Projections for real estate, school openings, business closures, and expectations of longer-term unemployment all hinge on each region's pandemic metrics and response. We thought it would be interesting to compare one of the "best" performing regions in the United States – the state of Connecticut – with a country that has been regularly criticized in the United States as having one of the "worst" approaches worldwide – Sweden.
For comparison, Connecticut has roughly 3.6 million people while Sweden has 10.3 million residents. To properly compare the detected COVID-19 cases and deaths, we multiplied Connecticut's raw figures by 2.86 (10.3/3.6) in order to have a single population size as a common denominator. The underlying data for total detected cases and total deaths are drawn from Johns Hopkins University and the World Health Organization.
Total detected cases. There are approximately 65,000 detected COVID cases in Connecticut, and 107,000 in Sweden – which has almost three times the population. When this is adjusted for the difference in population, Connecticut has 186,000 cases compared to Sweden's 107,000.
Of course, there is also a difference in both the amount and availability of testing between Connecticut and Sweden. This is why we identify this metric as 'total detected cases' rather than simply 'total cases.' However, given the general shortage of COVID testing in the United States along with the high out-of-pocket expense of paying for testing – especially when compared to a country with an advanced and comprehensive socialized health care system – there are likely to be more undetected cases in Connecticut than in Sweden.
Total deaths. The number of COVID-related deaths in Connecticut is approximately 4,500, whereas Sweden has roughly 6,000 deaths. When this figure is adjusted for the same size population, Connecticut's death toll becomes approximately 13,000 compared to Sweden's 6,000. On a percentage basis, the number of deaths as a percentage of total detected cases is 6.9% in Connecticut compared to 5.6% in Sweden.
However, the methods of attributing death to a particular cause can differ significantly among countries and states. For example, in the United States, those who die at home from COVID-related events (such as heart attacks, pneumonia, or strokes) may have their death attributed to those morbidities rather than to the virus itself. Furthermore, the politicization of the pandemic and the related data in the United States suggest that in certain regions, the official figures may have been revised downward to suggest that the pandemic is under control. Collectively, these suggest that the actual number of total deaths is higher than the stated figure.
With these data in mind, let's reconsider our opening thought: Connecticut is being praised as one of the U.S. states which is best handling the coronavirus, while Sweden is broadly criticized for having higher infection rates than neighboring countries.
According to the British Medical Journal, Sweden does have the largest number of cases and fatalities in Scandinavia. As of early June 2020, Sweden had 37, 000 detected cases, much higher than neighboring Denmark (12,000 cases), Norway (8,000), and Finland (7,000). At first glance, Sweden appears to have had at that time five times the infection rate of Finland. However, when one considers the relative sizes of each country – Denmark (5.8 million residents), Norway (5.4 million), and Finland (5.5 million) – Sweden's infection rate is only 2.6 times that of Finland.
Across the Atlantic, there has been little or no unified American response to the coronavirus. Federal responsibility for the pandemic was delegated to the individual states. The dominant narrative in the United States has been to largely ignore countries with a successful coronavirus approach, such as Iceland, New Zealand, Senegal, Singapore, Taiwan, and Vietnam. The flip side of that narrative is to scapegoat countries like Sweden for having a "terrible" coronavirus response – even though the data clearly show that Sweden's response is yielding better results than the best-performing of the individual American states. Of course, Sweden's response cannot be considered in isolation – it is a byproduct of a society with a high level of trust between citizen and state, as well as a robust socialized healthcare system.
The dominant narrative within the United States is one that largely normalizes or ignores the virus. By narrowing the denominator to the performance of individual American states, it effectively becomes a ranking of underperforming entities – "Well, I'm doing better than you are because my house is slightly less on fire than yours is" – knowing that some states will look better by comparison. But when these figures are compared to international data, a very different picture emerges. When it comes to the handling of the virus, the best-performing American states still underperform the more controversial of European countries.
This brings to mind an old Italian saying, "when one finger points forward, four fingers point back at the accuser."
Emily Weber is a guest contributor to NeighborhoodX.
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