1

Comparative COVID-19 epidemic trajectories in 7 countries

(China, South Korea, Italy, France, Spain, Germany and

Sweden), brief

François Robin-Champigneul1

News:

New confirmed cases seem to have resumed their decline in Italy and Germany (after a

resurgence in mid-June), but not in France and Spain. New deaths are still decreasing in

all of these countries and are now especially low in Spain.

In Sweden, the weekly numbers of deaths and cases are still much higher than in

neighboring countries.

China is taking drastic measures to contain the outbreak in Beijing's Xinfadi market.

Worldwide, 33,746 new deaths attributed to COVID-19 were counted in the last seven

days, compared to 33,777 a week earlier, according to the European CDC figures.

This brief is an update of the note entitled “COVID-19 epidemic trajectories and health measures,

comparison between 6 countries: China, South Korea, Italy, France, Spain and Germany”2 (see this

document for the references). This format is intended to be short in order to allow frequent and

synthetic update to complement the more developed version.

1 DEATH CURVES & TIMELINE OF MEASURES TAKEN

The number of deaths3 is a better indicator of the local pandemic development for international

comparison than the number of cases, which depends on the testing extent, which varies a lot from

one country to another, although the tests tend to become more and more generalized.

The mortality curves presented here are aligned between countries on the day of the 25th death,

except for South Korea which has been aligned with China, Italy and France on the date of the 2nd

death4. In this reference frame, the 25th death occurs on day “9” (except for South Korea), and the 2nd

Korean, Chinese or Italian death occurs on day “2”, according to a time origin that has been

arbitrarily defined in this way but does not constitute the beginning of the epidemic. The death dates

are here when the deaths were counted, since only Sweden always provides the actual death date.

1 PhD student in health data analysis, Associate member of the Laboratoire de Sciences Actuarielle et

Financière (SAF), ISFA, University of Lyon 1, MSc. (Telecom SudParis). 2 F. Robin-Champigneul, COVID-19 epidemic trajectories and…, #17, 5 April 2020 (online on the INED website).

3 Disclaimer about the deaths data: in none of the countries studied do the counted deaths fully represent

the mortality due to COVID-19. Depending on the country, only deaths of persons confirmed to be COVID+, or deaths transmitted electronically, or in-hospital deaths, etc. are counted. These figures should therefore theoretically be corrected by a multiplicative factor which remains difficult to determine to date. However, the shapes of the mortality trajectories should not be fundamentally changed. 4 The temporal alignment between countries is dependent on the completeness of the deaths, and on their

counting delay, since the day of the 25th

death counted, and of the 2nd

death, are such dependent.

Brief #16 1 July 2020

2

In this reference frame, in South Korea the first epidemic outbreak occurred 36 calendar days after

China, and then successively in Italy on the next day, in Spain 8 more days later, in France on the day

after Spain, in Germany 8 additional days later, and then in Sweden 6 days after Germany.

This reference frame is used both for the curves that follow and for the health measures timeline

which indicates the main measures taken in the countries, presented in the brief #2 and the note #17.

The main measures taken by Sweden were presented in brief #12 (and again in #13 & 14).

Cumulative deaths (top) and daily deaths (bottom), in logarithmic scale, in China, South Korea, Italy, Spain,

France, Germany and Sweden. Sundays are marked by diamond-shaped dots. Some deaths which were added with

several days of delay in the official counts without being broken by date are included only in the cumulative figures.

The initial trend of the daily deaths follows a similar exponential progression in all countries. Then, after strong

containment measures, the curves begin an inflexion as the epidemic decelerates, reaching a plateau in the

number of daily deaths, and then begin a descent (current situation in Italy, Spain, France and Germany), with, in

China, an acceleration and then a slowdown. The only exceptions are South Korea, where the number of deaths

has stabilized very quickly, and Sweden, where the inflexion and the descent are slower.

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2 THE EPIDEMIC BY COUNTRY

≤ 0,5 m> 0,5 m

< 2 m≥ 2 m

China 1 400 050 000 146 30 June (168) 4 634 3 96 0 4 0 0.0%

South Korea 51 780 579 518 30 June (132) 282 5 90 0 10 0 -50.0% 2.1%

Italy 60 359 546 * 200 1 Jul (132) 34 788 576 45 38 17 22 -41.2% 2.6%

Spain 47 026 208 * 93 30 June (123) 28 363 603 48 32 20 5 N/A 0.7%

France 67 063 703 106 30 June (122) 19 326 288 34 42 24 16 -19.7% 3.2%

Germany 83 019 213 * 232 30 June (114) 8 985 108 8 92 0 10 -15.5% 4.4%

Sweden 10 327 589 23 1 Jul (109) 5 370 520 26 74 0 23 -4.2% 21.4%

% of the population

living in regions where

this rate is:

New daily deaths

7-day

averag.

Weekl.

variat.

% of

the

peak

Deaths

/

million

inhab.

(m)

Country

Population

on 1 Jan 2020

(*: 1 Jan 2019)

Density

(inhab.

/km2)

Data cut-off

date (day in

the

reference

frame)

Cumula

-tive

deaths

China 127 18 Fev (35) 19 83 534 15 -37.0% 29 %

South Korea 7 28 Mar (38) 25 12 850 45 -6.5% 34 %

Italy 814 2 Apr (42) 41 240 760 193 -15.9% 87 -18.7% 4 068 3 Apr (43)

Spain 817 2 Apr (34) 36 249 659 368 7.1%

France 514 8 Apr (39) 35 164 801 505 -0.5% 574 -12.2% 7 019 8 Apr (39)

Germany 233 20 Apr (43) 31 194 725 468 -23.2% 337 0.0% 2 922 18 Apr (41)

Sweden 107 24 Apr (41) 61 69 692 1 053 -5.1% 137 -28.3% 558 25 Apr (42)

Cumula

-tive

confirmed

cases

New confirmed cases Patients in intensive care units

7-day

aver

-age

Weekl.

variat.

%

impor

-ted

Current

number

Week.

variat.Peak

Peak date

(day of the

reference

frame)

Days for

returning

under 25%

of the peak

Country

Deaths peak on 7-day average

Daily

num

-ber

Date

(reference

frame day)

IN CHINA (MAINLAND), the last COVID-19 death was on April 14, according to the last count published on 30 June,

although the media reported the death of Dr. Hu Weifeng on 2 June in Wuhan, infected in January. Since the

detection, on 11 June, of an epidemic outbreak at the Xinfadi wholesale food market, which supplies 90% of

Beijing’s agricultural products, drastic measures have been taken: market’s closure for disinfection, lockdown of

the surrounding neighborhood and of the Anxin district, massive testing of the population (nearly 500,000 tests

per day in Beijing), 28-day quarantine for people linked to the beef and sheep market, to which 54.3% of Beijing

cases have been linked. The number of new confirmed cases is now sharply declining.

IN SOUTH KOREA, the new cases count remains at an elevated level since the end of May. However, like in China,

the number of new cases remains low compared to those in the European countries.

IN ITALY, SPAIN, FRANCE AND GERMANY, the new deaths and ICU patients’ figures are still decreasing, but the decrease

in new cases has stopped in mid-June, with the emergence of larger clusters. This decrease, however, seems now

to have resumed in Italy and Germany. Spanish authorities completed the revision of death counts on 18 June and

have since published the revised figures, however have not published the historical series other than at national

level and in graphical form. Spanish deaths and cases, from 21 May on, are counted here by date of publication.

Spanish daily deaths are now particularly low, 0.7% of the peak, which could be explained by the fact that Spain

has been easing lockdown very gradually, by region (only on 21 June were gatherings of more than 15 people

allowed again in Madrid). In France, 10,487 deaths were counted in medico-social services and institutions (ESMS),

in addition to the in-hospital deaths reported here, that is a total of 29,823 (445 per million inhabitants).

IN SWEDEN, the number of new deaths is still much higher than in the neighboring countries (161 deaths recorded

in the last seven days, for 10 million inhabitants, versus 165 deaths, for 144 million inhabitants, in all neighboring

countries), which seems to be due to the fact that no strict lockdown has ever been put in place in this country.

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3 COMPARISON BETWEEN 10 REGIONS OF CHINA, ITALY, SPAIN, FRANCE, GERMANY AND SWEDEN

Cumulative deaths (top) and daily deaths (bottom), in logarithmic scale, for 10 regions from 6 countries.

Hubei 59 270 000 319 4 512 76 97.4 % 0 0.0% 122 18 Fev (35) 19

Lombardy 10 060 574 * 422 16 650 1655 47.9 % 9 -39.6% 2.1% 446 1 Apr (41) 30

Friuli Venezia Giulia 1 215 220 * 155 345 284 0.99 % 0 0.0% 1.7% 9 3 Apr (43) 35

Madrid community 6 663 394 * 830 8 427 1265 29.7 % 2 N/A 0.5% 304 29 Mar (30) 30

Grand Est 5 511 747 96 3 563 646 18.4 % 2 -39.3% 2.5% 97 9 Apr (40) 30

Île-de-France 12 278 210 1022 7 441 606 38.5 % 5 -30.6% 2.3% 216 10 Apr (41) 28

Brittany 3 340 379 123 259 78 1.34 % 0 0.0% 1.8% 8 16 Apr (47) 12

Bavaria 13 076 721 * 185 2 594 198 28.9 % 2 -50.0% 3.4% 67 18 Apr (41) 33

Stockholm county 2 377 081 420 2 303 969 42.9 % 3 -47.1% 4.4% 58 21 Apr (38) 31

Götaland 4 932 857 24 1 642 333 30.6 % 12 1.2% 41.9% 28 13 May (60) >49

Days to get

<25% peak

7-day

avera.

Weekl.

variat.

% from

peak

Daily

nb

Date (ref.

frame day)

Region

Population on

1 Jan 2020

(*: 1 Jan 2019)

Density

(inhab.

/km2)

% of

countr.

deaths

New deaths Deaths peak on 7-day averageCumula

-tive

deaths

Deaths

/millio.

inhab.

The situation in the first nine regions presented above had been analysed in the briefs #11 and #12.

ACKNOWLEDGEMENTS: Jean-Marie Robine, Michel Allard, Frédéric Planchet, Édouard Debonneuil, Anne Granier-Blanc,

Maxime Ben-Brik, Stéphane Loisel et Cyril Robin-Champigneul.