Thursday, September 2, 2021

Covid-19: how New Zealand compares with the rest of the world

People can argue ad nauseam (and they do) about the merits of the government’s management of Covid-19 and its aim of eliminating the virus through a strict lockdown policy – a strategy that comes loaded with economic and social consequences. But whatever you think about the government’s approach, there’s no disputing statistics that prove its effectiveness when judged purely in terms of mortality rates.

America’s Johns Hopkins University keeps a running tally of global deaths from the virus. It uses two measurements: the case fatality rate (the proportion of infected people who die) and deaths per 100,000 population. Judged according to these metrics, New Zealand’s 26 deaths make this country one of the world’s standout performers in minimising Covid-19 mortality, with a case fatality rate (CFR) of 0.7 percent and 0.53 deaths per 100,000 people.

Compare those figures with some of the countries we think of as generally similar to us:

Australia (1012 deaths): CFR 1.8 percent, 3.99 deaths per 100,000.

United States (640,108 deaths): CFR 1.6 percent, 195.01 deaths per 100,000.

United Kingdom (132,859 deaths): CFR 1.9 percent, 198.79 deaths per 100,000.

Canada (26,989 deaths): CFR 1.8 percent, 71.80 deaths per 100,000.

Peru has the unhappy distinction of heading the Johns Hopkins table, with 198,263 deaths, a CFR of 9.2 percent and a death rate of 609.84 per 100,000. It’s followed by Hungary, Bosnia and Herzegovina and North Macedonia, in that order.

In a table of 192 countries with the hardest-hit at the top, New Zealand is ranked seventh from the bottom. If you measure the threat posed by Covid-19 purely in human, personal terms – that is, the virus’s direct impact on sufferers and their families – then these figures represent a powerful vindication of the Ardern government’s elimination strategy. But of course the political equation is far more complicated than that because it has to take into account broader concerns such as the economic costs of lockdown, the disruption to children’s education and the effects of social isolation on personal wellbeing and mental health.

So which six countries have kept their Covid-19 death rates even lower than New Zealand? If the statistics collected by Johns Hopkins are to be believed, we’ve been out-performed by China (ironically, considering it was the source of the virus), Bhutan, Burundi, the Democratic Republic of Congo, Laos and Tanzania.

The data-gatherers may be too polite to say it, but these countries’ figures should probably be treated with some scepticism. Johns Hopkins does caution that there are inconsistencies in the way the statistics were compiled and that country-to-country comparisons may be misleading. The point should also be made that the figures don’t distinguish between the original virus and the much more contagious Delta variant.

Subject to those provisos, however, the Johns Hopkins table makes interesting reading. What else does it tell us?

■ Singapore is another standout performer, with 55 deaths, a CFR of 0.1 percent and 0.96 deaths per 100,000.  (Singapore’s CFR is the lowest on the chart, but that may be due to the exclusion of patients who had Covid but died of other causes.)

■ The shocking figures for Fiji (496 deaths, CFR 1.1 percent and 55.73 deaths per 100,000) are a stark reminder of the trauma experienced by one of our closest neighbours – a country that has dropped off the New Zealand media’s radar screen as a result of our absorption with our own imagined hardship.

■ Some commentators attribute New Zealand’s success in controlling the virus to the happy geographical accident of being surrounded by sea, and hence better able than many countries to protect its borders. But Malta (441 deaths, CFR 1.2 percent, 87.73 deaths per 100,000) and Iceland (33 deaths, CFR 0.3 percent. 9.13 deaths per 100,000) have been hit much harder despite being similarly isolated.

■ Sweden (14, 692 deaths, CFR 1.3 percent, 142.84 deaths per 100,000) controversially opted not to lock its population down, yet has fared markedly better than Italy, the UK, France, Spain and Portugal. On the other hand, its mortality rates have been much higher than in the other Scandinavian countries.

■ Israel’s vaccination programme has been held up as a model for the rest of the world, but with 7043 deaths, a CFR of 0.7 percent and 77.79 deaths per 100,000, it’s still in the wrong half of the Johns Hopkins table.

■ The countries that have suffered most from Covid-19 tend to be in Eastern, Central and Southern Europe (Montenegro, the Czech Republic, Bulgaria, in addition to those mentioned above) and Latin America (Peru, Brazil, Argentina, Colombia), though there are exceptions to the overall pattern (such as Belarus and Venezuela, assuming their figures can be trusted).

■ Germany (92,229 deaths, CFR 2.3 percent, 110.94 deaths per 100,000) and the Netherlands (18,368 deaths, CFR 0.9 percent, 105.97 deaths per 100,000) have managed significantly better than the other major countries of Western Europe, of which Belgium and Italy (15th and 16th on the table, respectively) fared worst.  

■ There’s surely a thesis to be written on why Canada suffered far less severely than the US, despite being just across the border and spending significantly less per capita on health.

■ There’s another thesis to be written on the contrasting Covid-19 strategies adopted in Australia and New Zealand, and their strikingly different outcomes. Whoever writes it might like to consider, among other things, why New Zealand appears more amenable to lockdowns. Setting aside contrasting political structures, I think it’s another reminder that despite all our superficial similarities, the two countries are culturally and socially quite distinct. Some might say it’s the difference between a larrikin country with lawlessness in its DNA (that would be Australia, in case you’re wondering) and one whose people are meeker and more compliant - or if you prefer, more inclined to pull together in pursuit of a common goal. But I won’t stick my neck out by going any further than that. 

(You can see the Johns Hopkins table here.)




GH said...

mortality rates.... in the short term.

Christine Pullar said...

“But of course the political equation is far more complicated than that because it has to take into account broader concerns such as the economic costs of lockdown, the disruption to children’s education and the effects of social isolation on personal wellbeing and mental health.“

Useful comparison of covid related stats and thus performance of governments. However in trying to assess the value to New Zealanders of our government’s single minded focus on elimination of covid in New Zealand, we cannot fairly make any comparison because we don’t see statistically the consequences of what is not being done while we are in lockdown. What is the difference in lifespan of people with other serious illness where diagnosis or treatment is delayed; increase in mental health interventions; suicides; education results etc?

Every commentator trying to grapple with the complexity of what covid is doing to our society appears to lump the other concerns together but doesn’t try to ‘balance the ledger’ so we don’t see if we are better or worse off. I know such analysis is more time consuming so am not complaining!

oneblokesview said...

Thanks Karl.

However(in my humble opinion)
We(Kiwiland) should ONLY be comparing ourselves to other islands.
Singapore, Taiwan Spring to mind.
Comparisons to Countries with porous borders(ie anywhere in Europe and North America are a chalk and cheese comparison.

We all know that stats can be used to support any argument-cherry picking - maybe I am guilty of that.

While NZ has survived well, I would look at why Singapore and Taiwan have been successful.

Your Wiki table by the way omits Taiwan :-)

I recommend

Its one place where you can look at charts of all sorts of events.
(It is also downloadable as a huge spreadsheet!!)

The history that will be written as to why NZ has been lucky in low numbers may well include references to.
Border control
Low population density
Consistent winds(dispersing virus)
A general outdoor life style
and other factors.

Of course Singapore and Taiwan do not have the luxury of those factors but beat NZ on a number of counts.

Andy Espersen said...

You are spot on, Karl. Had not been for our Labour government’s harsh lockdown in March 2020, we would most likely have had 2,500 fatalities last year – Sweden (similar to New Zealand in most significant ways), with 10 million residents, suffered ca. 5,000.

However, in your article you forget to mention one important fact, namely that until this very moment Covid 19 has NOT been endemic in this country – thanks only to Ardern’s lockdowns. At this very moment it may well be endemic in the Auckland area. It cannot then be eradicated there – except through vaccination. Now we are about to face what other countries have struggled with for 18 months. We have a huge head start, thanks to vaccination (now, and rightly so, to be hastened in Auckland) – and thanks to our intelligent, sensible obedience to lockdown rules. But only time will tell.

For ethical reasons Sweden chose not to enforce their lockdowns – but their population actually very conscientiously followed their government’s advice and did not travel or mix more than necessary. Their ethos, their aim, their reason, was to protect small businesses’ economy – and to humanely protect the vulnerable poor. It will be at least a couple of years before we can draw any valid conclusions as to the wisdom (and charity) of their ethos.

Let me tell you, Karl : I would take a lot more notice of your investigative abilities in, say, anno Domini 2024.

Karl du Fresne said...

If you read my piece again, you'll see that I mention several island countries - namely Fiji, Singapore, Iceland and Malta.
The Wiki/Johns Hopkins table does include Taiwan. With 835 deaths, a CFR of 5.2% and a death rate of 3.51 per 100,000, it does slightly better than Australia.

Graham Little said...

Useful article Karl. But you failed to discuss the single most important factor for NZ.

That is the huge gap between deaths per 100,000 for NZ compared to the rest of the world.

The government been effective in a short term tactic of curtailing deaths, and in educating and building social attitudes. But what about long term, It would seem the government stands to fail strategically or push NZ into a closed, society, of limited global contact.

I have raised these issues in my Face Book profile post.

oneblokesview said...


My apologies for not seeing Taiwan in the list age must be getting to me.

But my point stands.
Comparison to similar islands in Population etc better than continents.
Of course I forgot Cuba. CFR 0.8% and death/100,000 = 47.6

On further reading it appears the cases count in Taiwan is subject to politics and testing rate is about 10% of that in NZ. Hence the very high CFR.
Maybe Mr Trump had it right :-) The more you test the more cases you find.

Not withstanding all of the above. I really enjoy your posts. They challenge my thinking
Keep up the good work.

David McLoughlin said...

Thank you Karl. A very informative article to read with my lockdown breakfast. Totally straight analysis. I do wish your writings still appeared in the DomPost/Stuff. This would have been a great contrast to the drivel appearing there.

Odysseus said...

Dealing with COVID in the medium term requires a two-pronged approach, on the one hand locking down, on the other hand putting systems in place to maintain COVID-free status . Up to this point we have been successful with lockdowns thanks to our "meekness and compliance" (which also have their disturbing side). But pro-active measures like the vaccine rollout, secure quarantine facilities, testing and tracing frameworks etc, have fallen well sort of the mark and have left us poised on the brink of a Delta catastrophe. This is a government that has proven adept at banning stuff but it is thoroughly useless at doing much that is constructive. This is not a sustainable approach.

Andy Espersen said...

A nota bene : The Australia Spectator this morning mentions New Zealand’s “sacred religion of elimination”. A massive 85% of us support elimination - only 13% think Covid is something to be lived with.

I am very obviously in a minority.

Russell Parkinson said...

Unfortunately these figures don’t tell the full story. We normally lose 500 old people a year to seasonal flu. Other countries are much higher. Are COVID deaths just replacing seasonal flu deaths? I would think it’s the combined rate that is important. And if that is lower than normal then are we wrecking our economy to reduce deaths we normally accept as part of life? What percentages did we accept for SARS, the Hong Kong flu, etc did we just accept those deaths and get on with it.

Then we need to look at deaths from cancer, heart disease, suicide etc and see if these have increased due to lockdowns and changing priories in the health system. Are road deaths down? Drownings?

Unfortunately it is very difficult to find this information. The mainstream media (known as the team of $55 million in my house) aren’t telling us.

Total death figures on a year by year base might help.

At some stage hopefully very soon, we have to put a value on human life and get on with it, accepting the associated risks.

Steve Ellis said...

This Government's politically advanced strategy of Elimination is predicated on hard borders and population compliance with lockdowns, in whatever guise. It is entirely reliant upon there being no Human error or ill discipline. A noble, but in the long run, fanciful notion.

Steve Ellis

EscapeeinOz said...

Love the article and comments. As a Kiwi in OZ, I can report having completely switched off from the media items here telling me what I can and cannot (mostly that!) do. Every state and territory is doing its own thing, the prime minister has lost control and is bullying locked down states to open up their borders. The rules change every 5 minutes until you really have no idea what is possible anymore. Be grateful that, as a nation, Aotearoa seems to have a set of level headed instructions that everyone understands and, it seems, is obeying for the most part. Kia kaha!

Alexandra Corbett Dekanova said...

Interesting article, thank you. My family live in Slovakia and they repeatedly expressed their happiness that I was here out of danger. It was cca 6 months ago when they were struggling with thousands cases and hundreds deaths a day. Then they were double vaccinated went on holiday abroad and kept asking me why I was not coming to visit them as I had used before. So I had to confess that to this moment I have not been double vaccinated and that even if I were I cannot travel because I won't be able to return due to the shortage of MIQ facilities and the high price to be paid.
So as I see it, our lockdown at the beginning was a success but our government was not able to build on that success. They announced climate emergency instead of healthcare emergency that we all know we have. There were steps to do to prepare for the outbreak and life with the virus like increase salaries for doctors and nurses, make it easier for doctors and nurses from abroad to come here, build new hospital wards or even emergency hospitals, order and pay for enough various vaccines so that everyone who wanted could have been vaccinated by the end of July, order and buy all medicines and equipment proved to be effective in treatment of covid, promote and propagate prevention, vitamins, supplements, lifestyle etc. Then we could have opened the boarders with all the benefits it would bring. Instead the government spent millions on various mad projects and plans to centralise the power and introduce ethno state.
Alexandra Corbett Dekanova

Brendan McNeill said...

Eventually the virus will arrive in NZ. There are only two metrics that matter. Hospitalization and death. 11.5% of those hospitalized end up dead (on average).

The key to avoiding hospitalization is early intervention, which is to say early treatment. None of our Primary Health Care providers has an early treatment program. The grand narrative says 'there is none'. You wait until you have difficulty breathing and admit yourself to hospital and hope you are one of the 90% that survive, not the 10% that die.

So, why are our Primary Health Care providers not focused on early treatment? Why are there no committees examining international best practice? why is our Ministry of Health not issuing a best practice guideline?

Frederick Williscroft said...

I am sorry I only read this article tonight but I felt compelled to respond, albeit at the 11th hour, to put forward my perspective.
John Hopkins University seemed to have decided to exclude a number of countries from their statistics. Eleven countries have had Covid outbreaks but no deaths. Isn't that worthy of inclusion - could they not have put 0.00? Vanuatu and New Caledonia have had 3 deaths per 1 mill/pop - strangely excluded. That would make NZ around 19th. One could also point out that a number of countries have had no Covid, no deaths e.g. Tonga, which surely is the desirable outcome.
In comparing NZ success I think we should compare like with like. That is countries who are relatively sparsely populated, geographically isolated. Your post mentions Malta and Iceland. I would broaden that comparison and look at a number of South Pacific countries who as previously mentioned have never had Covid or Covid, no deaths. Going around the globe Falkland Is, St Helena, Greenland, Anguilla - no deaths, Faroe Islands 2.

I can never see the point in comparing NZ to countries in Europe who are surrounded by several countries and where border closure is near impossible. I see are we always comparing ourselves to the UK. NZ is a bigger country land wise and has 5 million, the UK 68 million. NZ has one entry point, UK dozens. NZ surrounded by a large moat, UK a few kms from Europe with a tunnel linking them. The UK could hardly close their borders and introduce 14 day quarantine for all returning British persons by commandeering a few hotels near Heathrow/Gatwick as per NZ. The UK had 2 very severe lockdowns, my sister and family only allowed one hour outside a day to exercise.

As Professor Des Gorman said, if you looked at the country best equipped for Covid it would be NZ given it's geographic isolation and other natural advantages hence our comparative success.

Tony Draaijer said...

I have been contributing to the 'FluTracking' site every Monday for a couple of years now and in the 26 September report on influenza in New Zealand there is a graph that shows that incidents of influenza have dropped dramatically since 2019. I acknowledge that this is just a small snapshot with 45,120 people reporting in. However, it does throw up some interesting thoughts.
If Influenza cases have dropped significantly, are there less people dying from that illness?
If so, has this been reported in the media?
I note that there were 905 deaths attributed to influenza and pneumonia in 2018. Statistically there have been around 500 flu deaths per year.
Why then is the Government so fixated on preventing deaths from Covid-19? Is it because it will reflect negatively on our WHO statistics?
So many questions. So few honest answers!