Sweden - How to get a poor grade

I heard the news that the European Union is opening up its sky and allowing flights from countries that have the Covid under control.

This meant that flights from the USA, Brazil and Russia would not be allowed.

I think the basis is looking at the total number of cases in these countries. If so, this is not really an apple to apple comparisons as the population in each country differs.

Do you want to know on an apple to apple basis which is the worse countries in the world in handling Covid 19? 

This is what I set out to do by looking at how countries performed overall based on the following indicators:

1. Cases per 1 million population
2. Deaths per 1 million population 
3. Oxford University Stringency index that I referred to in my 25 June posting.  This looks at several different common govt policy responses on 17 indicators such as school closures and travel restrictions. 
4. Malaysia GCI Index that I referred to in my 13 June posting.  The GCI ranks 184 countries on how well they are coping using a Severity Index and Recovery Index. 

• The Severity Index is designed to exhibit ‘scarring’ characteristics so that countries that have been affected badly can be compared with countries that have been similarly affected, and yet have been able to recover. 
• The GCI Recovery Index evaluates the main recovery parameters (eg tests, recoveries) to give a clear indication of how a country is performing on its path to recovery

I first ranked countries separately based on each of the above indicators and then identified the top 10 worst performers under each criterion.

To avoid being skewed by countries with a small population, I excluded those countries with less than 500,000 people.

I then looked to see whether there are common countries in each of the top 10 worst performers under the 4 criteria.

If a country appeared in all the 4 lists of worst performers, it meant that the population of the country suffered the worst (in terms of cases and mortality) and that the govt mishandled the situation.

What are the results?

• No countries appeared in all the 4 lists.
• Only Sweden appeared in 3 out of the 4 lists
• 4 countries appeared in at least two out of the 4 lists – USA, Singapore, Peru, and Oman

The interesting thing is that Brazil and Russia are not in any of the 4 top 10 worst performers' lists. 

 

Sweden

Are you surprised that Sweden is the worst in the world?

It did not impose any lockdown but it did close schools and universities. Primary schools have remained open, in part to avoid healthcare workers staying home with their children.

It also banned gatherings of over 50 individuals and people from visiting nursing homes.

 

There was also advice to work from home; avoid unnecessary travel within the country; engage in social distancing; and for people above 70 to stay at home, as much as possible

 

It was a sort of voluntary self-control by the citizens.

We should not be surprised by Sweden's standing.  Most of the time, when I see the news about Sweden (by non-Swedish), reporters/commenters tend to put the country's efforts as a failure.

According to news reports,  even the epidemiologist who led Sweden's controversial COVID-19 response, now says that the country should have done more to stop the spread of the virus. 

Details of Analysis

The details of each of the criteria are presented below (where No 1 meant the worst in the world). I also showed Malaysia's position just for comparison. 

 

1) These are the top 10 countries with the worst intensity of Covid cases (in terms of no of cases per million population). 

• The surprise on the list is Singapore

• I think Lexumbourgh made it into the list because of its 613,000 population just passed my 500,000 thresholds.

• Malaysia is no 135 so we are OK

Rank	Country	Total No of cases per m population
1	Qatar	32,311
2	Bahrian	13,867
3	Chile	13,311
4	Kuwait	9,809
5	Peru	8,030
6	Armenia	7,589
7	USA	7,441
8	Singapore	7,306
9	Oman	6,839
10	Lexumburgh	6,616

Source: Worldodometer 24 June 2020

Note: Excluded those countries with population < 500,000 that were listed eg San Marino, Vatican City, Andorra, French Guiana, Mayotte

2) These are the top 10 countries with the worst mortality rate per million population.  Note that US and Peru made it to both the mortality and no of cases lists

• Malaysia is no 140

Rank	Country	Total No of deaths per m population
1	Belgium	839
2	UK	635
3	Spain	606
4	Italy	573
5	Sweden	516
6	France	455
7	USA	376
8	Netherlands	356
9	Ireland	350
10	Peru	260

Source: Worldodometer 24 June 2020

Note: Excluded those countries with population < 500,000 that were listed eg San Marino, Andorra, Sint Maarteen, Isle of Man, Channel Islands

3) Oxford University Stringency score 

I assumed that by 1st April the whole world would have been aware of the seriousness of Covid 19 and have taken measures to control it.  So I looked at the top 10 worst countries as those with the lowest stringency score on this date.

• Sweden is on the list cos it did not have any lockdown

• But the surprise is Singapore and Japan

• Malaysia is no 59.  Remember No 1 is worst and No 160 is the best

Rank	Country	Stringency Score on 1st April 2020	Total number of cases by 1st April 2020
1	Belarus	8.3	163
2	Nicaragua	8.3	5
3	Burundi	13.9	2
4	Tajkistand	19.4	0
5	Chad	27.8	7
6	Taiwan	27.8	329
7	Sweden	38.0	5,320
8	Singapore	38.9	1,000
9	Yemen	38.9	0
10	Japan	40.7	2,384

4) Malaysia GCI

Malaysia ranked 178 ie among the top 10 best.  Remember No 1 here meant the worst.

Rank	Country
1	Hondorus
2	Gabon
3	Bolivia
4	Guinea Bissau
5	Equatorial Guinea
6	Notth Macedonia
7	Cabo Verda
8	Oman
9	Sweden
10	Moldova

Note: Excluded those countries with population < 500,000 that were listed eg Sao Tomei 

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Be fearless to get more to Stay Safe, Share this Blog

PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such. 

Will more tests lead to more cases? Insanely correct

President Trump said that if you test less, you will have fewer cases. 

So is this true for Malaysia?

As can be seen from the chart below, the number of daily tests reported for this month (based on 17 to 23 of the respective month) is lower than that for last month.

The strange thing is that the number of daily cases has also come down from 45 daily cases in May (based on 17 to 23 May) to 12 daily cases this month (based on 17 to 23 June)

Wow!  We have fewer tests and also less number of cases!!

So it is true then that the more we test, the more cases we will find!!!

 

Malaysia Actual Covid Test vs Capacity

Why are we not like the US where “more testing will lead to more cases”?

This is because the way to assess whether there are sufficient tests is to look at the positivity rate ie no of positive divided by the total number of tests.

On a cumulative basis as of yesterday (Source: Worldodometer)

• We have 1.2 % positivity rate
• The US is at 8.2 %
• WHO standard is to be below 10%
• Singapore is at 6.2 %
• South Korea is at 1.0%

The chart below shows how our positivity has changed over the past 4 months (based on 17 to 23 of the respective month)

You can see that we have been improving the testing performance since the start of the MCO from about 11.9 % down to 0.3 %

Note that this % is different from that 1.2 % reported above because we are looking at the rate based on a particular week whereas for the 1.2 % we are looking from a cum cases c/w cum tests.

 

For Positivity refer to left axis, For no of tests refer to the right axis

It is not just the number of tests that have come down.  It has come down at a time when we have more testing capacity since the start of the MCO.

Of course, we know that not all the capacity has gone for testing new cases, but even if you factor this in, there appears to be spare capacity.

What a waste – can’t we “export” it to the US?.  I thought Indonesia is short of testing capacity.  Since we could fly the test samples from Sabah and Sarawak to Peninsular, there is no reason why we cannot fly in the test samples from Kalimantan or even the other Indonesian islands. 

I think we could do with the forex income.

If MyEG can export its contact tracing app to the Philippines, I am sure the private sector would be exporting the testing to our neighbours. 

But on a serious note, we should see whether we can expand our targeted testing to some of the more common cases that seem to be surfacing currently

• Construction clusters

• Chicken (Pedas cluster) factories – I guess this is our equivalent the meat-packing industry that seemed to be the new clusters in US and Germany

• Large public events – we could make it part of the SOP for large events eg > 1,000 people so that we can have political campaigns, etc

When I see President Trump holding his political rally at Tulso last weekend, my first question was whether this is going to be the US Tabligh?

Do you remember our Tabligh?

• 3 days event with 16,000 participants
• 1,037 index cases
• Eventually, 3,375 tested positive and into its 5th generation
• 42,000 people were tested at the end of the day

So will we have another Tabligh as we relax the ban on public functions? 

I don’t think so for the following reasons

• The biggest challenge for Tabligh was contact tracing.  Today with the SOP  requiring the registration of participants' contacts, I think we will not have the same contact tracing problem

• We had people actually coming from other countries to attend the Sri Petaling event.  I am not sure how many of these were index cases.  Today this is unlikely to happen given our quarantine process for incoming travelers

• We have temperature checks for attendees so it should weed out those potentially sick from attending

• And of course today many would be wearing masks

If you look at my points, then you would agree that Tulsa may turn up to be Trumps’ Tabligh ie one event that triggered a massive spike in infection as

• Some staff helping to prepare the rally already tested positive for Covid 19 (OK it was before the start of the event)

• Some of the secret staff covering Tulsa have been asked to self-quarantine after one was tested positive

• Hardly anyone in the event wore masks

• I am sure that given the American propensity for freedom, there is no contact tracing app.  But I think they would have a list of those who attended as they had to book for tickets.  This will not prevent those who attended from catching the virus, but at least it will prevent the spread to several generations.

Time will tell.  Wait for 2 to 3 weeks. 

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such. 

Covid 19 - slow response and not the best

We are all interested to know how we are doing relative to the other Asean countries and/or the rest of the world in handling Covid 19. 

In my 15 June post, I talked about our Defence Minister saying that the govt action received recognition in a global survey (of public opinion) on how well the govt has handled the virus.  I had also said that we should be looking at “objective” indicators rather than people’s opinions.

  

In the context of “objective indicators”, in my 13 June post, I did mention about a Global Covid Index (GCI) created by Malaysia that looks at the severity and recovery of the Covid cases.  CGI then ranked countries based on the total scores for each country.  

• Malaysia ranked 12.  
• The No 1 rank is the best currently occupied by Australia.  
• NZ is ranked 6
• USA is ranked 128.

I came across another measure yesterday that was developed by the University of Oxford.

 

To compare each country’s response to the pandemic on a consistent basis, the University constructed a “stringency” index based on 13 policy responses (lockdowns, border closing, tests, etc) to measure how strongly each country responded over time.

I looked at how some of our reference countries have performed based on this index.

  

First I looked at the index at a date that is 2 weeks from the date of the 15th confirmed case in each country – a vital window for action based on a Stat article

Malaysia's 15th case was reported on 8th Feb 2020, so the date that is 2 weeks after this was 22nd Feb.

Based on the Oxford Uni index, Malaysia scored 19 on 22 Feb 2020 as per Chart 1.

Chart 1: Malaysia   (From Oxford Uni)

How did other countries perform on this stringency index based on 2 weeks after the 15th confirmed case?

• South Korea and Taiwan did better than Malaysia with scores of 31 each

• In the ASEAN countries, Indonesia, Vietnam, and Philippines did better than Malaysia

I am not sure that I believe the Indonesian and Philippines scores as the criteria is 2 weeks after the 15th confirmed case ie it is sensitive to the number of cases reported by each country.  I am not sure whether the number of cases is correct for these 2 countries. 

Countries	Date of 15th confirmed case	Stringency score on day 14 after 15th confirmed case
US	14/02/20	6
Australia	14/02/20	19
Germany	12/02/20	17
Korea	02/02/20	31
Taiwan	07/02/20	31
Indonesia	10/03/20	46
Singapore	31/01/20	25
Thailand	31/01/20	0
Philippines	10/03/20	100
Vietnam	11/02/20	47

Oxford Uni also tracked the performance over time so you can see from the Malaysian chart above that we improved on the score as time went by.  By Mac when we had gone into the MCO the score shot up from 19 in Feb to 73 in Mac.

So in comparing performance, we should not just look at a point in time.

I think we should also look at the time taken for Malaysia to ramp up its measures compared to the other ASEAN countries.  In this context as per Chart 2 below

• Vietnam ramped up first followed by Phillippines

• Malaysia was the 3rd Asian country to ramp up

• Singapore was the last to do so

Of course over time, most of the ASEAN countries' scores sort of “converged” as everyone adopted their respective stringent measures as can be seen from Chart 2 below.

Unfortunately, Malaysia's stringency score c/w its ASEAN neighbours is near the bottom in the months that mattered most ie April and May 2020.

Chart 2: ASEAN (From Oxford Uni)

But the interesting item is how Taiwan, Germany, Australia have currently come down from the peak as per Chart 3. 

• The US is still unchanged despite what we hear on the news

• South Korea came down and then seemed to re-introduce some stringent measures recently. 

Chart 3: Reference Countries  (From Oxford Uni)

When you look at Australia (35), Germany (50) scores as at 13 June, you can conclude that Malaysia at 64  has not opened up as aggressively as these 2 countries.

So what is your conclusion?  I think we were painfully slow and surely not the best in ASEAN.  

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Be fearless to get more to Stay Safe, Share this Blog

PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.