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Thursday, April 09, 2020

It's challenging to compare nations over coronavirus response

I think many people simply assume it's a fairly straightforward comparison to compare how the US is doing vs. how other nations are doing in terms of responses to the coronavirus or COVID-19. Many people simply look at the total case numbers and the total deaths between nations without considering other factors involved. However, consider the following variables:

  1. Population density

    Nations could have significantly different population densities. Indeed, cities within nations could have significantly different population densities. All things equal, the more dense a population is, the more challenging it is to maintain a certain distance from one another. Not to mention population density may impact a city or nation's access to its health care system as well as delivery of health care to the general population.

  2. Health demographics

    Nations could have significantly different population demographics which impact their health. Some nations may have a higher median age than other nations (e.g. China is 37.4, Italy is 45.5, USA is 38.1). Some nations may have "sicker" people at baseline than other nations (e.g. higher rates of obesity, higher rates of hypertension, higher rates of diabetes).

  3. Health care systems

    Nations could have significantly different health care systems. Take the quantity and quality of its health care providers and workers (e.g. some nations have more physicians per capita than other nations, some nations have better medical education and training than other nations). Take people's access to health care and a nation's delivery of health care to people. Some nations don't have a primary care system that stands in-between the general population and hospital systems like the US does, but instead the general population goes directly to the hospital, which could more easily overwhelm hospital systems. Some nations have socialized medicine which comes with its own complex sets of challenges.

  4. Private enterprise

    Some nations' health care systems allow for better cooperation with private enterprise than other nations. Some nations can better mobilize private industry to help. Some nations are more advanced in prior research and development of medical technologies (e.g. pharmaceutical therapies), though to be fair R&D isn't necessarily primarily a private enterprise. However, at the very least, R&D is often closely tied to private industry in Western-style democratic nations.

  5. Testing

    Some nations have done more and/or better testing of their populations than other nations. As Samuel Shem (pseudonym) points out in his satirical novel The House of God: if you don't take a temperature, you can't find a fever!

Of course, this isn't to suggest we can never reliably compare nations. This isn't to suggest we can't learn from other nations when they have failed. This isn't to suggest we can't adopt strategies from other nations when they have succeeded. Rather I'm simply pointing out that comparisons between nations can be more complicated and challenging than at first glance.

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