When working with COVID-19 stories, there are two ways that numbers are usually reported. One is the total number of cases or deaths—and on both those numbers, the United States remains its “lead,” with over 33 million cases and just under 600,000 deaths. These numbers seem straightforward enough, even if there’s a tacit understanding that official test numbers will by their nature omit a large number of cases. Though, considering a recent study that pegged excess deaths attributable directly to COVID-19 over 900,000, these numbers may be of significantly reduced value.
The other way that the severity of the situation is examined is by looking at cases or deaths against population. After all, you’re not going to have 33 million cases in the Netherlands when the total population of the country is only 17 million. Cases/population is likely the best we can do when trying to estimate just how hard any region has been hit, and how well local officials have responded in attempts to contain the disease. By this measure, the United States is still the worst among large nations, with a positive results rate of over 100,000 per 1 million people. In other words, at this point in the pandemic, a full 10% of the American public has tested positive for COVID-19. That’s not as bad as some smaller nations like Andorra (173,000 cases per million), but with much smaller populations, those nations are subject to having their values skewed one way or the other by a relative handful of cases.
But when looking at trends, the best answer might not be either the total numbers or the cases by population, but how things are changing as a percentage of what happened in past weeks. Cases in the U.S. are currently down 21% compared to the previous week—though that undoubtedly is a reduction due to low testing over Mother’s Day weekend. India is up 3% compared to last week, but compared to the double-digit increases of the last two months, that 3% climb is a relief. On the other hand, the 103 cases in Somalia over the last week represent a 385% increase over the previous week. Considering the small number of actual cases, it’s easy to overlook this increase. But what’s happening in Somalia, Vietnam, and the Maldives is definitely worth a look.
For most Americans, the Republic of Maldives is a nation obscure enough that it merits a brief description. It’s an archipelago of small islands in the Indian Ocean about 400 miles off the coast of India, and with a population of less than half a million, it would barely be a neighborhood in Mumbai or Bangalore. Like its giant neighbor, until recently the number of cases of COVID-19 in the Maldives had been bad—but not that bad. It’s only in the last weeks that cases there have soared. Weekly cases were up 82% last week and show no signs of slowing down.
It’s one of several countries, like Nepal, that has seen sharp increases as the massive and ongoing outbreak in India spreads into neighboring nations. Other areas in Asia that aren’t exactly neighbors—like Vietnam and Malaysia—have also seen increasing cases.
However, if the numbers can be trusted, India itself may finally be rounding the bend, though at horrific cost. Cases remained above 329,000 on Monday (which is generally the lowest reported number of the week), but that’s down from 355,000 cases on the previous Monday. The over 3.7 million active cases in India have the nation’s healthcare system straining at every seam, but this week may actually generate a glimmer of hope.
Meanwhile, the increases in cases in several African states as well as in Asia are a reminder that only 2% of the world population is known to have had COVID-19. The potential for the pandemic to get much worse remains, and widespread distribution of vaccines remains critical.
Booster shoots, get your free booster shots
The evidence remains good that the current generation of COVID-19 vaccines (Pfizer-BioNTech, Moderna, and Johnson & Johnson) are all effective against known current variants of SARS-CoV-2. However, some variants do demonstrate a degree of vaccine evasion due to mutations in the spike protein, and as time goes on these changes are building up. All of the major vaccine manufacturers have been preparing updates that provide a booster shot containing proteins that reflect some of these more recent variants. Right now, it’s unclear when those boosters might be needed since we know that COVID-19 vaccines should be good for at least six months (and likely considerably longer). But there’s a chance that sometime next fall, it may be time for your latest flu shot—and a COVID-19 booster.
When that happens, don’t expect to have to pay for it. COVID-19 boosters, like this year’s vaccine, will be free.
As The Hill reports, David Kessler, chief science officer for Biden’s COVID-19 response team, appeared at a Senate hearing on Tuesday to let senators know that the federal government is picking up the tab for the second round of COVID-19 vaccines, if necessary. The funding for any 2022 vaccines will come out of the money that has already been allocated by the various COVID-19 relief bills, so there’s no need for Congress to pony up more cash to keep vaccination free and vaccination levels high.
Kessler suggested that beyond 2022, it may be time to “transition back to the commercial market.” In other words, if COVID-19 becomes endemic and a regular COVID-19 booster becomes an annual affair, then it’s likely require bringing out a credit card sometime in 2023. Pfizer’s vaccine is currently the most expensive at $39 a dose, but it’s impossible to predict what an individual dose will cost in two years.
A semi-post-mortem for Sweden
As a citizen of the nation that did worst in the world when dealing with COVID-19, it’s fantastic to be able to look at nations like New Zealand and see what the world can be like given competent leadership and a populace willing to work together. The cases per 1 million population there stand at just 528, meaning that the U.S. has a rate that’s 19,000% higher.
On the other hand, it’s also possible to reach out and see that there are other nations that also FUBAR’d this thing so, so, so badly. That’s not exactly comforting. But it does mean that, for the average citizen, we share a kinship … of shame. And horror. So let’s check in on Sweden.
You may recall at the outset of the pandemic, Sweden set out to follow all those rules that U.S. governors like Ron DeSantis and Kristi Noem found so compelling. You could keep your businesses open, keep the schools going, and keep the effects of COVID-19 low as long as you packed the old folks safely away. Or, as was written here more than a year ago, they were conducting a godawful experiment with their citizen’s lives, taking a gamble on a highly controversial theory and cheerfully pretending that if they just closed their eyes and whistled, all would be fine.
In April 2020, the way I covered that was by saying:
In a way, Sweden has done the world a service: it has demonstrated what does not work. But it needs to stop before the price is higher than it’s already proven to be.
At the time, the pandemic in Europe was barely a month old, and though Sweden was outpacing its Nordic neighbors when it comes to cases of COVID-19, it is also larger than neighboring Norway, Finland, and Denmark. Now, a year later, it seems like a good time to check in and investigate the wisdom of libertarians and the Great Barrington Declaration.
So … how’d it go? It went like this.
Well, yes, that does look bad. However, Sweden is larger. So how does it look when those values are changed to cases by population?
All right that looks … remarkably the same. Though the population values have brought down the disparity a bit, cases in Sweden still more than double those of the worst of its neighbors.
But maybe all of this is looking at it incorrectly. After all, the whole purpose of the Great Barrington Declaration was to feed the idea that reaching herd immunity could be done with lower deaths than cowering indoors. Reaching herd immunity means more cases. So the real measure of Sweden’s effectiveness shouldn’t be cases at all, but deaths. How did that turn out?
Worse. That’s how it turned out. The discrepancy of deaths between Sweden and its neighbors was actually much worse than the difference in the rate of deaths. Why? In large part because the healthcare system in Sweden was put under much greater strain because a bunch of geniuses decided it would be a great idea to get more people sick more quickly.
Way back in October of last year, before the worst of the holiday wave of cases, the Journal of the American Medical Association found that when it looked around the world, the United States and Sweden made up a unique set of nations. They were not only nations with a high rate of mortality, but were the only countries who failed to rapidly reduce mortality rates over the course of the pandemic. Both started bad. Both stayed bad.
As the medical journal The Lancet made clear, once that new wave of cases was underway last December, deaths in Sweden had reached a level 4.5 to 10 times higher than its neighbors.
This difference between Nordic countries cannot be explained merely by variations in national cultures, histories, population sizes and densities, immigration patterns, the routes by which the virus was first introduced, or how cases and deaths are reported. Instead, the answers to this enigma are to be found in the Swedish national COVID-19 strategy, the assumptions on which it is based, and in the governance of the health system that has enabled the strategy to continue without major course corrections.
Sweden needlessly threw away the lives of 14,000 citizens to test a theory concocted by a libertarian think tank that put a patina of respectability over a policy of doing nothing. But of course, Sweden did hold out through the year with a GDP growth of 1.2%, which was … exactly that of Norway, but slightly better than Finland. All worth it then.
What was the title of that Daily Kos article on Sweden back in April 2020? Ah … “Sweden has been conducting an experiment with its citizens' lives, and it's time to stop.” Only they didn’t stop. And now Sweden and the United States are the neighbors. Not on the map, but on the list of nations that did worst in handling the COVID-19 pandemic.
Don’t expect things in Stockholm to get better soon. While Our World in Data shows about 27% of the Swedish population has been vaccinated, the capital has been roiled by a whole series of anti-vax/anti-lockdown protests as the government attempts to take belated action. And, just to make that echo even louder, the largest of these protests was called “The Protest for Freedom and Truth.” As The Local reports, protesters carried signs reading “the mass media is the virus,” “Covid-19 was planned,” and, “The pandemic was invented.”
“I don’t believe in this pandemic,” said one woman at the protest as she complained about the very light social distancing rules that had recently been implemented. “Look how the police are behaving. There’s no longer democracy in our country.”
She said Covid-19 was “just an ordinary virus”, claimed that there was no excess mortality in Sweden, and argued that the virus was “just a way of frightening people”.
It’s not just us. But that’s … not comforting at all.