Has COVID-19 subverted global health?
Official data have fooled us more than once into regarding COVID-19 as a rich-country pandemic
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Pandem-ic tracks pandemic inequality across countries (ic) by income group, region and subregion. It publishes insights around three themes: (1) the understated severity of the pandemic in the developing world, (2) the unseen scale of the Omicron escalation and (3) the unmet need for global vaccine equity.
The first theme is the understated severity of the pandemic in the developing world. Official data on pandemic mortality have fooled us more than once. Early on in the pandemic, official data underpinned the claim that COVID-19 would leave the developing world “unscathed”. Later on, again underpinned by official data, this became: the pandemic has been “mild” in developing countries with young populations and therefore they “do not need vaccines”. But nothing could be further from the truth once we take a broader look.
That broader look is made possible when we use the concept of excess mortality which represents the gold standard to assess the true and total impact of the pandemic. The chart above shows just how intensive the mortality impact has been in the developing world not just in absolute terms but also in per capita terms. Lower-middle income countries registered by far the biggest blow. Other country income groups are clustered remarkably closely together, which is an astonishing outcome in and by itself given the huge demographic differences across income groups.
The posts on pandemic severity tackle a number of questions:
And why is this – and has it always been – a developing country pandemic?
The most recent posts on pandemic severity are listed here, where all but a few are updated daily:
Official data have fooled us more than once into regarding COVID-19 as a rich-country pandemic
New estimates of excess deaths make vaccine inequity all the more disturbing
Perspectives on pandemic mortality that go beyond the official data
Let’s not lose sight of the excess mortality picture in the absolute
How different types of mortality data support opposite views on pandemic severity across countries and why one of them is completely wrong
Media attention has focused excessively on officially reported COVID-19 mortality rates. To assess global impact accurately, we need to look beyond that.
How population outliers completely distort the rankings of pandemic severity between rich and poor countries
A review of WHO excess mortality data through end 2021 for India, Russia, Indonesia, USA and Brazil
In most countries they do (if we can trust the estimates)
Official data have fooled us more than once into regarding COVID-19 as a rich-country pandemic
New estimates of excess deaths make vaccine inequity all the more disturbing
Perspectives on pandemic mortality that go beyond the official data
Let’s not lose sight of the excess mortality picture in the absolute
How different types of mortality data support opposite views on pandemic severity across countries and why one of them is completely wrong
Media attention has focused excessively on officially reported COVID-19 mortality rates. To assess global impact accurately, we need to look beyond that.
See also the following external articles and blogs republished here:
World Bank
The second theme is the previously unseen scale of the Omicron escalation. Since mid-December 2021 , Omicron has enveloped the world, which led – initially accompanied by Delta – to an unprecedented expansion in the number of confirmed cases. Pandem-ic documents this escalation and highlights its unequal impacts across countries. It also discusses the implications of the sheer scale of the escalation for the future course of the pandemic.
The above chart captures well the scale of Omicron escalation. It shows the ratio of the most recent peak in cases and deaths per capita relative to the earlier peak in these numbers before November 1, 2021. We can see that the escalation in cases has been remarkable (it would be even more so if we could count all infections correctly). The mortality numbers have remained under earlier peaks, but are nevertheless considerable.
Against this backdrop, a number of questions arise:
What are the implications of the scale of infection for the future course of the pandemic?
Below is a list of posts on the Omicron escalation, which are updated daily:
The world remains underprepared against the downside contingency of a highly contagious and more lethal variant. If it materializes, what will we wish then we had done differently today?
If US states were countries, how many would be in the global Top 50 for cases per capita?
Waves have been roughly synchronized, but mortality impacts have been anything but similar
A huge escalation in cases, but what has been the mortality impact?
Even with lower severity, Omicron’s contagiousness may still wreak havoc on the developing world
Cases in South Korea have risen at a pace previously unseen among peers
Transmissible variants and policy shifts have left their mark
The world remains underprepared against the downside contingency of a highly contagious and more lethal variant. If it materializes, what will we wish then we had done differently today?
If US states were countries, how many would be in the global Top 50 for cases per capita?
Waves have been roughly synchronized, but mortality impacts have been anything but similar
A huge escalation in cases, but what has been the mortality impact?
Even with lower severity, Omicron’s contagiousness may still wreak havoc on the developing world
Cases in South Korea have risen at a pace previously unseen among peers
The third theme is the unmet need for global vaccine equity, the importance of which pandem-ic has sought to emphasize since the inception of this resource. The road towards vaccine equity across countries has been long and it remains long as the persistent gaps in vaccine coverage continue to remind us. The greatest shortfalls in primary vaccination are registered among the lower-income countries. Meanwhile, booster programs are being rolled out around the world and they seem to follow the exact same patterns of inequality that marked the primary vaccination campaign.
Today we count 2.5 billion people who have not yet received a single COVID-19 vaccine shot. The above cartogram shows where the unvaccinated live. With land mass distorted to represent the head count of the unvaccinated, it illustrates the main locus of the vaccination challenge: Sub-Saharan Africa and South Asia. In relative terms, however, the challenge is most intense in Sub-Saharan Africa as the colors of the chart suggest.
The material published on global vaccine equity addresses the following questions:
What are the characteristics of countries that do well and do less well?
If access to health care is considered a human right, who is considered human enough to have that right?
Boosters are rolling out more slowly than primary vaccinations and similar patterns of inequality apply
The global vaccination campaign has been highly regressive, with countries mired in extreme poverty facing the lowest vaccination rates
Countries that manufacture COVID-19 vaccines tend to outperform their peers on vaccine coverage
How front-runners in the vaccination space compare across countries
Cuba stands apart from most other countries when it comes to vaccine coverage and pandemic outcomes
A huge contrast between those boosting and those lacking first shots
How disadvantage begets disadvantage
The world’s revealed capacity to vaccinate its population remains blatantly regressive
If access to health care is considered a human right, who is considered human enough to have that right?
Boosters are rolling out more slowly than primary vaccinations and similar patterns of inequality apply
The global vaccination campaign has been highly regressive, with countries mired in extreme poverty facing the lowest vaccination rates
Countries that manufacture COVID-19 vaccines tend to outperform their peers on vaccine coverage
How front-runners in the vaccination space compare across countries
Cuba stands apart from most other countries when it comes to vaccine coverage and pandemic outcomes
See also the following articles on global vaccine equity published originally elsewhere and republished here:
While these three thematic areas are presented as separate themes, they are of course intimately connected. The various posts attempt to bring out these connections. For example, the need for global vaccine equity is accentuated by the understated severity of the pandemic in the developing world. This is why it is useful to jointly examine excess mortality and undervaccination. Also, while Omicron appears to be less lethal within the context of more fully immunized populations, its high degree of transmissivity nevertheless has meant that the Omicron escalation has proven to be severe in many locations.
This completes the description of the three main themes of this data analytics resource. Comments and suggestions are most welcome!
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