Table of contents - J.P. Morgan

EYE ON THE M ARKET • M I CHAEL CEMB AL EST • J .P . MORG A N L ast u p dat e d 11/ 3/2 021

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1

[2] Global infection, hospitalization and mortality trends

This section analyzes COVID infections and mortality reported to local, federal and intergovernmental agencies, and are heavily influenced by testing rates and differences in government reporting standards and capabilities. Serology tests suggest that the true number of COVID infections may be much higher than the number of reported infections. However, trends in reported infections are still important to monitor, since they influence government policy and the behavior of citizens and companies.

Table of contents: 1. Summary of infection and mortality trends by region ............................................................................................. 2

2. What’s new: In the US, COVID risks among the unvaccinated ................................................................................ 4

3. What’s new: Europe .................................................................................................................................................. 5

4. What’s new: South America, Central America, Caribbean ...................................................................................... 6

5. What’s new: Asia and India ....................................................................................................................................... 7

6. What’s new: MidEast, Israel, Africa .......................................................................................................................... 8

7. What’s new: Russia and Eastern Europe .................................................................................................................. 9

8. COVID at a glance: infections and mortality per mm in the developing world ..................................................... 10

9. Infection, mortality and hospitalization snapshots ................................................................................................ 11

10. Global testing data .................................................................................................................................................. 13

11. How lethal is COVID, and for whom? ...................................................................................................................... 14

Comments on infection data. Several countries show up with almost no COVID outbreak reported. In cases like New Zealand, Taiwan, Japan, Vietnam and South Korea, we interpret the lack of a material outbreak as possible based on the quality of data reporting and testing. Other countries which report low incidence of COVID include Nigeria, Kenya, Angola, DR Congo, Tanzania and Mozambique. As per various news reports1, there‘s a shortage of reliable data in many of these countries, and the lack of funds to carry out broad testing. On the other hand, while infections can be obscured, it’s harder to obscure a sharp rise in mortality; even when accounting for some under-reporting of deaths, Africa mortality rates are still much lower than expected. The few antibody surveys conducted in Africa reveal COVID prevalence that is similar to other European countries; in other words, COVID is spreading in Africa as it is elsewhere. The most likely explanation for lower relative mortality is age: Africa’s median age is 18, compared to 35 in North America and 42 in Europe. Since those over age 65 experience 80% of COVID mortality, age distributions are the most likely reason for lower African COVID mortality rates.

On data sources. We generally use infection and mortality data from Johns Hopkins, with any exceptions noted in chart sources. While JHU data usually match sources such as covidtracking.com and Worldometers, this is not always the case. Any large differences usually work themselves out over time; even so, such differences are a warning against over-extrapolating any short term trends seen in the data. There are also patterns in some countries in which tests and infections drop over the weekend, only to rise the following week. Other anomalies: countries and US states sometimes make large one-time additions or subtractions to infections or deaths data to reflect over- or underestimations made over the course of the entire pandemic. JHU and other data providers do not amortize such adjustments over time and simply reflect them on the day they are made; we do the same.

1 Examples include “In Africa, lack of coronavirus data raises fears of silent epidemic”, Reuters, July 8, 2020; and “Corona-free? How disinformation could be clouding the true pandemic picture in Africa”, Bulletin of Atomic Scientists, September 21, 2020.

https://itunes.apple.com/us/podcast/eye-on-the-market/id1367963156

EYE ON THE M ARKET • M I CHAEL CEMB AL EST • J .P . MORG A N Coronavirus

2

Summary of infection and mortality trends by region

Delta infections are starting to rise in the developed world. Pass-through to hospitalization and mortality has been lower than during prior COVID waves due to the effectiveness of vector and mRNA vaccines, and due to the lower age of many newly infected unvaccinated persons. In the Emerging countries for which we have more confidence in reported data, mortality is tracking infections due to lower rates of vaccination. Fourth chart shows how US states currently represent most of the Global Hotspots shown below.

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Daily infections # per mm (LHS)

Daily deaths # per mm (RHS)

Developed regions

Source: JHU, IMF, JPMAM. Nov 2, 2021. 7 day smoothing.

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Hotspots: AK MT NE ND OK WV WY UK

UK vs US Hotspots hospitalizations

Source: HHS, various country sources, IMF, JPMAM. Nov 2, 2021.

Current hospitalizations, # per mm, smoothing = 7 days

0200400600800

1,0001,2001,4001,6001,800

02/20 05/20 08/20 11/20 03/21 06/21 09/21

AKMTNDMNWYSGPUKROM

Global hotspots

Source: Johns Hopkins University, IMF, JPMAM. Nov 2, 2021.

Daily infections, # per mm, smoothing = 7 days

0100200300400500600700800900

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UKHotspots: AK MT NE ND OK WV WYRussia regionEM Asia 5 (Indo, Thai, Mal, Phil, Viet)S AmericaSouthern Africa

Regions: high infections



0.02.04.06.08.0

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Hotspots: AK MT NE ND OK WV WYRussia regionUKS AmericaEM Asia 5 (Indo, Thai, Mal, Phil, Viet)Southern Africa

Regions: high mortality


Daily deaths, # per mm, smoothing = 14 days



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Countries

25 highest infection rates vs Dev World ex-US

Source: Johns Hopkins University, IMF, JPMAM. November 2, 2021.

Daily infections, # per mm; US states, top 50 countries by GDP

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25 highest mortality rates vs Dev World ex-US


Daily deaths, # per mm; US states, top 50 countries by GDP

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02/20 05/20 08/20 11/20 03/21 06/21 09/21

UK

US

Europe ex UK

CAN

US / Canada / Europe



UK

Southern Africa

EM Asia 5 (Indo, Thai, Mal, Phil, Viet)

US

Europe

Hotspots: AK MT NE ND OK WV WY

S America

Russia region

Scandinavia

C America

E Europe

M East

CAN Europe ex UK

Dev Asia

NLD

73%

17%46%

67%

74%

56%

67%

34%

75%

51%

37%

36%79% 74%77%

76%0.0

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Vaccination, mortality and infection trends by regionMortality per million people, 14 day avg; percentage = unique people vaccinated as % of population

Infections per million people, 7 day avgSource: Johns Hopkins University, IMF, JPMAM. November 2, 2021.



4

What’s new: In the US, COVID risks among the unvaccinated

• US infections, mortality and hospitalizations are rolling over • Overall hospitalization is higher for some states than during the pre-vaccination winter 2020/2021 period

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Current hospitalizations # per mm (LHS)


US

Source: JHU, IMF, HHS, JPMAM. Nov 2, 2021. 7 day smoothing.

0100200300400500600700800900

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02/20 05/20 08/20 11/20 03/21 06/21 09/21


US ex Hotspots

US hotspot states



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Hotspots: AK MT NE ND OK WV WY: hosp by age

Source: HHS, JPMAM. November 2, 2021.

Prior day admissions, 14 day average

Age group:

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AK MT WY VT ID WA OR ME CO WV UT HI ND MN NH

Current hospitalization levels vs winter 2020/2021 average15 largest ratios

Source: HHS, IMF, JPMAM. November 2, 2021.



5

What’s new: Europe

• UK Delta variant wave less severe (mortality and hospitalization) since 94% of people over 50 are vaccinated • Infections are rising in Continental Western Europe; hospitalizations and mortality showing a very small rise,

reflective of high levels of vaccination

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United Kingdom

Source: JHU, IMF, OWID, JPMAM. Nov 2, 2021. 7 day smoothing.

0100200300400500600700800900

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02/20 05/20 08/20 11/20 03/21 06/21 09/21

NLDBELDEUFRAITAESP

W Europe



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W Europe

Source: various country sources, IMF, JPMAM. Nov 2, 2021.

Current hospitalizations, # per mm, smoothing = 7 days

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Scandinavia



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6

What’s new: South America, Central America, Caribbean • Case counts and mortality have been declining sharply from very high levels. Note that Gamma and Lambda

variants have been more prevalent than Delta variant

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South America



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BRACOLCHLARGVENURUPARECU

South America



0100200300400500600700800900

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TTODOMCUBBAHJAM

Caribbean



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BLZCOSGUAPANMEXHONSLV

Central America





7

What’s new: Asia and India • Infections remain low in Developed Asia outside Singapore • Malaysia infections and deaths rolling over after spiking in September

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Other Asia



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India region



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IRNSRIINDNEPPAKBAN

India region





8

What’s new: MidEast, Israel, Africa • Israel infections and deaths are rolling over. Israel saw high levels of infection during the Delta wave despite

a 70% vaccination rate. See Section 1 on evidence of fading immunity in Israel • Africa infections have rolled over. While reported infections in Africa are lower than in India/LatAm, there

are questions about reliability of African data and many of its healthcare systems are less equipped to handle the increase in sick patients

0100200300400500600700800900

1,000

02/20 05/20 08/20 11/20 03/21 06/21 09/21

TURLEBUAEKWTSAU

Mideast



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Source: JHU, IMF, OWID, JPMAM. Nov 2, 2021. 7 day smoothing.

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What’s new: Russia and Eastern Europe

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Russia region



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10

COVID at a glance: infections and mortality per mm in the developing world

Normally we show infection and mortality data in linear terms. But when comparing across the Emerging World, the dispersions are too great to properly grasp on a linear axis so we use a log scale instead. As a reminder, on a log scale each increment represents an increase of 10x vs the prior value. To be clear, there are substantial uncertainties regarding the accuracy of COVID infections and deaths reported in some countries; this chart shows the data as reported by Johns Hopkins.

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AfricaEM AsiaS AmericaC AmericaM EastE Europe

Infection and mortality trends in Africa, EM Asia, S America, C America, M East, E Europe


Mortality per million people, 14 day average, log scale

Infections per million people, 7 day average, log scale



11

Infection, mortality and hospitalization snapshots The charts below show current rates of infection and mortality compared to the rate 21 days ago and the case fatality rate for the 50 largest countries based on GDP. These countries represent 94% of global GDP.

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Infection rate 21 days agoCurrent infection rate

Infection levels for the largest 50 countries based on GDPSorted by trailing 7 day average infection rate per mm people

Source: Johns Hopkins University, IMF, JPMAM. Countries shown represent 94% of World GDP. November 2, 2021.

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Mortality rate 21 days ago

Current mortality rate

Mortality levels for the largest 50 countries based on GDPSorted by trailing 14 day average mortality rate per mm people


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NCase fatality rates for the largest 50 countries based on GDPSorted by case fatality rate (mortality divided by reported infections)




12

The charts below show current rates of infection, mortality and hospitalization compared to the rate 21 days ago for the 50 US states and DC.

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Infection rate 21 days agoCurrent infection rate

Infection levels for US statesSorted by trailing 7 day average infection rate per mm people


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Mortality rate 21 days ago

Current mortality rate

Mortality levels for US statesSorted by trailing 14 day average mortality rate per mm people


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Hosp. rate 21 days ago

Current hosp. rateHospitalization levels for US statesSorted by trailing 7 day average current hospitalizations per mm people

Source: HHS, IMF, JPMAM. November 2, 2021.



13

Global testing data The charts below track infection, hospitalization, testing2 and mortality data for the US in aggregate as well as a comparison of testing levels across the largest 50 countries by GDP. See section 3 for a chartpack which covers the full range of infection, hospitalizations and mortality for countries and US states.

2 40 states report the total number of “testing encounters” or “testing specimens”; the rest show the number of people tested each day that have never been tested before or include untested probable cases. We only compute testing rates for the 40 states that provide encounter or specimen data.

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Daily infections levels (LHS)

Current hospitalizations levels (LHS)

Daily deaths levels (RHS)

US


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US testing states

Positive testing rate

Source: Johns Hopkins University, JPMAM. Nov 2, 2021.

Daily infections, % of total tests, smoothing = 7 days

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US testing states

US testing: 40 testing states


Daily tests, # per mm, smoothing = 7 days

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Testing rate 21 days ago

Current testing rate

Testing levels for the largest 50 countries based on GDPSorted by trailing 7 day average testing rate per mm people

Source: OWID, JHU, IMF, JPMAM. Countries shown represent 94% of World GDP. November 2, 2021.



14

How lethal is COVID, and for whom? Let’s first compare it to the flu. A key issue to keep in mind: there’s a difference between case fatality rates (deaths as a % of reported cases) and infection fatality rates (deaths as a % of all infected people, whether symptomatic or not). The latter can only be derived through antibody testing and other sampling methods involving molecular assessments of infection. The IFR of the seasonal flu is reported to be well below 0.1% with other estimates ranging from 0.02% to 0.04%. In contrast, the IFR for COVID has been estimated at 0.23% by Stanford’s Metaresearch Innovation Center, and at 0.7%-0.9% by the CDC. Either way, COVID is significantly more lethal than the seasonal flu. Tracking “excess” abnormal death levels is another way to understand the incremental mortality impact of COVID (see second chart). In addition to higher mortality than the flu, COVID also appears to entail more longer-lasting medical complications (see web portal section 5).

Mortality by age in the US The first section in the table below shows the distribution of US COVID deaths by age bracket. People over the age of 85 represent around 30% of all COVID fatalities to-date. However, the number of people over age 85 is much smaller than other age cohorts; as a result, fatality risks are much greater for people in this age group. The second section reflects this by showing deaths to date per mm people in each age bracket (you can divide one number by another to obtain relative mortality probabilities). The third section looks specifically at mortality risk across age brackets relative to older populations. For example, a person aged 55-64 is only around 14% as likely to die from COVID compared to someone over the age of 75, and only around 8% as likely to die as someone over the age of 85. Differences across states are generally minor.

WHO Oxford CDC

Stanford Meta-Research

Innovation Center (global)

University of Wollongong

(global)CDC US

Pandemic Planning Scenario

CDC US Seroprevalence

Survey

Imperial College London

(global)

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

Flu vs COVID-19 infection fatality rates%, estimated infection fatality rate

Source: CDC, WHO, Stanford, Oxford, Imperial College London, University of Wollongong. 2020.

Seasonal influenza COVID-1940,000

50,000

60,000

70,000

80,000

90,000

2017 2018 2019 2020 2021

Actual deaths from all causesThreshold for excess deaths

Tracking US excess deaths from COVIDTotal deaths per week

Source: CDC, JHU, JPMAM. October 23, 2021. Dots are estimated using most recent JHU data.

DISTRIBUTION OF ACTUAL MORTALITY: Mortality to-date by age group, % of total mortality< 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65-74 yrs 75-84 yrs > 85

United States 0.0% 0.0% 0.0% 0.2% 1.0% 2.6% 6.4% 14.1% 22.6% 26.1% 27.0%

MORTALITY RATES FOR EACH AGE BRACKET: COVID deaths to-date per mm population in each age group< 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65-74 yrs 75-84 yrs > 85

United States 36 4 4 41 164 457 1,147 2,452 5,286 12,046 30,076

RELATIVE MORTALITY RISK: risk of dying across age brackets< 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-34 yrs 35-44 yrs 45-54 yrs 55-64 yrs 65-74 yrs 75-84 yrs > 85

Relative to 85+ 0.1% 0.0% 0.0% 0.1% 0.5% 1.5% 3.8% 8.2% 17.6% 40.1% 100.0%Relative to 75+ 0.2% 0.0% 0.0% 0.2% 1.0% 2.6% 6.6% 14.2% 30.6% 100.0%

Source: CDC, JPMAM. October 23, 2021.



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