A few small grains of truth

"The millions of cases in the U.S. were not inevitable. And of course that means the hundreds of thousands of deaths weren’t inevitable either," writes NCSE Executive Director Ann Reid as she demonstrates—using rice—the high number of COVID-19 cases in the U.S. compared to other countries.


Check out our entire series explaining the science involved in the coronavirus pandemic. Sign up to receive our coronavirus update each week.

This week, a story in pictures.

I have to tell you, digging into some aspect of the coronavirus pandemic every week can be emotionally difficult. I mean, living through it is bad enough, right? But then also to look carefully at what is happening in detail brings, for me, at least, another level of strain. Sometimes it makes me scared; sometimes, frankly, it makes me furious. And this is one of those furious weeks.

It seems like a lot of Americans have a fatalistic attitude toward the pandemic, as though it came out of nowhere, could not have been anticipated, and cannot really be controlled. If this were true–if nothing we could have done, could do now, or could do in the future could really make much of a difference–then an argument along the lines of “it’s not worth destroying the economy with restrictions on everyday activity” would make sense.

But this is just so maddeningly wrong. And this makes me so mad, because so many people are sick and dying when they didn’t have to be—and our economy is nevertheless taking a beating.

Right now, this fatalistic attitude is reinforced by the fact that the virus seems to be surging everywhere, and even places that had their outbreaks largely under control are experiencing new surges. So nothing makes a difference, right? But in fact these outbreaks are not at all at the same scale, and states and countries are imposing new restrictions at dramatically different levels of new cases.

I was trying to figure out how to get across the idea that different places have had dramatically different experiences with the pandemic and I thought I’d return to my old standby of 10×10 matrices of pasta. But it turned out that the magnitude of the differences among different places was just too enormous to illustrate with pasta. So I turned to my next favorite starch: rice.

In the following photos, each grain of rice represents one case of coronavirus per 100,000 people, since the beginning of the pandemic (all numbers come from the Johns Hopkins COVID-19 Tracker). I don’t claim comprehensiveness here, but as far as I can tell, the country with the fewest cases per 100,000 is Taiwan at three, followed by New Zealand at 43. South Korea, Hong Kong, and Australia also have case rates per 100,000 that are low enough to justify counting out individual grains of rice.

Taiwan through Australia

For the rest of the examples, I enlisted the assistance of a highly trained scientist (thanks, honey!) who came up with a methodological breakthrough involving counting the number of grains of rice in a tablespoon. The answer was about 500. (We used short grain rice. If you want to reproduce the experiment with long-grain, or get really fancy with arborio or Pusa 1121, you’ll have to do your own calibration. But you can’t use black forbidden rice, for obvious reasons.)

So now let’s turn to some European countries, where the case rates per 100,000 are fairly similar across the continent:

Taiwan, France, Poland

Where does the U.S fit in? Well, on average, the U.S. has about 30% more cases per 100,000 than most European countries.

France, US

But, of course, the U.S. is a big country, and states have taken wildly different approaches to trying to slow the spread of the virus. Some states are doing considerably better than average, with Vermont among the lowest case rates. (Check out this story comparing South Dakota with Vermont.)

California, Washington, Vermont

On the other hand, some states have done far worse than average. Remember Taiwan, at 3 cases per 100,000? It’s represented on the left in the photo below. On the right is North Dakota, at 10,936 cases per 100,000. And while North Dakota has the highest number, it’s not exactly an outlier. South Dakota clocks in at 9,828, Kansas at 6,077, and Florida at 4,999.

Taiwan v. North Dakota

So there you have it. The reason that some weeks I just get spitting mad. The millions of cases in the U.S. were not inevitable. And of course that means the hundreds of thousands of deaths weren’t inevitable either.

How did Taiwan keep its numbers so low? It’s not that Taiwan is sparsely populated–it has 1,742 people per square mile. By contrast, the U.S. has 94 people per square mile. And North Dakota has only 10.2! It’s not that there isn’t a lot of travel between Taiwan and the rest of the world—according to Wikipedia, Taiwan gets some 10 million visitors each year. It’s not because Taiwan has shut down its economy and locked everyone in their houses since March 2020. On the contrary, while early shutdowns were strict, the Taiwanese economy has been pretty much fully open for months and, in contrast to the rest of the world, is even expected to show growth of over 1.5% in 2020.

I try not to rely too much on anecdotes—after all, the plural of anecdote is not data—but I heard a story yesterday that goes a long way toward explaining how Taiwan kept its numbers so low. A friend told me about a young man from Taiwan who decided back in March 2020 to return to his home country to ride out the pandemic (a wise choice, it turns out). When his flight from the U.S. arrived, he was met by health officials at the airport. He was put in a taxi by himself that took him straight to his apartment. He was given a bag of groceries and a phone number to call if he needed anything. He was not to leave his apartment for 14 days. Then he was free to go about his business.

Perhaps that sounded draconian at the time, but as we now enter our ninth month of restrictions, with schools and businesses struggling and hospitals strained across the country, the results are clear. Community transmission can be interrupted, with brief but comprehensive shutdowns followed by intensive testing and tracing. Then life can return to normal.

It just didn’t have to be this way. And that makes me spitting mad.

NCSE Executive Director Ann Reid
Short Bio

Ann Reid is a former Executive Director of NCSE.