Is Singapore the best COVID-19 fighter?

I’ve looked into the Singaporean figures on COVID-19, since they are critical to a recent paper by Jan Frederick Cruz—publicized by the media as “the Ateneo study”—suggesting that 98 percent of the COVID-19 cases in the Philippines in the second quarter of 2020 went undetected (see his “An empirical argument for mass testing: crude estimates of unreported COVID19 cases in the Philippines vis-à-vis others in the ASEAN-5,” Working Paper No. 2020-14, Ateneo de Manila University Department of Economics and Ateneo Center for Economic Research and Development, 8/18/20).

Cruz favors estimating the true number of Philippine COVID-19 cases by multiplying the number of reported Philippine cases by the ratio of the Philippine death rate to the Singaporean death rate. A death rate is the proportion of confirmed fatalities to confirmed cases.

He says he made Singapore the “baseline” because it has the lowest death rate in the region. Using worldometers.info as my source, as of 8/27/20, I see that Singapore has 5 deaths/1M, out of a very large 9,658 cases/1M, where /1M means per million of the population. Dividing the deaths by the cases gives a Singaporean death rate (let’s call it SinD) of 0.05 percent, meaning only 5 deaths per 10,000 cases. This points to Singapore as the best COVID-19 fighter, in terms of the rate of survival of confirmed cases.

On the other hand, the Philippines has 29 deaths/1M, out of 1,843 cases/1M, implying a Philippine death rate (let’s call it PhD) of 1.57 percent, meaning 157 deaths per 10,000 cases.

The PhD is roughly 30 times the size of the SinD. This means, by Cruz’s formula, 29 unreported cases for every 1 reported, or an astounding undercounting rate of 29/30 = 96.6 percent; hence the great publicity received by his paper.

In the Asean region, the Singapore case rate is the largest by far, and the Philippine case rate is the next largest. Other case rates in Asean, all /1M, are: Indonesia 595, Malaysia 283, Thailand 49, Cambodia 16, Vietnam 11, Myanmar 11, and Laos 3.

Incidentally, the world case rate is 3,148/1M, showing that all Asean rates are much lower, except for Singapore, which is very much higher. World deaths are 106.9/1M, or 3.40 percent of the cases, or 340 deaths per 10,000 cases.

The death rates of the other Asean countries, in relation to their number of cases, are: Indonesia 4.20 percent, Malaysia 1.39 percent, Thailand 1.63 percent, Vietnam 2.72 percent, and Myanmar 0.91 percent. I see the PhD of 1.57 percent as in the center of the Asean cluster; only Malaysia and Myanmar are lower. I computed these death rates from the deaths and cases in worldometers. Cambodia and Laos have no reported deaths, and I don’t want to assume they are zero.

Singapore is the great exception of Asean, because it has an extremely low death rate, as well as a very high case rate. I guess Cruz also wants to emphasize that Singapore is the most massive COVID-19 case-counter, due to its having done one test for every 3 Singaporeans.

Elsewhere in Asean, based on worldometers, there has been 1 test for every 27 people in Malaysia, 46 in the Philippines, 93 in Thailand, 97 in Vietnam, 133 in Indonesia, 193 in Laos, and 363 in Myanmar. That shows a decent testing effort in the Philippines, relative to its neighbors.

Increased testing in the Philippines will certainly discover more cases. But I don’t see how testing in itself lowers the PhD. South Korea’s testing is 1 out of 28, yet its death rate is 2.72 percent. Testing is 1 out of 4 in Russia; its death rate is 1.72 percent. Testing is also 1 out of 4 in the United States; its death rate is 3.06 percent.

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