Franklin/Weinstein: US COVID-19 deaths are still high, but let’s learn from forecasters’ mistakes – Post Bulletin

In a recent NFL game, the Indianapolis Colts led the Minnesota Vikings 33-0 at halftime. At that point, Las Vegas was offering odds better than 100-1 the Colts would win, but the Vikings staged a furious second-half rally and won on a field goal in overtime. It was one of the biggest comebacks in NFL history and proved once again that it is not always possible to predict the outcome of an event before it ends.

The same is true of the COVID-19 pandemic as it enters its fourth year. In May 2020, Business Insider CEO Henry Blodget and journalist David Plotz wrote: “Back in January, the United States and South Korea each identified their first confirmed coronavirus case on the same day. South Korea responded immediately and competently, by testing, tracing, and isolating cases and getting ahead of the epidemic. The United States … never marshaled the strong federal response that could have slowed the outbreak before it really got rolling. Three months later … South Korea is close to exterminating the virus.”

In early 2021, Pulitzer Prize-winning science writer Lawrence Wright critiqued the US COVID-19 response: “We did the worst job in the world.” Blodget, Plotz and Wright were merely echoing common sentiments of many medical observers that the US had controlled COVID-19 less capably than any other country.

That was then; this is now. According to Worldometer, an independent website that has provided COVID-19 statistics throughout the pandemic, at least 30 and possibly as many as 50 industrialized countries have had more COVID-19 cases per capita than the US has had. (The number depends on whether small island nations are included.)

As 2020 ended, the US accounted for 25% of the world’s COVID-19 cases. Now it accounts for just over 15%, and the fraction is dropping steadily. Some countries that were initially lauded for their COVID-19 response — Singapore, New Zealand and the Czech Republic — have long since passed the US in cases per capita. And South Korea, which was supposedly close to exterminating the virus? Overall cases per capita are now higher than in the US South Korea currently has one of the highest case totals in the world.

There are some important caveats. This data includes officially reported cases and doesn’t include many cases identified by home testing or those never reported to public health officials. So while there are more cases in the US than the Worldometer numbers report, there is no indication the US underreports cases disproportionately compared with other countries.

This should not be taken as evidence the US has improved its response dramatically; rather, the newer variants have obviously caught up with other countries. Omicron and subsequent variants have overwhelmed many countries least affected in 2020, despite their policies of social distancing, vaccination and masking.

Since the fall, Japan has had the highest absolute case total in the world. In the first year of the pandemic, Japan had a quarter of a million cumulative cases; it now has more than 100 times that number.

Unfortunately, the US trend line of deaths per capita isn’t falling as dramatically as the trend line for total cases. The US is currently 16th in the world in deaths per capita and moving up, behind only Peru and countries in Eastern Europe. For comparison: Deaths and mortality, which is total deaths divided by total cases, are dropping in the US but much slower than in the rest of the world. In addition, according to a study in the journal Nature, during the pandemic the US has had one of the world’s highest rates of excess deaths — that is, the number of observed deaths from all causes beyond the expected number if the pandemic had not occurred. .

There is no obvious reason US mortality and deaths per capita are higher here than in most of the world. It has little or nothing to do with the varying quality of medical care globally, as some postulated early in the pandemic. Vaccination rates are probably a partial reason — the US rate is lower than in many industrialized countries — but overall, US vaccination rates are higher than those of many countries with lower death rates and lower mortality rates.

The major reason US death rates are comparatively high is probably the high number of high-risk, susceptible patients in its population — a relatively higher percentage of patients who are elderly, obese or immunocompromised than in most other countries. Regardless of the caustic criticism leveled by many science journalists and medical experts, we can’t remake the nation’s demography. Yes, giving booster shots to high-risk individuals will improve things but will not solve the problem.

Expert predictions do not always age well. In July, Dr. Eric Feigl-Ding, one of the world’s most cited public health experts, predicted the United Kingdom could see 60,000 monkeypox cases per day by the end of 2022. Yet in one recent week, there were five total cases and official reporting in the UK has stopped due to low case numbers.

Clearly, there are forces at work that no can understand completely. As bettors cocksure the Colts would trounce the Vikings could have told you.

Dr. Cory Franklin is a retired intensive care physician. Dr. Robert Weinstein is an infectious disease specialist at Rush University Medical Center.

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