Almost every country in the world is by now keeping a close eye on the daily changes in coronavirus cases and where they find themselves on the COVID-19 curve.

But it is important to understand the limitations of this case data, especially when comparing different countries.

A new COVID-19 report by the Caribbean Development Bank, for example, shows that Montserrat and the Cayman Islands have by far the highest number of coronavirus cases on a per capita basis in the Caribbean.

Cayman cases

Cayman currently has 66 cases, with one death related to COVID-19. Seven of the infected have recovered, resulting in 59 active cases in the islands. Cayman has a population of about 65,000. Montserrat recorded 11 coronavirus cases for a population of less than 5,000.

Like all global data about coronavirus cases, this information must come with the caveat that results are highly dependent on the level of testing. Countries that conduct more COVID-19 tests are more likely to find cases of infection.

Montserrat and Cayman have the highest number of COVID-19 cases on a per capita basis in the Caribbean. But this is likely to be the result of the high level of testing relative to the size of their respective populations.

Small island nations are also in a better position to test a larger share of their population, if they have the necessary infrastructure. Or if they have the ingenuity and good fortune, like Cayman, of obtaining an order of tests large enough to test the whole population several times over.

Given that Cayman and Montserrat are leading the Caribbean in coronavirus testing per capita, the number of cases relative to the population is a reflection of this high level of testing rather than the virulence of COVID-19.

Although Cayman has analysed only 778 coronavirus tests, this is just slightly less on a per capita basis than the US, which has tested about 3.9 million Americans. Montserrat’s meagre number of 36 tests in total still means it has carried out the second most tests in relation to its population in the Caribbean.

Massive under-reporting

Bermuda is another example for how testing influences case data. The island in the Atlantic, which is not part of the Caribbean Development Bank report, has slightly more coronavirus cases per capita than Cayman, with 81 reported infections and five deaths. Bermuda, like Cayman, has tested about 1% of its population.

Despite conducting far fewer tests than its European neighbours, the UK is currently overtaking Italy as the country with the highest number of active COVID-19 infections in Europe.

On a per capita basis, this is about 15 times more than Jamaica, a country that has reported just under 200 cases for a population of 3 million.

Outside of the region, the UK COVID-19 data showed that a low initial number of infections, compared to other European countries, was merely the result of inadequate testing. Even now, the UK has tested only half a million people. This is about a third of the tests conducted by Germany, Spain or Italy on a per capita basis. Yet, the UK is about to overtake Italy as the country with the second-highest number of active cases in the world, trailing only the US.

Iceland is the worldwide leader in COVID-19 testing. The small island nation has carried out more than 45,000 tests for its population of 353,000. The Faroe Islands and the Falkland Islands follow in second and third place, respectively, having tested 12.3% and 9.2% of their populations.

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