Monday, March 30, 2020

Coronavirus #5

Five days ago I computed and showed elsewhere Deaths/Cases from the coronavirus for Italy, Spain, Switzerland, and the USA. The ratios for Italy and Spain were several times those for Switzerland and the USA. Calculating the same ratios today shows (a) higher ratios for all four countries, and (b) Italy and Spain remain several times those for Switzerland and the USA.

This Worldometer page says the following about such ratios. "Once an epidemic has ended, [the case fatality rate] is calculated with the formula: deaths / cases. But while an epidemic is still ongoing, as it is the case with the current novel coronavirus outbreak, this formula is, at the very least, "naïve" and can be "misleading if, at the time of analysis, the outcome is unknown for a non negligible proportion of patients."

Of course, the ratio might be "naïve" and "misleading" if used to predict the ratio when the pandemic will end. However, that was not my purpose. My purpose was clearly to compare the countries' healthcare system's effectiveness of response to the pandemic, and I don't believe the above argument undercuts that. There is a competing explanatory hypothesis -- Italy and Spain have a higher fraction of their populations ages 65+. But I am keeping my doubt that age differences fully explain the fatality differences.

Italy and Spain both have far more government control of healthcare and health insurance than Switzerland and the USA. Italy and Spain also spend far less per capita. They are indicative real world examples of single-payer healthcare and Medicare for All. Bernie Sanders and Medicare for All promoters advocate both much more government control and spending far less.

Doctors in Italy have said there is a severe shortage of ventilators and younger patients have higher priority than older patients. This doctor tearfully says the same about Spain. Yet an advocate of Medicare for All, whom I wrote about three days ago, naïvely asserts by innuendo that there will be no waiting lines if there is Medicare for All. Tell that to those older patients in Italy and Spain. At the latest count Switzerland has more cases per 1,000 population than Italy and is not far behind Spain. Yet in Switzerland there is much more concern about a shortage of staff than there is a shortage of ventilators (link). 

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