FEATURE | Covid-19 in the NMI vs the rest of the world

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COMPARED to the rest of the world, Saipan and the CNMI are faring quite well. 

Covid-19 testing levels here are higher, while disease rates and death rates are lower than most other parts of the world.  As I have previously blogged (, Saipan is especially vulnerable to Covid complications, as they occur at much higher rates in those with diabetes.  Since Saipan has one of the highest rates of diabetes in the world, we need to be especially careful here.  In the following paragraphs I will outline how the CNMI compares to other parts of the world in terms of Covid-19 testing rates, rates of disease, and of course death.

Covid-19 testing

So far the CNMI has tested 1,480 people for Covid-19 infection.   Directly comparing this to other parts of the world can be difficult.  Most studies will list findings in testing per million population.  Maybe my epidemiology skills just aren’t strong enough, but I have trouble picturing what a gathering of a million people would look like.  I can, however, easily picture 1000 people.  Therefore, most of the numbers I discuss will be in cases per thousand population.  As the estimate of our CNMI population is 56,682, doing the math tells us we have done 26 Covid tests for every thousand people living here.

Most countries have done far less than this.  I will list a few below, again this per thousand people.

  1. CNMI 26
  2. Italy 34
  3. USA  21
  4. Turkey 12
  5. South Korea 12
  6. India 4
  7. California 1.9
  8. Japan 1.4
  9. Philippines 1.0

Only a handful of countries have done more testing per capita than the CNMI.  These include Iceland, Estonia, and Italy.

Another interesting comparison is to other U.S. territories.  Guam has done comparatively well, but lags behind the CNMI.  In order of the number of tests per thousand population.

  1. CNMI 26
  2. Guam   19
  3. U.S. Virgin Islands 10
  4. American Samoa      1
  5. Puerto Rico    0.4


The CNMI has done more Covid testing per person than almost everywhere else in the world.  Guam is not too far behind, but CNMI has tested 26 times more than American Samoa, thirteen times more than California, and 60 times more than Puerto Rico.

I consider the level of testing done in the CNMI thus far to be quite remarkable.  We should all be very proud of our first responders, the leadership of CHCC as well as the governor’s Covid-19 task force.  They had very limited resources to work with, and clearly maximized them.  This accomplishment is even more extraordinary when you consider that other parts of the world all had a significant head start.   Our first Covid case was announced on March 28.  The U.S. as a whole had it’s first case in early January.  Many, many other countries had a very slow start to their testing, not the CNMI.  It is also important to consider that the Virgin Islands, Puerto Rico, and Guam are much wealthier than the CNMI.

Covid prevalence

So far 14 people have been diagnosed with Covid-19 in the CNMI.  This is less than one person per thousand (0.25).  About 1 of every 4,000 people in the CNMI has been diagnosed.  Most parts of the world are much worse than this, here is a partial listing of cases per thousand population.

  1. CNMI 0.25
  2. Spain 5.3
  3. USA 3.7      
  4. Italy 3.5
  5. Great Britain 2.8
  6. South Korea 0.21
  7. Japan 0.12   

From the above you can see that most major countries in Europe, as well as the United States have between 15 to 20 times more cases per thousand than the CNMI.  Among Major countries only South Korea (barely) and Japan have a lower prevalence than Saipan.

Now a comparison to other U.S. territories: Covid cases per thousand population.

  1. CNMI                         0.25
  2. Puerto Rico  0.60
  3. U.S. Virgin Islands    0.62
  4. Guam   0.89
  5. American Samoa   zero

In other words, most of the other territories have 2.5 to 3.5 times more cases per thousand than us in the CNMI.

Deaths from Covid

So far two people have died from Covid-19 infection in the CNMI.  With so few cases, statistical analysis is difficult, and even one more case can dramatically change the numbers.  I will list a few anyway.  2 deaths in the CNMI is equivalent to 1 in 28,000 or (0.04).   Because the numbers are so small I will use deaths per 100,000 for comparison purposes:

  1. CNMI 3.5
  2. Guam 3.6
  3. Spain 54
  4. Italy 48
  5. Great Britain 43
  6. United States 21
  7. South Korea 0.5
  8. Japan 0.4

Most countries have a death rate from Covid-19 between 7 and 17 times higher than the CNMI.  Guam and Saipan are very similar to each other, while South Korea and Japan have extraordinarily low death rates compared to virtually anywhere else.

Overall, these findings have been highly reassuring to me.  Of course great caution and care is still needed, things could easily get worse.  I had feared it would be far worse at this point.  I will encourage my friends at CHCC and the governor’s task force to keep up the good work.  What has been accomplished so far with testing is simply amazing.

Don Hardt is an eye doctor and the first certified diabetes educator in the NMI.  He graduated with a doctor of optometry degree from the University of California, Berkeley in 1992, and has been practicing on Saipan, Tinian and Rota since 2000. For more information go to


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