The U.S, Italy, and Indonesia have the highest mortality rates from COVID-19, according to Hong Kong-based venture capital firm Deep Knowledge Venture.

Hong Kong-based venture capital firm Deep Knowledge Venture (DKV) released the latest data on countries with the highest mortality rates. The U.S tops the chart, followed by Italy, Indonesia, Spain, Iraq, Iran, the Netherlands, France, the U.K., and the Philippines (as of April 2, 2020).

As of April 3, the U.S had recorded 245,373, with 6,095 dead and 10,403 recovered. New York is the state with the highest numbers of infection cases (93, 053 cases).

Italy, one of Europe’s economic powerhouses, has seen 14,681 deaths due to COVID-19 (at the time of writing). The virus has infected 119,827 so far. The prosperous state of Lombardy is the hardest hit, and the Italian government has prolonged the lockdown until April 13.

As of April 4, Indonesia has seen 2,092 COVID-19 positive cases, with 191 deaths and 150 recoveries. Indonesia’s National Disaster Mitigation Agency (BNPB) has extended the outbreak’s emergency status until May 29. All gatherings have been banned, offices and malls have temporarily closed. 

Singapore is the most efficient in handling the pandemic

The tiny state of Singapore is the most efficient in dealing with the COVID-19 outbreak (with treatment efficiency score reaching 66). As of April 3, the country had recorded 1,144 active cases with six deaths so far, the official data showed.

South Korea came second (score:55), followed by Hong Kong, Taiwan, and China. Unlike other countries that have slapped a nationwide lockdown, Singapore and South Korea prioritize mass rapid tests and transparency to contain the outbreak.

What Singapore and South Korea are doing have drawn praises

South Korea’s Deputy Health Minister, Kim Gang-lip, stated as quoted from South China Morning Post (SCMP) that Seoul chooses a combination of voluntary public participation and the application of advance technology to contain the infection.

South Koreans receive warning notification via short text messages from the authority targeting those working or living in the area where every new case is confirmed.

The government provides information about patients’ trip records and where they live. South Koreans are also aware of the importance of hygiene, and they are not allowed to leave homes without wearing masks. Free mass matters, too. South Korea manages to conduct 15,000 tests a day. As of March 15, South Korea saw 8,086 confirmed cases with 72 deaths.

Singapore’s COVID-19 handling puts transparency above everything. Like South Korea, Singapore uses advanced technology to track people who had contacts with COVID-19 patients.

Singapore is well-prepared in dealing with the outbreak (based on its past experience with SARS in 2003),with a recovery rate of 23.2 percent. Its well-equipped healthcare system is outstanding, and no stories about medical workers are running out of protective clothes.

Why is the COVID-19 mortality rate tricky to measure?

The COVID-19’s mortality rate is relatively low (3.4 percent) compared to that of SARS (Severe Acute Respiratory Syndrom) with 9.6 percent and MERS (Middle East Respiratory Syndrom_ with 34 percent, as the World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus previously said.

However, the WHO boss stated when the New Coronavirus cases were around 90,893, with 3,110 deaths. As the virus continues to spread quickly, questions about the accuracy of the 3.4 percent mortality rate linger.

The mortality rate can differ from country to country as there are many factors behind it. First, some of the experts claimed that not all cases had been reported. An epidemiologist at the University of Edinburgh Mark Woolhouse claimed that if mild cases go unreported, the 3.4 percent is considered too high.

The accuracy of a massive test also plays an essential factor. One of the reasons why the numbers of COVID-19 cases in Spain are high is because of its less accurate test kits the country had used. Italy focused on testing people with severe symptoms, limiting tests for people with no or a few signs, causing the death toll to soar.

“I think that the different demographics of the populations in different countries is an important factor,”  Another factor though maybe to what extent those countries have been able to implement more widespread testing because we know that the more you test, the more you’re going to find. In South Korea for example, where they were able to rapidly ramp up the production of the tests and to test broad swabs of the population and to quickly implement quarantining of the infected people and their contacts, they were able to relatively quickly have a significant effect on controlling things or trying to control things.

“If you don’t test as much, countries that have limited testing to only the sicker patients, are not detecting the infections in the more mildly ill patients, so their overall numbers are going to be reflected very differently. They may report higher death rates in those countries that are doing only testing in the people sick enough to be hospitalized because it’s the hospitalized patients that are more likely to die of it. Whereas if you were testing a lot of people with colds who end up having COVID-19, then you’ll have a much larger number in the denominator and your death rate falls,” said Dr. Juan Dumois, Pediatric Infectious Diseases physician, Johns Hopkins All Children’s Hospital in a Newswise panel.

Second, underlying diseases that trigger a fatality. Preliminary data in China during the early period of the outbreak showed that people with cardiovascular disease have a COVID-19 mortality rate of 10.6 percent, as Our World In Data showed.

Third, the population factor. A study in JAMA quoted by Telegraph showed that 40 percent of infections and 87 percent of deaths in Italy had hit elderly patients (people above 70 years old) as of March 23.

It is difficult to tell why the death rates in some countries are high, while those in other places are low, given that lots of factors can play a role, as Prof. Eric Forgoston, mathematician from Montclair State University said.

“I’m not going to be able to speak about because it certainly depends on epidemiology and medical demography of different countries. There are a wide variety of possible reasons, again different countries their demography is different, they have different amounts of older individuals versus younger individuals, and we certainly seem to see a difference in how this disease affects younger individuals to older individuals,” Forgoston stated.