“Success” against the virus ≠ zero deaths

Covid beach

One of the most fascinating aspects of the reaction to Covid-19 in the West, has been the near-perfect alignment between the political Left vs Right, and the sides of caution vs courage. Almost without exception – after a few early weeks of confusion – those who favour big government and intervention, also favour lockdown, wearing masks, almost permanent health screening and continued economic dislocation. Those that favour small government, lean towards Swedish-style herd immunity, and want an end to the lockdown and for people to just get back to work. Anecdotally, there are very few people crossing over at all, which I find remarkable.

In East Asia, by contrast, the response has been uniformly lock-step: everyone tolerates intrusive government and everyone supports the (virtue-signalling*) wearing of masks. Expats in Hong Kong, for instance, have felt heavily the weight of – effectively – racial prejudice for their differing attitudes on what constitutes “best practice”. All pretense of those traits of modernity – self-reliance, independence and adventure – which were driving urban Asia forward have vanished as these societies demonstrate their true colours of sheepish governmental dependency and open embrace of social closure.

The economic debate has raged for some time. Just to take headlines from recent days, one side (rather too gleefully for my liking) posits “Four reasons state plans to open up may backfire — and soon”, while the other retorts that “The lockdown left is no friend of the working class”. But for me the most pernicious rhetoric is that of men like Andrew Cuomo, whose popularity is premised on the logically fallacious claim that:

“ … if you ask the American people to choose between public health and the economy, then it’s no contest. No American is going to say, ‘accelerate the economy at the cost of human life.’ Because no American is going to say how much a life is worth.”

In this assertion we see the defeatist and absurd idea that lives should be protected at all costs. The fawning view that “Asian countries focused on containment in a bid to minimise mortality” has been accepted as the rightful moral goal of virus policymaking. The economics debate is fruitless, since it pits logic against emotion; but the moral point is important.

The analogy between Covid-19 and the common ‘flu is compelling and purposefully misunderstood: it is not a biological parallel per se, but rather one of social morality. It is an impossible and unnecessary task of government to eliminate death from natural causes. There is such a thing as “natural attrition” from disease and old age; and the ‘flu, which kills tens of thousands each year in the UK and US, remains the last bastion of socially accepted, blameless death on a large scale. The ‘flu is not like dying from traffic accidents, which might arguably be prevented; it is natural process of life and if this virus does not come to get you, the next one will. To try to prevent this is to commit yourself to a problem with no solution other than feeding an unquenchable appetite for resources – and in turn would ultimately spell the end for universal public healthcare which would be burdened intolerably by the expense. I will say this again: an acceptable level of deaths from Covid-19 in the UK should number in the tens of thousands before severe economic dislocation is necessary; several times more again in the US. “Success” was never, and should not be measured against, negligible mortality – for this virus or future ones.

Both Trump and Boris have thus made significant errors in their response; but the error was not so much their technocratic plans on testing and quarantines. Rather, the biggest blunder they made was to allow the narrative to move on to the grounds of protecting all life. From inception, both governments suddenly found themselves on the hook for an unachievable and undesirable objective: limiting deaths to zero or almost zero. This put them on a hiding to nothing and set a terrible precedent for both – though Trump and the US is likely to escape a touch more lightly. But Trump has also made a rod for his own back with his China rhetoric – since however true it is that the virus came from China, externalizing the cause, rather than making people accept it as a normal part of existence, strengthens their belief that “success” means stopping it like one would a foreign invader.

By the same token, for the first time in my recent life, I now no longer feel China is necessarily the long-term “winner” it might be. The government is very nearly promising its people protection against the unprotectable, setting expectations that may not long from now see them demand healthcare instead of military expenditure. All very well, but it will build no independent Great Power status like that.

I for one do not believe we should – or will – inhabit a world where major viruses lead again and again to the necessity for lockdowns. By the same token, neither do I believe that we should inhabit a world “safe” from such lockdowns only through constant testing, screening and health surveillance. Instead, we simply have to become a society of humans capable of digesting the idea that death is a fact of life; deaths from viruses and other natural causes, all the more so. To be constantly worried about death of this nature (as opposed, for instance, to war) is to be petty, parochial and apathetic, unable to see the bigger picture. I liken it to a company whose employees and management are constantly focused on cost-control and the bottom line; all the while forgetting the visionary focus on growing the top-line. Such a company is one living in the past, occupying the twilight of its existence, not looking to the future. It constitutes a lack of ambition.

Speaking personally, for all the distress and heartache that any disease or event incurs, I would rather not live in a society which exerts its time and resources, however good the intention, in trying to protect its people from life rather than encouraging them to jump into it. I would always favour courage over caution. Perhaps in this, I have finally discovered my true, core, Toryism.

 

* Curiously, a piece written by Jason Ng, an anti-government activist and lawyer, which vocally disapproved of expats during the virus and pretty much specifically called for expats to wear masks in order to “show solidarity” with locals – the very definition of virtue signalling – has been taken down from the Hong Kong FP website where it had been posted.

What Covid-19 mortality might look like if we all counted like the Germans

Germany Covid

One of the less covered aspects of the Covid-19 crisis has been the wildly differing ways in which countries – and within the US even states – count the dead. This in turn has made comparability between countries almost meaningless, with very little to be learned between the numbers of deaths in Italy for instance, and those in Sweden. And by the time you bring China into the discussion, comparability ceases even to be mentioned. The singular failing of the WHO is not failure to combat the virus (which it has little power to do), but failure to at least coordinate consistent numbers. On this basis alone, the WHO has been a fiasco.

The problem is that how one counts deaths, even though it sounds like it should be scientific process, is actually an art. There will always be huge amounts of subjectivity in interpreting whether a virus like Covid-19 constitutes the “primary cause” of death, or whether it is merely a “contributary factor”. The discipline with which a group of medical practitioners understand and stay within guidelines on this reflects all sorts of local conventions and culture. Generally, one might assume that the more technocratic a society is, the more strict they would be.

Step forward Germany. Throughout recent months, German numbers have been hailed as an example of what good governance should look like, with early testing being seen as key. Yet if you look at the details, a puzzle is presented: although German total deaths are much lower than that of France, for instance, its total numbers of infections are almost the same.

Total Covid deaths

Note: mortality rate defined as reported Covid deaths as % of total infections “Non-German Europe” are countries coloured in red; Source: Worldometer.info

All the good governance in Germany would, one assumes, mostly have led to lower deaths through lower infections, yet this has not occurred. Rather, the gap between total deaths is partly filled by the differences in counting methodology. In fact broadly speaking “Greater Germany”, encompassing Austria, Switzerland and Denmark, together average a mortality-to-infection rate at around one-third that of Non-German Western Europe (and this is already distorted by the fact that in Switzerland, non-German cantons are reporting much higher mortality than their German brethren).

So what is going on? Whilst I have no doubt that the Germans are doing better, they are not doing that much better. But at present, if there is a difference in counting methodology, I also have no doubt that I would lean towards the German over the non-German way. What then would the UK and other countries’ mortality rates look like under the German system?

First, I have assumed a simple re-basing of these mortality rates to the Greater German average, creating a like-for-like “Germanic deaths” number for each country. This lowers them substantially. “But”, I hear you cry, “is the German healthcare system not better?” Well, perhaps it is – though in fact there does not appear to be much consensus on this from various authorities. But let us say for the sake of argument that there is a qualitative difference, we might use a simple proxy such as the number of hospital beds per capita to readjust this number and make it more apples-for-apples.

Greater Germany Covid

Source (for beds): Nationmaster.com

Greater Germany does have a better-than-average provision of hospital facilities, particularly in Austria and in Germany itself. Taken together, the Germanic average of hospital beds per capita is higher than most other Western European countries, although France is also quite high. If we then adjust the “Germanic deaths” number upward again, by the number of beds, we have an indicator of what German-style Covid-19 death counts might look like.

European Covid like for like

Note: “adjusted” figures adjusted for hospital beds per capita compared to Greater Germany

Despite making this adjustment upwards, non-German Covid-19 deaths, whilst higher than Germany’s (and almost certainly correctly so), are still substantially below the current reported numbers. In other words, if the UK used German-style death counting, its numbers of Covid-19 deaths might be about half the current number and possibly well below. The same applies to all other countries in the region. I would posit that this is the basis of real comparability, not the published statistics.

Of course, this is all back-of-the-envelope stuff and many will complain that this does not take into account all the nuances of each country’s policies and virus reactions. But there can be no doubt that:

  1. Each country is counting in a different way;
  2. If the UK were counting along German lines, reported deaths would be much lower; and
  3. Conversely, if Germany were counting along UK lines, their numbers would be higher.

However taking into account what has been happening in each country, if I were to guess at who’s numbers are a better and more accurate representation of the real situation, I know where my money would be. But then, I am Austrian.

 

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(For reference I did the same analysis incorporating the Asian OECD statistics, which seem remarkably similar to Germanic numbers. China in particular, whatever else is may have covered up, has a stringent policy of how it reports Covid deaths and the region as a whole would likely be similar. However the outcomes from this analysis did not move the needle enough to start having to justify commonality between Asia and Europe)

Asia OECD Covid