The COVID-19 mortality rate is an interesting measure of government policy

In just over four months between the first confirmed case of COVID-19 in January and the 3rd May, 28,205 people have died in the UK. In that same time in South Korea, a country with a population roughly 4/5ths the size of the UK, only 250 people have died. Trying to understand just how that has come to pass is very difficult because of the lack of consistency in how governments are measuring the impact of the outbreak. A good place to start however is with the mortality rate.

I have been using the Johns Hopkins University study, the WHO situation reports and the World Bank as the sources for the figures on the populations living in South Korea, UK, USA, Spain, Germany, and Globally. I have chosen those population groups, as mentioned previously, because not only do they offer an interesting set for comparison purposes, but because I need to understand why my friends and family in the UK and Spain are at greater risk from dying than in many other countries.

As of the 3rd May 2020 and just taken from the populations that I have chosen to follow closely, Spain still had the highest percentage of its population with confirmed cases of COVID-19 at 0.46% of the total population. Coming in a close second was the USA with 0.34% of the total population, and in third place was the UK with 0.28%. (see graph below)

A simpler way of understanding those figures, and the one that is often used in measures of public health, is that for every 100,000 people in in the general population, in the UK 276 people have caught COVID-19, in the USA 346 people have caught it, and in Spain 463 people have caught it. Compare that to the global rate, which on the same day was running at 44 cases per 100,000 people worldwide, to get an idea of just how badly these three countries are being managed.

While interesting, these figures don’t tell the whole story because they only take into account the people that have both been tested for the virus and who have contracted it. Because of this they are limited by the number of tests that each government carries out, which is invariably a political decision as opposed to a public health decision. The only way you could ever know for sure how many people have contracted it would be if ongoing and population wide testing was taking place.

Of course a government wouldn’t need to go to these lengths if the testing criteria was more accurately targeting the spread of the virus, as in the case of contact-tracing and testing. After all we seem to be pretty sure that it is spread through contact, therefore you could simply follow the spread of the virus by following the contacts of those already infected.

Unfortunately for those unlucky enough to live in a country where their government either don’t have the humility to defer to experts, or the brain capacity to understand basic epidemiology, we find ourselves facing a problem on an entirely different scale. For instance, as in the case of the UK, one of the key outcomes of the quasi-‘herd-immunity’ strategy is that it is nearly impossible to get a definitive grasp on the actual scale of the problem without making some informed assumptions.

For instance, as we can see in the chart above the % of the UK population that has been confirmed with having contracted COVID-19 is significantly lower than that of Spain and the USA. However, when you then look at the number of deaths as a percentage of the population, as in the graph below, things become more complicated.

The death rate as a percentage of the population is accelerating so very fast in the UK, that it is now pulling away from the USA, Germany and the global average. In fact, it is now closing the gap on Spain at such a rate, that the UK is very likely to have passed Spain within a few weeks.

So what can we discern from this? Not a huge amount other than the UK government is doing a profoundly bad job of protecting the UK population when compared to every other government on the planet. The lack of extensive and effective testing means that it is quite difficult to see how they are doing such a bad job, and what would need to change. Which is why, on face-value alone, this data doesn’t really give us any tangible insight into what is going on in the UK

This is when things like the World Bank figures are helpful to scrutinise non-expert explanations. For example, what was the life expectancy in these countries before COVID-19. Were the varying populations significantly different in terms of their general health. And what we can determine from that is that the average life expectancy across the planet was 72 years, while in the UK it was 81 years. By this measure the UK should be performing significantly better than the global average.

In order to test that hypothesis we could use the confirmed cases and the death toll to generate a mortality rate for the virus. This would tell us how many people that the government are reporting as having contracted it are actually dying from it.

As of the 3rd May, the % of the global population that had been confirmed as having contracted COVID-19 was 0.044%. And with a death toll of 0.003% of the global population, this meant that the average mortality rate across the planet for COVID-19 was running at roughly 7.112% of those confirmed with COVID-19.

On that same day the UK was reported as having 0.276% of its population having contracted COVID-19, with a per capita death toll of 0.042%. This means that as it stands the mortality rate in the UK for deaths as a percentage of confirmed cases is currently running at 15.370%. That is over double the global average.

Which suggests a problem in the strategy. Perhaps we simply have one of the worst health care systems on the planet, or perhaps it is because we are not giving the healthcare workers the correct equipment, or it might even be that we are vastly underestimating the number of people with COVID-19 in the UK.

I must declare a prejudice biasing my opinion on this. Having watched the NHS care for my friends and family over my entire life, and having spent the last twenty years studying the behaviour and policies of the 1% and their political flunkies my instinct tells me that the official figures for the number of confirmed cases is vastly underestimating the real situation, and this is likely being compounded by a lack of proper equipment.

Based on a simple extrapolation from the mortality rate in the USA of 5.858% and in Germany of 4.129%, the UK has probably already exceeded 550,000 cases of COVID-19. Which means that there is likely to be somewhere in the region of 300,000+ people with COVID-19 that the government is unaware of, and while neither treating or effectively quarantining, is allowing them to continue spreading the virus through the wider population.

So what can we discern from all of this? Not a huge amount from first sight other than that the UK government is doing a profoundly bad job of protecting the UK population when compared to every other government on the planet. And that they clearly have no idea of what the reality of the situation is.

It is not difficult to make the case that by simply changing the way that we look at the figures we can begin to see that one of the key outcomes of the government policy of ineffective and sporadic testing is that it makes it very difficult to estimate even the level of spread in the UK.

This, at least, goes some way to explain the mixed and often conflicting messages that are coming out of government on a daily basis. After all how can they formulate an effective strategy when they don’t even understand what the problem is.