Should we be taking population density into account when comparing countries on Covid-19?

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May I first offer my sincere sympathy to all those who have been directly affected by Covid-19 through their own illness or through loss or illness of loved ones. This is a truly terrible illness and my heart goes out to all those who have suffered, as well as the many NHS, care and key workers who have put their life on the line to help others.

One of the horrible sides of the pandemic is that it is often reduced to slides of statistics. When reducing thousands of individual tragedies of people’s lives cut cruelly short to graphs, it is terribly superficial. So I apologise for writing a post about the numbers. Behind every fatality there is the story of a beloved human being leaving behind grieving loved ones.

I suspect it will be many years before the full picture of this pandemic and our (human beings’) handling of it becomes clear.

When comparing countries, it seems now that poor old Belgium is top of the list of Covid-19 death rates. (Originally it was the USA, based on sheer absolute figures, which was a bit bonkers given the size of the country).

However, even though it is many moons ago, I remember the odd school geography lesson telling us that the Low Countries have a very high population density. So, surely the disease is bound to spread more quickly when the population is much closer to each other.

There are many other comparative figures to consider, of course – not least different methods of number preparation and countries being on different points of the pandemic cycle. Of course, I do not mean to make any definitive statement with the following numbers (from last night’s update of Worldometer. Bear in mind that the UK figure, as of yesterday, includes deaths in all settings – not just hospitals).

All I mean to point out is that putting Belgium at the top of the list may not be entirely fair.

Currently the list ranked by deaths per million people looks like this:

However, when adding a column for deaths per million/population per square kilometre, the ranking looks like this:

Obviously, doing this sort of jiggery-pokery with the numbers is getting a little extreme, but it does provide a little context.

Sweden has had virtually the same death rate as Ireland, but its population density is much less. Ditto the USA compared to Switzerland.

Spain has had roughly the same death rate as Italy but Italy has more than twice the population density of Spain.

It’s a very rough comparison, intended just to provide a little context.

What such a comparison does not take into account is regionality. For example, in the USA, it would be probably better to look at individual states, such as New York, rather than roping in places like Wyoming into the density figures. I recommend the Financial Times’ free graphs, which are regularly updated and take into account regions.

Again, I express my sympathy to all those affected by this disease and heartfelt thanks to all those who are risking their health, and that of their families, by working in this environment.

* Paul Walter is a Liberal Democrat activist. He is one of the Liberal Democrat Voice team. He blogs at Liberal Burblings.

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17 Comments

  • I believe the three key factors are population density, major international airports, international hubs.

  • Phil Beesley 30th Apr '20 - 11:21am

    Road deaths per billion-vehicle-km or per population are noticeably higher in Belgium than elsewhere in northern Europe. We’d expect Belgium to be very similar to the Netherlands (higher pop density, but culturally similar) but the stats are 40% or so higher.

    Maybe there is just something about Belgium?

    A big, big limitation of national comparisons of this type for Covid-19 is that fatalities and incidence do not reflect the natural pattern of the pandemic. The good things and the bad things which nations do to encourage ‘safer’ behaviour make a lot of difference.

  • Peter Martin 30th Apr '20 - 11:54am

    I’d say there are too many variables to be able to come to any firm conclusions. There will be differences in the way countries do their counting. Differences in the time the virus first appeared in the country. Difference in the demographics. Italy and ourselves have a relatively older population.

    It’s quite possible that countries such as Germany and New Zealand which appear to be doing well are simply storing up more problems in the years to come. What happens if Kiwis and Germans, who haven’t been exposed to the virus and so have no immunity, want to travel abroad where the virus is still prevalent? What happens when they finally re-open their borders? If a vaccine come quickly all will be well. But if it doesn’t………

    There’s too many uncertainties to be able to say for sure what the best strategy might turn out to be. It is important, though, that the NHS is not overwhelmed and so far we’ve avoided that.

  • John Nicholson 30th Apr '20 - 12:30pm

    This is a helpful approach, though there may be others. At least it attempts to look at real issues. The media have been absolutely awful about numbers, with the BBC in particular becoming artificially sombre when some arbitrary milestone like 20000 deaths is passed, but otherwise unable to cope with mortality rates or changes in daily death rates. No-one seems to have asked what the eventual total of deaths might be, though they have been quick to suggest that Neil Ferguson saying we would do well to keep the number to 20000 was somehow a prediction that 20000 would be the number. I have looked in vain for a sober, careful and above all numerate discussion of where we are, and not found it anywhere until now. So thank you Paul.

  • Laurence Cox 30th Apr '20 - 1:01pm

    @Paul

    What makes your population density argument inaccurate is that some countries, like Sweden but also Norway, Finland and Iceland in Europe, have large areas with almost no population. So the meaningful density statistic for these countries would be population density in the most densely populated areas, not averaged over the whole country.

    If you were doing the same within the UK, you would note that most of the population of Wales is concentrated along its south coast and in the valleys north of Cardiff, with a secondary population area along its north coast and very little population elsewhere, while in Scotland most of its population is concentrated in the Central Belt.

  • Paul, the elephant in the room is the fact that the UK (at least the general population) has no idea how many have died of Covid effects…
    This winter and early spring has been one of the mildest on record so, even using the number of deaths above the seasonal average, is probably an understatement..

    I don’t like statistics because the criteria used can give you whatever answer suits…A technique this government is so, so adept at…

  • Sue Sutherland 30th Apr '20 - 2:26pm

    I’ve been shouting at the telly at the lack of context of the figures of overall deaths especially when comparing the USA with European countries. Your post has remedied that but, as you and some commentators say, it has thrown up a need for even more context about death rates in different regions.
    This may link into the concern about deaths being more prevalent in Black and Asian people, with a correlation between poverty, ethnicity and high density housing. There are also cultural differences which may affect the spread of the virus like living in extended families, close to the elderly and infirm who are more susceptible to the virus. This also mustn’t undermine any research into whether certain ethnic groups may have a genetic weakness to this virus, as happens in sickle cell disease.
    The object of these comparisons is to understand more about how the virus is spreading and therefore to manage further outbreaks better than this initial one, so fewer people die. There are so many tragedies accompanying this pandemic.

  • Nigel Jones 30th Apr '20 - 3:14pm

    Thanks Paul. The Times data is particularly helpful regarding excess deaths; as was said on Newsnight, this is an important indicator. Yet, as Peter says and as Lawrence points out, country comparisons are complicated.
    The basic message, as Ed Davey says, is that we must demand a full enquiry, so that we can assess what actually happened in the UK, judge how it could have been better and what lessons are to be learned for the future.

  • As I understand it, the main reason for Belgium having so many Covid-19 deaths is their love of bureaucracy. They record everything meticulously and that includes deaths. If they think the death is due to Covid-19 then that is recorded, whether the unfortunate person died in hospital, in a care home, in their own home or anywhere else. When the figures are compiled they include everyone who is likely to have died of the disease unlike the figures produced by other countries.

  • Phil Beesley 30th Apr '20 - 7:23pm

    Peter Martin: “I’d say there are too many variables to be able to come to any firm conclusions.”

    I have worked with many social scientists, providing the software tools which they use, observing how they are used. Ditto for medical scientists. Archaeologists, criminologists and epidemiologists use the same toolsets — from the disparaged world of geography — to map data, and comprehension is not constrained by concepts of geography. Once you map data, good scientists spot significant incidents.

    And wow, there are amazing coincidences. Which do not matter and are confusing.

    “There will be differences in the way countries do their counting.”

    Up above, I cited road fatalities in Belgium. The difference between Belgium and neighbouring countries cannot be ascribed to accountancy; the data was collected, theoretically, to eliminate such factors. Data has been collected for years.

  • We need to take into account demographics and initial population health and ethnicity and etc. and apparently we can’t make any comparisons till much later in the day. Even the experts are not experts in this area and I just wish everyone would be quiet. I’m going to do yoga now.

  • Laurence Cox 1st May '20 - 1:33pm

    @Ian Sanderson

    I don’t think it was the late introduction of driving tests (even though it was only in 1977). Anyone driving now who did not have to pass a driving test would have had to have been born before 1959, so would be at least 61 now. This article from the LA Times in 1990 points up some of the problems with Belgian drivers, which are nothing to do with being tested:

    https://www.latimes.com/archives/la-xpm-1990-12-09-mn-8468-story.html

    Having driven in France, but never in Belgium, I knew about priorite a droite, but not how extremely Belgian drivers apply it.

  • Jem Coulson 28th May '20 - 6:59pm

    All good points Paul and worthy of consideration. It is worth recognising that the UK comprises 4 nations (ie England, Scotland, Wales and Northern Ireland) all of which have significant levels of devolved government – including their own Health Services. It would therefore be both valid and useful to separate out Covid statistics for each of these 4 UK nations. Finally, it is of note that England (vs UK) has a higher population density than even the Netherlands.

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