In Vikings' Dec. 17 comeback against the Colts, a lesson for COVID predictions

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In a recent NFL game, the Indianapolis Colts led the Minnesota Vikings 33-0 at halftime. At that point, Las Vegas was offering odds better than 100-1 the Colts would win, but the Vikings staged a furious second-half rally and won on a field goal in overtime. It was one of the biggest comebacks in NFL history and proved once again that it is not always possible to predict the outcome of an event before it ends.

The same is true of the COVID-19 pandemic as it enters its fourth year. In May 2020, Business Insider CEO Henry Blodget and journalist David Plotz wrote: "Back in January, the United States and South Korea each identified their first confirmed coronavirus case on the same day. South Korea responded immediately and competently, by testing, tracing, and isolating cases and getting ahead of the epidemic. The United States … never marshaled the strong federal response that could have slowed the outbreak before it really got rolling. Three months later … South Korea is close to exterminating the virus."

In early 2021, Pulitzer Prize-winning science writer Lawrence Wright critiqued the U.S. COVID-19 response: "We did the worst job in the world." Blodget, Plotz and Wright were merely echoing common sentiments of many medical observers that the U.S. had controlled COVID-19 less capably than any other country.

That was then; this is now. According to Worldometer, an independent website that has provided COVID-19 statistics throughout the pandemic, at least 30 and possibly as many as 50 industrialized countries have had more COVID-19 cases per capita than the U.S. has had. (The number depends on whether small island nations are included.)

As 2020 ended, the U.S. accounted for 25% of the world's COVID-19 cases. Now it accounts for just over 15%, and the fraction is dropping steadily. Some countries that were initially lauded for their COVID-19 response — Singapore, New Zealand and the Czech Republic — have long since passed the U.S. in cases per capita. And South Korea, which was supposedly close to exterminating the virus? Overall cases per capita are now higher than in the U.S. South Korea currently has one of the highest case totals in the world.

This should not be taken as evidence the U.S. has improved its response dramatically; rather, the newer variants have obviously caught up with other countries. Omicron and subsequent variants have overwhelmed many countries least affected in 2020, despite their policies of social distancing, vaccination and masking.

Since the fall, Japan has had the highest absolute case total in the world. In the first year of the pandemic, Japan had a quarter of a million cumulative cases; it now has more than 100 times that number.

Unfortunately, the U.S. trend line of deaths per capita isn't falling as dramatically as the trend line for total cases. The U.S. is currently 16th in the world in deaths per capita and moving up, behind only Peru and countries in Eastern Europe. For comparison: Deaths and mortality, which is total deaths divided by total cases, are dropping in the U.S. but much slower than in the rest of the world. In addition, according to a study in the journal Nature, during the pandemic the U.S. has had one of the world's highest rates of excess deaths — that is, the number of observed deaths from all causes beyond the expected number if the pandemic had not occurred.

There is no obvious reason U.S. mortality and deaths per capita are higher here than in most of the world. It has little or nothing to do with the varying quality of medical care globally, as some postulated early in the pandemic. Vaccination rates are probably a partial reason — the U.S. rate is lower than in many industrialized countries — but overall, U.S. vaccination rates are higher than those of many countries with lower death rates and lower mortality rates.

The major reason U.S. death rates are comparatively high is probably the high number of high-risk, susceptible patients in its population — a relatively higher percentage of patients who are elderly, obese or immunocompromised than in most other countries. Regardless of the caustic criticism leveled by many science journalists and medical experts, we can't remake the nation's demography. Yes, giving booster shots to high-risk individuals will improve things but will not solve the problem.

Clearly, there are forces at work that no can understand completely. As bettors cocksure the Colts would trounce the Vikings could have told you.