The Code COVID19 International Update is a weekly snapshot of the COVID-19 pandemic, assessing efforts by nations around the world to test, track and fight the virus. It’s compiled by Dr Priscilla Robinson, an Adjunct Associate Professor of Public Health at La Trobe University, and an editor for the Australian and New Zealand Journal of Public Health.
Hello One and All,
As the Snapshot shows, things are heating up again worldwide, with almost one third more cases and two thirds more fatalities notified to WHO this week. I am not sure how accurate this is as there was quite a lull in reporting for the last couple of weeks, and in several countries case numbers have fallen – Africa has removed fatalities from its lists for two weeks now, hence the minus numbers in the snapshot – so there may well have been a recalibration – we just need to keep an eye on it all. Quite a lot of the jump has been from the Americas which have reported about one million cases for a while but this week almost three times as many. No particular countries stand out, apart from the half a million cases reported from China, and the third of a million from Australia.
It is worth, in this context, considering countries with very high notification rates and very low death rates. For example, Iceland has now reported cases in 55% of the population, and a fatality rate of 0.08% – a high case rate and very low fatality rate. As so many cases are notified it is very possible that this low fatality rate is accurate. Countries with similar fairly high case rates and low fatality rates include Singapore, Malta, New Zealand, Australia, and South Korea, all countries with fairly robust notification systems. This poses questions about herd immunity and the effectiveness of vaccines, as since vaccines have been available the worldwide fatality rate has declined, and is now at 1.19 and falling. Remember, two years ago when the pandemic was just getting started it was at about 6%, and even in January 2021 was about 2.3%. Yes, the most vulnerable people are less likely to survive and therefore constitute a high proportion of early deaths, and yes, public health measures do work, and yes, many countries in the world have maintained the mask-wearing etc very well, and yes, vaccines help too. There is also the point that if officially at least 8% of the world’s population has been notified with COVID, up to 90% have still NOT had it. And even in those countries with high rates, only Iceland had had COVID in more than 50% of people. So maybe this combination of factors might at last see it all slow down.
I certainly hope so!
Vaccinations seem to be grinding to a halt – resource poor settings seem to have had a problem with no rise in coverage for the last week. Worldwide there is the smallest of rises, and the only progress seems to be in the booster dose department, with many countries completing immunisations in fewer than 1% of their populations. Many countries have not reported their data for a few weeks (and a few since about December 2021) though, so the accuracy of these numbers is actually questionable in several places.
This week a paper from Nature demonstrates another way of considering control of diseases like COVID in a setting where legally it is not possible to use lockdowns. As I have said many times, we still need some better – i.e. more nuanced – epidemiology than that which we have, and this paper goes some way to helping. It also shows that most people infect very few, but a few infect very many – superspreaders.
And a few superspreaders amongst a lot of people is a bad idea.
See you next week,
About Dr Priscilla Robinson and The CODE COVID-19 International Update
Dr Robinson is a public health epidemiologist with particular interests in international health and communicable diseases, and public health competencies. She has worked in health departments in England and Australia, has managed public health teaching programmes, and taught and researched many aspects of public health epidemiology and policy in many countries. She is an adjunct Associate Professor at LaTrobe University, and to stop herself being bored is an editor of PHAA’s journal ANZJPH, and holds board positions (almost all unpaid) on various NGOs, journals, and at her local hospital. Otherwise, 10 acres of untamed bushland on a hill in South Gippsland, VIC, makes weight-bearing gym exercise and strength training a bit redundant.
The CODE Update is a regular Intouch feature to keep readers informed of COVID-19 developments around the world.
The CODE Update originally began at the start of the SARS CoV-2 pandemic as Priscilla’s way of explaining to her friends and family around the world what was happening, and counter their experiences of information overload and misinformation. The update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. Published weekly, it includes a short commentary to provide context to the numbers included in the spreadsheets.
Note: While every attempt is made to transcribe all data faithfully, every now and again mistakes are made and not noticed until the next Update. Also, on occasion, numbers are revised after posting at the source databases.
We hope you will find these updates to be a helpful tool, and the links to current information useful.