th:
    https://www.euromomo.eu/graphs-and-maps

    Excess European deaths increased by ~113k in the 5 weeks through April 20th. For countries they give Z scores, which I thought were useless since the standard deviation should change (winters are more variable), but it seems like they base it on variation during spring & autumn to minimise flu & heat wave variance.

    Through April 20th England was at Z=49 and hadn’t peaked. Italy peaked at 22, Belgium at 29. If EuroMOMO standard deviation doesn’t vary much between countries then England has seen the worst weeks in Europe. The other home nations look a bit better.

    If anyone’s understood the details I’d be interested, but my coffee’s just finished brewing and I should get into actual work right now.

    • Clive Best says:

      Interesting graphs. Austria actually seems to have even have a reduced death rate ! I think the data must be updated in arrears because every country shows a drop in the latest week. However in general it will be excess deaths above normal which eventually tell the full story. Some of excess those deaths will be due to knock on effects of delayed treatments for Cancer, Strokes and Cardiac Arrests. I also think being cooped up at home for 23 hours a day is itself unhealthy!

    • dpy6629 says:

      I think there is something wrong with England’s Euromomo statistics. Look at the 15-65 age group and you will see virtually all the countries show virtually NO excess mortality or a small spike. Englands spike is huge and may be contaminating the aggregate numbers in this age group. This age group is not strongly affected by this disease and so should be showing in England what virtually every other country shows, viz., nothing or a mild spike.

  4. Hugo says:

    Hi perfect, why are the Netherlands not included… ? And why not Denmark and Norway for comparison to Sweden

    Maybe you can also mirror it with the 2018 influenza figures.

    http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/data-and-statistics
    Europa http://www.euromomo.eu/
    https://www.cdc.gov/flu/about/burden/index.html

    Include that 96% of the victim’s is 60+
    Then include the viral load factor. (why so many health care victims why concentrating patients is so bad.)
    Then include that they only test for 1 flu virus.
    Then include that suddenly the top 5 causes of death dropped heavily. (if you have terminal prostate cancer and positive your death is categorized to corona)
    Then include the effects of intubation. normally 40% die too.
    Then include the fear factor.

    Note.
    First year 4 vaccines were supplied together and also that healthy 60 year also were included.
    And also check that the WHO complained that the vaccines dropped below the 50% effectivity.

    Best regards,
    Hugo

    • Clive Best says:

      Here I have added Norway, Denmark and the Netherlands! Norway is the winner and Denmark more or less follows Germany. The Netherlands looks very bad. I hadn’t realised that before.

  5. Hugo says:

    Deaths are included only if tested positive.
    But tested positive and you die of fatal cancer its corona too. The Italian style.
    In New York they included an estimate for that. Spike..in graphs.
    You can only make estimates of infection. and even with that is does not say much because you can get positive again after being cured depending on the viral load. than there is the precision of the tests.
    2018 USA 34 million were estimated to be infected.
    around 70.000 estimated deaths,.

    But… now there is only Sars ?? no influenza ?
    Influenza disappeared ?

  6. Cytokinin says:

    It is interesting to look at the Swedish approach. They have protected their vulnerable and let citizens course to be sensible. Schools are open, people are working, the hospital’s are doing and their curve is flattening. They did not panic, they were cool Swedes. They have tested extensively and estimate that one infection in a thousand is critical. I would imagine that about half of these are unable die to pre e existing conditions and that about half of the remainder will die, but don’t have the facts yet. They are using the virus as the vaccine and anticipate herd immunity by the summer.

    New Zealand on the other hand looks as though it is doing well, but will have no immunity in the population, so will have to remain isolated from the world until a vaccine is made, perhaps a year, perhaps several. The best strategy will emerge in time and the history books will make interesting reading.

    • Clive Best says:

      very true. Without a vaccine we are just delaying any return to normality.

    • Myths. In Sweden higher education is closed, congregations with more than 50 not allowed. Many working from home, many parents keep their schoolchildren home, closing bars/restaurants who cannot keep distancing measures etc. There are also notable differences between regions re measures and number of deaths. Stricter measures and fewer deaths in the south. Actually not big difference between Norway and Sweden. Ex shops and restaurants open i Norway with distancing and hygienic measures. Better testing and isolation of cases in Norway combined with some stricter measures. Illustrates that this is a tightrope. Norway is more like Veneto and Sweden more like Lombardia in Italy.

      The swedes have not tested extensively. And of course the 1 in 1000 was an embarrassing model error. It would mean that 6 million of Stockholm’s 2 million inhabitants were infected!! They are nowhere near herd immunity.

    • Clive Best says:

      Several countries are on the verge of eliminating the virus from their populations – New Zealand, Australia, Taiwan, Iceland. It helps to be an Island but in order to remain virus free they may have to isolate themselves off from the rest of the world until a vaccine arrives.

  7. alsomaninthemirror says:

    Clive, as you know, developing a vaccine for a specific respiratory virus is no easy task. The vaccine has to be effective and give basically lifelong immunity. Pharmaceutical companies don’t want this business because the COVID-19 is a respiratory virus and will mutate and any developed vaccine become less efficacious or even totally ineffective. Also developing antiviral medications to certain respiratory viruses such as the corona group of viruses, the common cold being one such ailment with no vaccine and only minimal antiviral medications, is not what Pharmaceutical companies want to put their research and money into developing. These respiratory viruses will mutate at some point and this will jeopardize the effectiveness of any developed vaccine. The ‘flu vaccines are as you know, very suspect in their effectiveness for a variety of reasons. There will be no available vaccine for COVID1-19 for at least 2 years unless there is something about the novel virus that lends itself to being susceptible to a vaccine.

  8. Hugo says:

    Hi Clive, The Netherlands is not that bad. Belgium is bad I think you mixed things up.

    NL 17300000 4518 0.026%

    BE 11500000 7000 0.061%

    Best regards,
    Hugo

  9. Peter Mott says:

    Are UK deaths hospital deaths or all deaths? On the nightly briefing there is a chart with two UK lines plotted, one tracks France but the other is much shorter and much worse. France does include care home deaths, I believe. Unsure about other countries.

    • Clive Best says:

      The deaths are just hospital deaths. It looks like these will increase significantly once care homes are folded in. It looks like infection was taken from hospitals to care homes when ICU beds were cleared of elderly patients ahead of the surge in cases.

  10. Peter Mott says:

    Right. France added 17355 cases on 3rd April from care homes – I assume that their deaths count includes care.homes. I did not know about the clearing if ICU beds..

    • Clive Best says:

      UK just added 3,811 deaths which have occurred outside hospitals bringing the total to 26,000. They then announced 765 deaths occurred in the last 24 hours. However it is not clear whether this figure now includes BOTH hospital deaths AND care homes. We will find out in the coming days.

  11. Peter Mott says:

    A friend pointed me to this: https://www.politico.eu/article/why-is-belgiums-death-toll-so-high/ The upshot is that Belgium deaths have been overstated due to counting “possible” COVID deaths in care home.

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