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How does Australia compare in the global fight against COVID-19?


Matt Woodley


8/09/2020 4:52:21 PM

As worldwide cases surpass 27 million and deaths approach 900,000, Australia has experienced different levels of success in battling coronavirus.

Australia on the globe
Australia is among the world leaders when it comes to COVID testing.

Since it was first identified in China in late 2019, coronavirus has spread to more than 210 countries and territories around the world.
 
Authorities have approached the unprecedented public health challenge in a number of different ways, with varying levels of success.
 
From nationwide lockdowns and mass testing in the pursuit of elimination, to a ‘business as usual’ attitude that downplays the seriousness of the crisis and emphasises the economy over virus suppression, there is no one-size-fits-all strategy.
 
Australia has targeted mass suppression of the virus and (to date) generally succeeded in the approach, with only Melbourne currently experiencing widespread community transmission.
 
The success of this response can be crudely measured by comparing the number of cases and deaths per million, while the amount of testing conducted, the percentage of positive tests, and the case fatality rate also offer an opportunity for comparison.
 
Cases and deaths per million
As of 8 September, Australia had recorded around 29 deaths per million people, a rate nearly four times lower than the global average of 114, according to the University of Oxford-backed ourworldindata.org website.
 
It has also detected 1030 cases per million people since the start of the year, whereas the global rate is currently more than three times higher at 3483 per million.
 
In countries with more than one million citizens, the highest rates of cases and deaths per million have been recorded in Qatar and Peru, with rates of 41,684 and 904 respectively.
 
Overall, the US has the highest number of total cases and deaths (6.3 million and 189,000), but it may eventually be overtaken by India, which leads both categories over the past seven days.
 
But these statistics can be skewed by a number of confounding influences, including the rate of testing being conducted and the way in which deaths are recorded.
 
Belgium has the second highest deaths per million rate in the world (854.82), but it has also included the deaths of non-hospitalised people who are suspected of having the virus – but not tested positive – to its overall total.
 
This contrasts with other countries such as Germany, which requires a positive test, and the UK, which originally only counted deaths that occurred in hospital. Yet more countries, such as Mexico, have likely severely undercounted their totals.
 
Another measure commonly cited is the case fatality rate (number of deaths per confirmed case). But, like other coronavirus statistics, this is also a flawed indicator than can be affected by a number of factors, such as the amount of testing and age of the population.
 
For example, Italy has the highest case fatality rate in the world for a country with more than 1000 deaths (12.8%), but to date has only conducted 91 tests per thousand people, compared to Australia’s 261.
 
As a result Australia, with a case fatality rate of 2.9%, has conducted on average 254 tests before returning a positive result compared to Italy’s 20, and its percentage of positive tests (0.4%) is more than 10 times lower (5%).
 
Italy also has the second highest median age in the world which, given coronavirus kills people aged 70 and over at a disproportionately higher rate, has likely affected the case fatality rate, while other potentially confounding influences such as climate, air pollution, and race are also not factored in.
 
This means Australia is doing a better job of identifying cases, but is not as far in front in terms of treatment as the case fatality rate would suggest.
 
Testing
Australia performs well in most per-capita testing metrics.
 
Aside from having one of the highest ratios of tests per confirmed cases in the world (behind only New Zealand [576] and Fiji [278]), it is currently third in terms of new daily tests per thousand people, and has the second lowest percentage of positive cases per test – again behind New Zealand (0.4% vs 0.2%).
 
Early in the pandemic, Executive Director of the World Health Organization (WHO) Health Emergencies Programme Dr Mike Ryan suggested a positive test rate of less than 10% would indicate ‘a general benchmark’ of a system that’s doing enough testing.
 
At the other end of the spectrum, one in three tests in Colombia over the past week have returned positive samples, while in Mexico nearly 45% of all tests have been positive. Argentina also has a positive rate at around 50%.
 
Restrictions
According to ourworldindata.org’s Government Response Stringency Index, which measures school and workplace closures, stay-at-home orders and public transport cancellation across 180 countries, Australia had the 27th strongest restrictions in the world during August.
 
This is a marked increase from an average rank of 144 in April, and reflects the second wave of cases currently being experienced in Melbourne.
 
On this scale, Eritrea, Libya and Peru currently have the most restrictions, whereas other nations, such as Belarus and Nicaragua, have minimal measures in place.
 
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Dr Cameron Geoffrey Martin   9/09/2020 12:02:08 PM

The statistic "deaths per capita / deaths per million" is completely useless for comparison until the pandemic is over. Stephen Duckett (Gratten Institute) repeatedly makes the same error.
The statistic "deaths per case" is far more useful. Yes, it does need to be adjusted for age and the rate of testing, which can be done. Each death is, by definition, a confirmed case - so the true death rate will only ever decrease over time.