Since its emergence in late 2019, the novel coronavirus has spread swiftly across the globe. From isolated cases in Wuhan and the Hubei Province of China, COVID-19 has infected nearly 8.5 million people (as of June 18) in at least 188 countries and territories with countries including the United States, Brazil, Russia, and India hardest hit.
In attempts to curb the spread of coronavirus, many countries around the world have imposed travel restrictions beginning as early as March. Airport closures, the suspension of all incoming and outgoing flights, and nationwide lockdowns are just some public health measures that have been taken to help contain the pandemic. These measures are widespread as data from the Pew Research Center indicates that at least 93% of the global population now lives in countries with coronavirus-related travel restrictions. While the policy measures seem to be ubiquitous, the feasibility and effectiveness of such measures seem to vary based on the geographic formation of the country – especially whether the country is an island or non-island country.
While non-island countries face a discernibly larger challenge in locking down their land borders, the isolation and distance enjoyed by many island countries appear to have insulated their population from the worst of the pandemic. The geographic advantage theory is shared by Sheldon Yett, a senior representative at the United Nations, who stated in regards to island nations, “there are a number of reasons why these states have been able to avoid any infections, but the biggest is simply that they are blessed by geographical isolation.”
Seeking to validate these patterns in data, we decided to analyze whether there was any significant discrepancy in the number of cases and deaths per capita in island countries when compared to non-island countries. For our study, we used data from the European Centre for Disease Prevention (ECDC) on the number of daily cases and daily deaths from COVID-19 by country.
The math underlying the graphs was pretty simple. We normalized the case and death counts for each country relative to the country’s population size to create a per capita measurement. We then assigned countries to binary categories: island or non-island.
The first two charts illustrate the number of cases and deaths per capita of island countries vs non-island countries as well as an aggregate of both (see world column) as a control. The differences between both the number of cases and the number of deaths per capita between the two categories appear to be significant.
As of data provided on July 18, 2020, the number of cases per capita in non-island countries was about 21% higher than that of island countries. Furthermore, the data on deaths per capita is even more significant with the number of deaths per capita in non-island countries 84% higher than that of island countries.
In addition to the overall per capita case and death rates, we created time-series plots that display the average daily cases per capita and average daily deaths per capita over time in island countries vs. non-island countries. Again, the aggregate world data was plotted as a control.
As displayed by the time-series plots, the number of average daily cases and average daily deaths per capita in non-island countries appear to heavily outpace those of island countries. Since the onset of numerous travel restrictions imposed by countries in early-mid March, it appears that the rate of increase of daily cases and deaths, at least initially, increased at a much faster pace in non-island countries.
It is important to acknowledge that in a study of something as inherently complex as the transmission of the coronavirus, no one variable can be isolated as a significant indicator without the existence of a plethora of confounding variables. The causes of higher or lower case and death rates across different countries are widely contested among public health officials and experts. Many factors including but not limited to the swiftness of government response, population density, climate temperatures, and population demographics have been widely speculated upon. This theory of geographic isolation as an advantage for island countries is another factor that may be noteworthy.
Assuming that the geographic isolation of island countries is a significant deterrent in the spread of coronavirus, it is important to consider potential implications. In a worst-case scenario, the lower per capita case and death rates represent a temporary delay of an inevitable large-scale outbreak in island countries. In this scenario, unaffected island countries may see similar exponential growth in cases and subsequent overloading on their healthcare infrastructure as seen in the United States, Italy, Iran, China, etc.
A second scenario holds that the delay in the number of initial cases and deaths bought valuable time for island countries to prepare themselves to better manage an outbreak. While many non-island countries experienced the earliest wave of the pandemic, the delay in the outbreak provided island countries enough time to prepare adequate healthcare infrastructure, impose public health guidelines, and utilize the learning curve from other nations to more effectively flatten the curve.
A third scenario holds that geographic isolation has allowed countries to maintain the spread of the virus within their own borders and scathe off an influx of foreigners who may carry the virus. This may hold future policy implications in island countries moving forward as they attempt to protect their isolation. Already, Australia and New Zealand have announced the creation of a travel bubble as both countries have locked down their borders to all other international travel until 2021.
Future research on this subject might include studying other confounding factors including the policy decisions made by island country governments versus those of non-island country governments. Furthermore, researchers can look into the differences in island economies versus non-island economies and whether pressure from the tourism industry may affect lockdown practices. Finally, it would be interesting to see whether supply chains that run through island countries were less affected by the crisis.