With the declining trend in mortality slowing globally, and reversing in Europe to collide with the approaching winter influenza season, and the relative share of Asia, led by India, home to over half the global population, rising, there are reasons to worry
By Alok Sheel
Global Covid-19 deaths now exceed the 1.1 million mark. Publicly available Covid mortality data from 31 countries, that account for 73.5% of the global population, and 95% of Covid deaths, to date, has been aggregated into five successive six-week periods beginning from March 6 and ending October 21. For analytical purposes, these 31 countries have been divided into three regions, namely the Eastern Atlantic, the Western Atlantic and South and East Asia. The accompanying table also separately shows the distribution and mortality rates aggregated across the continents.
The data reveals two distinctive new trends over the last six weeks. First, the declining trend in Covid deaths observed over each of the four preceding six-week intervals has continued, albeit at a declining pace. During the first six-weekly interval beginning March 6, and ending April 20, global mortality increased exponentially from practically nil (outside China) to 4778%. The growth rate then showed a declining trend of 142% in the second six-weekly period ending June 6, and 54% in the third six-week interval ending July 21, 40% as of September 5 and 31% during the last six weeks ending October 21.
Second, the East Atlantic has bucked the trend of declining Covid mortality over the last six weeks. Mortality growth in Western Europe, a high-income area with a good public health system, was initially high but was controlled quite quickly, with the exception of Russia. The current resurgence is possibly an early indication of a second wave on a collision course with the heightened mortality during the winter influenza season.
At the starting point of the five six-weekly intervals on March 6, 2020, there were very few Covid deaths outside China, with the latter accounting for 90% of all Covid deaths. During the six weeks ending April 20, Covid-19 was stopped in its tracks in the country of origin, even as it spread rapidly westwards, first to the East Atlantic, and then to the West Atlantic.
As of April 20, the East Atlantic accounted for 58.5% of all Covid deaths. The Covid Axis continued its swift westward march, with the former’s share declining to 41.8% as of June 6, while the West Atlantic’s share rose from 28% to 47% during the same period. This trend continued into the next three six-weekly intervals ending October 21, with the East Atlantic’s share declining in each successive interval to 22.9 % on October 21, even as the West Atlantic’s share peaked at 55% as of September 5, declining marginally to 53% by October 21. Meanwhile, the share of South and East Asia has risen steadily from 4% as of April 20 to 13.2% as of October 21.
While the future course of the Covid pandemic is still unknown, its legacy deaths are very skewed globally. Geographically, the two Americas (West Atlantic), with just 13.1% of the world population, account for 55% of all Covid deaths to date, and Europe with 9.6% of the population accounts for 21.4% of deaths. Meanwhile, Asia, home to almost 60% of the global population accounts for just 20% of all deaths. The African continent, with 17.2% of the population, accounts for only 3.6% of Covid deaths.
Thirteen big countries, with just 14% of the global population, presently account for 66% of all Covid deaths to date. Covid mortality exceeds 500 per million of the population in each of these countries. These are all either high income or middle-income countries. Nine of these are in the Americas (US, Mexico, Brazil, Argentina, Peru, Colombia, Chile, Bolivia and Ecuador) and four in Europe (France, Italy, UK and Spain). This hall of shame does not include a single country from Asia or Africa, or a low-income country, where public health systems are much weaker, even as it includes four of the G-7 countries. This is rather astonishing and counter-intuitive as it points to a negative correlation between per capita income and Covid mortality.
Three big countries, namely the US, Brazil and India, with 25% of the global population currently account for about 45% of all Covid-19 deaths to date. These three disparate countries share the common feature of populist rightwing leadership that tends to disregard evidence-based expert scientific advice. This story is repeated in Iran and Turkey, where too Covid mortality has shown no declining trend over the last three six-weekly intervals.
The biggest surprise of all is the United States, which has a very high per capita income and one of the highest expenditures on health. While most countries have shown a declining mortality trend over the last three six-week intervals, US mortality has remained steady at around 30 % over the last three six-weekly intervals. With just 4% of the world population, it currently accounts for 20% of global Covid deaths.
The other big surprise is India’s performance relative to the rest of Asia. Its Covid mortality at 84 per million is far lower than the average in the West and East Atlantic regions. However, it was the worst performer in Covid mortality globally over the last six weeks, with Covid-19 deaths increasing from 136.5% in the preceding six-week period to 176% in the six weeks ending October 21. It is also located in a low mortality region, where the overall average is around 50 per million. Its share in Asian Covid deaths has shown a sharply increasing trend over the last few months. It currently accounts for 51% of all Covid deaths in Asia. This includes some high mortality countries in West Asia classified as part of the East Atlantic region. If the eight major countries in South and East Asia selected in the Table (China, Indonesia, Japan, South Korea, Pakistan, Bangladesh, Australia and India, accounting for 48% of the global population), are considered, India accounts for a disproportionately whopping 78% of all Covid deaths. The relative performance has worsened over time, as it accounted for 86% of all deaths in these eight countries during the last six weeks. Its Covid mortality rate of 84 per million of the population is almost twice that of Indonesia, the second-highest in the region, and compares even more unfavourably with that of its immediate big South Asian neighbours, Bangladesh (35) and Pakistan (30), despite being a richer country and possessing a superior public health system.
With the declining trend in Covid mortality slowing globally, and reversing in Europe to collide with the approaching winter influenza season, and the relative share of Asia, led by India, home to over half the global population, rising, there are reasons to worry regarding the future course of the pandemic and the prospects of a quick and robust economic recovery.
The author is RBI chair professor in macroeconomics, Icrier