Latin America gets a two week head start on coronavirus suppression - March 2020
Latin America gets a two week head start on coronavirus suppression - March 2020
Several countries are acting earlier in their outbreaks than the US, Italy or Spain, which gives them a chance to prevent the worst case outcomes.
In terms of numbers of cases, many of Latin America’s largest countries are where the US and Spain were two weeks ago. They’ve crossed the hundred case mark and reported cases are rising on an exponential curve. The big question is whether the cases follow the path of the US and Spain or look more like South Korea or Japan after those countries hit the hundred case mark.
You’ve likely seen some version of the graph below in recent weeks. The cases that go beyond the 15 day mark show how cases in Italy, Spain and the United States continue to rise while South Korea and Japan have largely controlled the spread.
In terms of scenarios moving forward for Latin American countries, those two groups of countries (Italy, Spain and the US on one side; South Korea and Japan on the other) are the analogies to watch.
The graph above also includes several large Latin America countries, though they are hard to see in the bottom left corner of the graphic because none are beyond the 10 day mark and they all follow a similar trend.
Here is the bottom left corner of the graph with only Latin American countries included. Once again, it is on a logarithmic scale.
Latin American strategies are diverging
In the early days since they hit the 100 case mark, the countries are all a similar path and slope. However, there are now diverging strategies among the countries, meaning the lines should split apart in the coming two weeks.
Brazil and Mexico, as discussed last week, continue to take the issue less seriously. Their lines will likely track with Italy and the United States for the coming weeks. This means they are about two weeks from resembling the current US situation and less than four weeks from seeing some of their hospital systems overwhelmed by cases. At some point, their governments will be forced to recognize the reality of the crisis and implement social distancing, but every day they delay adds to the problem.
Many countries including Argentina, Bolivia, Chile, Colombia and Peru are going to quarantine measures right now, implementing the same measures as Madrid, California, New York and Illinois, but with a 10-14 day head start on those same suppression efforts in Spain and the US. This, in theory, should cause their curves to bend earlier and resemble South Korea. I’ll be tracking these charts over the coming weeks to see if that is the case.
The countries that are acting early have seen the collapse of a portion of Italy’s health care system and the large numbers of deaths that have occurred. They recognize that their systems would be hit even harder.
It is important to implement social distancing and quarantines early, before the crisis hits
This faucet graphic from Carl Bergstrom, professor of biology at University of Washington, is a useful demonstration. If countries wait until they see crisis levels in their hospitals, it is already too late to prevent an overwhelming of the system.
Countries must use the extra time they are gaining to implement long term and sustainable suppression and mitigation efforts
The quarantine measures implemented in many countries should bend the curve, but they are also incredibly disruptive to economies and societies. They will need to be lifted at some point in the near future and when they are, the cases will increase unless other measures have been put into place.
Those measures must include implementing a high volume and accurate testing effort as well as improving hospitals and getting necessary medical equipment including ventilators. No country has enough ventilators for this crisis and Latin America must use some of its ingenuity to join the global effort to hack together new ventilator systems with the parts that are available.
All of Latin America is watching the US. The Trump administration bought itself a few weeks of extra time by banning flights from China. That time should have been used to get testing in place, implement social distancing and help hospitals get ready for a surge of cases. Unfortunately, that didn’t occur as the Trump administration dropped the ball, with the president failing to understand the urgency of the issue. The extra time gained with the travel ban was wasted. Governors, mayors and the private sector have taken the lead, but the lost time due to the lack of federal leadership will prove deadly in the coming weeks as some hospital systems are overwhelmed.
Those Latin American countries that are acting early should learn from the example of the US and not believe that the extra two weeks of suppression are enough to stop the virus. The countries that succeed in using the next two weeks wisely will be the ones who prevent the most deaths and get their economies back to growth the quickest.
Data nerd notes
I’ve also published these charts at my blog and some may find it a slightly more readable format. I’ll try to update on the blog every few days and will include an update of the charts in a newsletter next week.
The data I’ve used for these charts is from the European Centre for Disease Prevention and Control and the Our World in Data website which aggregates the ECDC data.
There are plenty of faults with using reported cases data including:
Reported cases only capture a small fraction of the total cases.
Reported cases will increase with increased testing (and increased testing is a good thing).
The size of the country matters, with 100 cases in Brazil being very different from 100 cases in Panama on a per capita basis.
Reported cases can also be manipulated by governments, as is likely occurring now in places like Venezuela and China.
Still, given the data that is available in each country and the very clear difference between the trend lines in Italy and South Korea, I think this is the correct statistic to monitor over the coming 30 days to understand whether countries’ hospital systems will be overwhelmed. Some have argued for transitioning to Covid-19 deaths as the correct statistic to monitor and I think that may make sense several weeks from now.
Thanks for reading
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