COVID-19 Testing – The U.S. is STILL in the Middle of the Pack By Randall Bolten

COVID-19 cases have surged tremendously in the U.S. in the last couple of weeks.  The latest excuse cited by some federal and state government officials is that the increase is the result of more testing.  This note challenges those assertions as flatly dishonest.

Below is a graph comparing the total testing done by about 40 countries over the last ten weeks.  These countries include most of Europe, plus relatively affluent countries in the rest of the world – it would be unreasonable to include poor and developing nations in this comparison.  The metric used is Strategic Tests (see note below for further detail), which measures the extent to which a country is testing proactively in its effort to control the spread of the pandemic.

Strategic testing has improved significantly in the U.S., from being virtually nonexistent ten weeks ago.  But most of the other countries shown have made similar increases.  Of the 41 countries shown, as of yesterday (6/25) the U.S. ranks 24^th in number of Strategic Tests per 1MM population.  Most of the countries included in the above graph have seen significant declines in the number of new cases reported over the last ten weeks, which is not true in the U.S.  If the increase in reported COVID-19 cases in the U.S. is due to increased testing, why has the number of new cases continued to decline in those countries, but not the U.S.?

To answer that question, we need to look at how each country – and in the U.S., each state – is managing the pandemic and the economic paralysis and how they trade off additional COVID-19 cases and the resulting deaths against the economic benefit of opening up the economy.  Only an honest assessment of the pandemic’s consequences can help us do that.  A good comparison would be with the four Scandinavian countries – Sweden, Norway, Denmark, and Finland – and how they give the rest of us a great opportunity to make that assessment.

These four countries are geographically close to each other and have cultural and social characteristics in common, but are following very different policies toward the pandemic.  Sweden has taken a relatively laissez-faire approach, including keeping schools open as well as most businesses.  The other three countries – let’s call them the “Nordic Combined” – have taken the much stricter approach common to many countries, especially in the wealthy west.

The differences are striking. Compared to the “Nordic Combined,” Sweden has reported well over double the number of COVID-19 cases and more than six times the number of deaths per capita.  In a country the size of the U.S., with 331MM people, that difference in mortality equates to more than 120,000 lives – more than double the current U.S. toll of just over 100,000 lives.  Moreover, it’s a virtual certainty that the differences between Sweden and the other three countries will widen even more over the next several weeks – you can tell from the gaps between the weekly markers, which are shrinking significantly for the Norway, Denmark, and Finland curves, but not for Sweden.

Norway, Denmark, and Finland combined have done almost 60,000 tests/MM – more than two-and-one-half times the testing rate in Sweden.  If testing slows the spread of the disease by identifying asymptomatic or mild cases of COVID-19, that difference in testing would contribute to the large difference in deaths.

Some point with alarm to the higher death rates in countries like Sweden. Others argue that all we’re doing is slowing the rate of a pandemic that will ultimately affect everyone, and that’s not worth the economic damage.  The debate rages, even in Sweden. A look at Scandinavia gives us a clear, quantitative look at the illnesses and the deaths involved. So as we start to reopen the economy in the U.S., let’s be honest about the numbers and understand the consequences of our decisions and our actions.

About Randall Bolten

Randall Bolten is an author and finance executive. Randall Bolten has 30 years’ experience at high-tech companies in Silicon Valley, including 20 years as CFO, for both public companies and venture-backed private companies, including IPO and several other public transactions. He was recently the starring guest of Dinis Guarda’s interview series.

Randall Bolten is the author of “Painting with Numbers: Presenting Financials and Other Numbers So People Will Understand You” and Other Numbers So People Will Understand You, published in 2012. Randall speaks frequently, and provides workshops and training to Fortune 100 companies in the area of presenting complex numerical information clearly and effectively.

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