Updated COVID-19 (Coronavirus) statistics and analysis

Reported Coronavirus cases of countries per capita

Data update date: 2 Jun

See our Coronavirus data Dashboard for individual country data.

Key COVID-19 Questions

This COVID-19 statistics page has been through three phases. The first was about looking for data and statistics showing whether COVID-19 would spread. The second phase was about assessing outbreaks, how large and deadly they would be. These questions are no longer in doubt. The current page is now about determining when the virus will peak and how long shutdowns will be in place.   

  1. How many COVID-19 cases are there? We believe the headline case statistics are not useful for comparison due to a range of collection issues. We focus on severe/critical hospitalisation statistics as a better measure. China, Iran and Italy all have significant question marks over their COVID-19 statistics.
  2. Is Winter an issue? Likely. But with a big disclaimer. Summer and Tropical countries are lagging Winter countries in absolute numbers which probably means a heat/light/humidity factor. But the growth rates are very similar now. My best estimate is there is some benefit, but the benefit can easily be wasted if (when?) governments are slow to act. 
  3. What is an acceptable level of hospitalisations? There is a trade-off between economic activity and health outcomes. We are mostly a supporter of the views expressed in the hammer and the dance: you need the “hammer” of harsh shutdowns for a few weeks followed by a “dance” of increasing/decreasing quarantine measures to keep the disease at bay. We believe countries will (eventually) aim to maximise the amount of economic activity that doesn’t overwhelm their hospital systems. We are using 25% of Intensive Care Unit or hospital capacity as a rough estimate.  
  4. When will COVID-19 peak?  We are looking at five main factors which will determine the outcome: aggressive testing, aggressive case tracking, widespread face mask use, strict shutdowns, gradual re-opening. We suspect if countries tick all the boxes then 4 weeks of hard shutdown followed by 4 months of reduced activity will reduce transmission to treatable levels. However, we also suspect the semi-shutdowns we are seeing in most developed countries will extend those time-frames significantly.

We have chosen to leave the economic and investment impact off these pages. We note that while more deaths and cases are probably worse economically, there is not a linear relationship. A reduction in cases/deaths due to draconian lock-downs is going to be economically much worse than the same decrease in cases/deaths with a more intelligent system of social distancing and aggressive contact tracing. 

About our COVID-19 statistics

Given we use this data for making our investment decisions, we focus on countries in the G12. We also include Norway, Iceland, Czechia, South Korea and Singapore as they have interesting characteristics. See here for all countries. 

All charts on this page are expressed as a proportion of population to normalise statistics.   

Due to issues with testing between countries, we no longer aggregate case data except for Summer/Winter comparisons. From 1 April we are no longer tracking the source of infections as: (a) the case numbers are so large it is increasingly unavailable (b) the purpose was to ascertain the extent of local transmission, which is no longer in doubt.

Question 1: How many COVID-19 cases are there?

There are four main gaps between reported cases and actual cases:

  1. Insufficient testing: Countries that do not have the systems or capacity to test properly
  2. Yet to be reported cases: People who have the virus but are either: yet to show symptoms, yet to be tested, or had a test that showed a false negative     
  3. Asymptomatic cases: Estimates are that around half of all people who get the virus will never show symptoms
  4. Deliberately under-reported: Some countries look to be deliberately under-reporting cases 

The net result is the number of global cases is likely to be so significantly different from reported statistics. Recent estimates are that global infections are as much as 500% to 1,000% higher than reported. Which basically makes any aggregated reported numbers useless. 

We started our analysis in January by excluding Wuhan data, then all Chinese data. Then Iranian data looked suspect. Then Italy changed definitions to under-report cases. After that, we gave up on aggregates and focussed on individual countries. At least that way, changes would be based on a relatively consistent methodology.

Ideally, testing would be randomised, significant in size and from a trustworthy source. Iceland, Norway, Australia, Germany and South Korea (in green below) rate the best.  Switzerland, Italy, Japan, US and Netherlands (in red below) rank poorly. Dashed lines are countries with widespread face-mask use.

Reported coronavirus cases percent population

The above chart is misleading. For example, Iceland rates at the top, but not because it has the most number of severe cases. Instead, Iceland rates highly as it has been doing far more testing – including random sampling. 

We are focussed now more on the number of critical or severe cases. While the definition of these will vary between countries, they are likely to represent hospitalisations which we believe are a better indication of the current severity. 

Serious/Critical coronavirus cases per 100,000 population

Note also these are a measure of the current active numbers. Total case numbers can only increase, but these numbers can decrease as sick people either die or are cured and are removed from the count. So, it represents a better indication of the stress on the hospital system.

Countries outside the G12 that we included are:

  • Czechia (formerly the Czech Republic) as an interesting European case which has implemented mandatory mask-wearing and looks to be coping much better than other European countries
  • Singapore and South Korea who both have widespread mask use and aggressive contact tracing  
  • Iceland as it engaged in a randomised test of 5% of its citizens and so represents the most complete dataset globally 
  • Norway as it is starting randomised testing.

Stock markets will likely be focussed on the aggregate number of new cases and deaths in advanced countries. We are of the view that a reduction in cases/deaths will not be the end of the larger bear market in stocks due to debt and unemployment constraints. However, we suspect a sustained reduction in cases/deaths will be the start of a bear market rally.

New Coronavirus Cases - Europe vs USA

New Covid-19 Deaths - Europe vs USA

Question 2: Is Winter an issue?

At the moment our base case is coronavirus is worse in winter but delayed or poor responses in tropical or summer countries can offset most of the benefit.  

We split cases into: 

  • Northern Hemisphere Countries that are now in spring and are getting warmer 
  • Tropical countries: Countries near the equator where temperatures are relatively high all year
  • Southern Hemisphere Countries now in autumn and are getting colder

In aggregate numbers the differences are still stark:

Coronavirus cases Summer vs Winter

The COVID-19 statistics in these charts are based on where the case was caught. For example, as at 01-Mar two-thirds of the cases in Thailand were caught in China or Iran but diagnosed in Thailand. So, in that example, one-third of cases are allocated to Equatorial and two-thirds to Winter. 

There are suggestions that UV-B radiation and vitamin D played a role in reducing deaths in the Spanish Flu pandemic. Other studies suggest humidity greatly reduces the aerosol transmission of viruses, but some suggest humidity increases the surface transmission. It is unknown how these affect COVID-19.

The below charts are the pessimistic take on the summer/winter divide. Cases are spreading just as quickly and tropical countries are sustaining significant outbreaks. Also, a number of large population tropical countries have poorer testing/reporting: 

Covid-19 cases Summer vs Winter log scale

 

 

Question 3: What level of hospitalisation is acceptable?

We note the economic trade-off:

  1. Humanitarian. The bigger the shutdowns, the greater the preventative measures, the fewer people will die.
  2. Economic. The bigger the shutdowns, the greater the preventative measures, the more significant the economic impact will be.

We are of the view that governments around the world are experimenting, trying varying levels of shutdowns to get hospitalizations down to a level that does not overwhelm the healthcare system.

As Tomas Pueyo eloquently puts it, the solution is in two forms, the Hammer and the Dance:

We are making the assumption that governments will eventually come to the same conclusion.

To get cases down to an acceptable level, the Hammer is needed. Then the Dance begins where governments will need to adding capacity and mitigation strategies while gradually opening up.

South Korea has probably been the best example.

So what level of hospitalisation is acceptable during the dance?

We are assuming that an acceptable level of hospitalisations is around 25% of existing beds or intensive care units. This accounts for regular patients and case clustering. So, the target needs to be considerably lower than the capacity.  

We estimate:

  • it takes about two weeks for patients to die.
  • it takes four weeks for patients hospitalised to be released.
  • about a quarter of hospitalisations need to be admitted to intensive care.

So new patients will need to be below 4% of capacity each day. As Intensive Care Unit beds are created and treatments become more effective this will improve.

There are two ways to look at whether a country needs the hammer or whether it can advance to the dance.

Hammer/Dance 1: Is the hospital system is overwhelmed?

We have used the capacity available prior to the coronavirus outbreak to assess this measure. While many countries are adding temporary capacity to deal with patients, these are emergency measures. If we are looking at an extended period before vaccines are available then coronavirus patients should take up only a relatively low proportion of a country’s intensive care beds: 

Prior ICU Capacity vs Estimated Critical Coronavirus Cases

 

Hammer/Dance 2: How fast are cases and deaths growing?

The second is the speed of growth of cases and deaths. If cases are quickly growing then the hospital system will be overwhelmed, even if it is currently coping.

We use a target of 20 days to double cases/deaths. This is roughly the time for an Intensive Care Unit bed to become free either through a cure or death. For now, those levels are a reasonable target:

Number of Days to Double: Covid-19 Cases vs Deaths

Question 4: How long will COVID-19 last?

We are looking at five main factors will determine the outcome: aggressive testing, aggressive case tracking, widespread face mask use, strict shutdowns, gradual re-opening. We suspect if countries tick all the boxes then 4 weeks of hard shutdown followed by 4 months of reduced activity will reduce transmission to treatable levels. However, we also suspect the semi-shutdowns we are seeing in most developed countries will extend those time-frames significantly.

We believe undiagnosed cases substantially outnumber reported cases. The good news is that COVID-19 is less deadly and we are closer to herd immunity. The bad news is the virus is far more virulent than first thought and harder to stop.

The key factor is if epidemics get out of control, then they can be over relatively quickly in a single location: six weeks to two months (with a lot of deaths). However, if quarantines and shutdowns manage to slow the disease, the epidemic can last for considerably longer. The best that could be expected is probably three months. More likely to be multiples of that.

Because there are multiple locations across multiple countries, it is likely to last considerably longer, and there may be multiple waves. 

Here are some sample epidemics showing the effect at a city, country and global level:  

1918 Spanish Flu Epidemic: Comparing death rates in individual cities

1918 Spanish Flu epidemic death rates per city

2014 West Africa Ebola cases
Source: Wikipedia
Probable SARS cases from 2002-2003
Source: WHO

 

More COVID-19 Statistics and Analysis

See our latest blog posts or podcasts here. See our Coronavirus data Dashboard for individual country data

Data sources

This is a list of some of the main data sources we use:

https://www.worldometers.info/coronavirus/ Probably the best source of the latest COVID-19 statistics

https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 Tomas Pueyo has written a number of very good summaries of the strategies to overcome coronavirus

https://www.capitaleconomics.com/the-economic-effects-of-the-coronavirus/ Good source of fast-moving China economic stats.

https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/ If you want to be bombarded with every breaking news story, this is the place

https://ncov.dxy.cn/ncovh5/view/pneumonia  Faster than worldometers for Chinese data, but slower on rest of the world data. I don’t think China cases matter anymore.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports I’m less enamoured of the WHO data now than I was at the start of the crisis. They are providing less information now than they were at the start of the crisis, and it sometimes contradicts country-level data.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 The prettiest pictures, but one of the slower sites to update. I don’t find the charts that useful.

https://www.youtube.com/user/MEDCRAMvideos has a daily youtube wrap-up

https://www.youtube.com/user/ChrisMartensondotcom has a daily youtube wrap-up