Covid19 Linked to Affluence

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Colby Cosh writes at National Post COVID-19 is showing us what a real First World problem looks like Excerpts in italics with my bolds.

On Monday, a reader, Max Anderson of Vancouver, wrote in to observe that, at this point in the COVID-19 epic, Canada does not appear to be doing so well by the developed world’s standards at preventing coronavirus deaths. The case isn’t complicated. It involves looking beyond the United States for comparisons, always a difficult optical exercise for Canadians.

Consider the OECD, the 37-member club of high-income liberal democracies. If you pull the COVID-19 death rates for these countries off of Wikipedia, you find a vast range of figures. Lucky Australia, as I write this, reports 4 fatalities per million residents; Japan and New Zealand are also at 4, with Slovakia and South Korea at 5. At the high end, Belgium, known to be liberal in its definition of a “COVID-19 death”, tops the table with 688 deaths per million. Spain is at 540, Italy at 483, and the U.K. in fourth place at 433.

But the median rate for the OECD countries is just 42 deaths per million, and Canada is at 99. So we probably shouldn’t feel smug because the U.S. stands at 209. Maybe we should be angry. Well, a lot of us are angry anyway.

A defence of Canada could start with the same data. A median is just the middle in a set of data points, the value at which half the things you measured are above and half below. The actual average, the mean, of OECD COVID-19 death rates is 128 per million. Suddenly Canada is doing better than average! A median and a mean can spread pretty far apart when a set of numbers isn’t symmetrically distributed, and in this case there are many small countries with death rates in the teens and 20s, including Latin American OECD members. (Those, with their rates, are Colombia, 7 per million; Chile, 14; and Mexico, 17.)

What’s astonishing here, I think, is the even-bigger-picture. Early in SARS-CoV-2’s bust-out from China, it became apparent that the heaviest impacts were in the very wealthiest countries. Eight or 10 weeks ago, there was widespread terror at the thought of what the virus would do when it reached the less developed world. This has, so far, proven to be the proverbial unbarking dog.

The website Our World in Data has a chart of countries with their per-capita GDP on the x-axis and their confirmed deaths per million on the y-axis. With logarithm scales on both axes, the data points on the chart are still, in May of the plague year, damned close to a straight line sloping upward from left to right. Allowing for differences in COVID case definition, there is, at the moment, no very poor country anywhere on Earth which has been hit significantly harder than Canada — and no large richer country that isn’t worse off aside from Norway.

Wealthy Canada is therefore more or less exactly where you would expect it to be on that chart (as is, for that matter, the U.S.A.). On the May 4 version of the chart we are in a little cluster, a mini-Pleiades, quite close to Germany, Austria and Denmark. Those are pretty comforting neighbours to have, I think (at least in this century). Denmark has perhaps the world’s best population-health data system. Germany is being celebrated for mobilizing the resources of the Robert Koch Institute, a federal disease control agency that can boast of actually controlling disease.

I think we can start believing, tentatively, that COVID-19 may be inherently a disease of affluence.

The assumption that it is only so circumstantially has prevailed for an awkwardly long moment. If GDP remains tightly correlated to national death tolls, countries are likely to judge themselves on whether they are high in the death table, or low, for their own particular degree of economic development.

It is not difficult to think of mediating factors that feed into the wealth-COVID relationship. Richer countries undertake more international business and pleasure travel, and attract more of it. The citizens within them are generally more mobile and more urbanized. People in the richer countries live longer, so their populations tend to have more old and vulnerable persons. Obesity is a known co-morbidity of COVID, and the rich countries have more of that, too — along with higher rates of hypertension and type 2 diabetes. And those countries are, of course, concentrated in one hemisphere of the globe: nobody knows anything meaningful yet about how weather (or any other regional phenomenon) affects SARS-CoV-2.

Add it all up and you get that (log-log) “straight-line” relationship. The trick, if the straight line continues to hold, will be sorting out exactly which correlates of GDP contribute, and how much. But the straight line is, in itself, quite surprising.

Anyone would have expected — and most experts still half-expect — that our lack of social deprivation, by itself, would more than compensate for lifestyle excesses and material privileges in a crisis like this. This is to say nothing of Canada’s sophisticated, and publicly provided, health-care system, which doesn’t seem to have bought us much extra protection against a nightmare from the past. No one expected an infectious disease with these special characteristics, which remain mysterious. We all joked around about “First World problems” for a long time. Anybody having a laugh at this one?

Footnote:  Background on Modern Affluence

Alex Epstein (here) is among those who demonstrate from public information sources comparisons between societies who use carbon fuels extensively and those who do not. The contrast is remarkable: Societies with fossil fuels have citizens who are healthier, live longer, have higher standards of living, and enjoy cleaner air and drinking water, to boot. Not only do healthier, more mobile people create social wealth and prosperity, carbon-based energy is heavily taxed by every society that uses it. Those added government revenues go (at least some of it) into the social welfare of the citizenry. By almost any measure, carbon-based energy makes the difference between developed and underdeveloped populations.

In addition, developed societies protect most of their citizenry from natural disasters, including extreme weather events.

The EM-DAT database provides three disaster impact indicators for each disaster event: economic losses, the number of people affected and the number of people killed. . .The data show large differences across disaster indicators and regions: economic losses are largest in the OECD countries, the number of people affected is largest in the BRIICS countries and the number of people killed is largest in the RoW countries.

Fig. 3 Economic losses normalized for wealth (upper panel) and the number of people affected normalized for population size (lower panel). Sample period is 1980–2010. Solid lines are IRW trends for the corresponding data.

Clearly, the wealthier nations build and maintain more robust structures and infrastructures, which incur costly damages from natural events, but which greatly reduce human deprivation and deaths.  Ironically, these advantaged nations now provide large numbers of attractive hosts for this novel coronavirus, absent defences from medical technology.  It is also the case that these privileged populations are so rooted in presumed physical security that the hysterical media has triggered a panic pandemic, overshadowing the actual viral outbreak.

Postscript: For the latest social distancing etiquette as restaurants reopen:

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