The US Ranks 14th in International Comparison of COVID-19 Fatalities

The United States has more COVID-19 cases and more fatalities than any other country in the world, but given the size and age distribution of the US population, it is not surprising that there are more COVID-19 fatalities in the US than in many countries in Europe and South America. A meaningful international comparison of the impact of COVID-19 requires a comparison that controls for the size and age distribution of a country’s population, as well as other underlying health factors that could mean a country’s population faces a higher risk from the pandemic.

In this article I measure confirmed COVID-19 fatalities by country, as reported by the Johns Hopkins COVID-19 Dashboard as a proportion of the expected mortality in 2020 in each country as estimated by the World Population Review. The COVID-19 fatality rate I report equals the number of fatalities due to confirmed COVID-19 cases, as a percentage of the fatalities that would have been expected, absent the pandemic, in 2020.

Figure 1

For example, in the US, as of July 19, there were 140,534 confirmed COVID-19 fatalities, which is 4.83% of the number of deaths that would have been expected in 2020, absent the pandemic (almost 2.91 million). As illustrated in Figure 1, using this COVID-19 fatality ratio, the US ranks 14th internationally between France and Qatar. Belgium has the highest number of COVID-19 fatalities relative to the expected mortality in each country. Eight of the 20 most severely impacted countries are in Europe, with four countries each from North America, South America, and the Middle East. To understand how severely the pandemic has already affected Belgium, the US is currently suffering through an average of about 771 COVID-19 deaths per day (up substantially from 471 deaths per day in early July), but would only reach Belgium’s current situation if there was no improvement in COVID-19 fatalities over the next 20 weeks (until about December 10).

Figure 2 shows that there are quite large differences in the impact of COVID-19 in different regions in the world. In Asia and Oceania (Australia, New Zealand, Papua New Guinea and Fiji) COVID-19 deaths have been less than a fraction of one percent of the expected mortality in 2020. North America, South America and Europe have experienced the most significant impact of COVID-19.

Figure 2

Figures 3-7 show the impact of COVID-19 on mortality by country within each region. Figure 3 shows that despite the variation in COVID-19 fatality rates across countries in Asia, in only one country does the ratio of COVID-19 deaths to expected mortality exceed one percent. Figures 4-6 show that there is substantial variation in the impact of COVID-19 cases within regions. In each of these regions (Europe, North America and South America) there are both countries where COVID-19 fatalities exceed five percent of expected mortality and others where COVID-19 deaths account for less than one percent of expected mortality.

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Conclusion

It is unclear why certain countries have been impacted so differently by COVID-19 even after controlling for population size, age distribution, and other health factors that influence a country’s mortality rate. It is clear, however, that because of the surge in cases and deaths in the US, Mexico, Brazil, and other countries in South America, the impact of the pandemic in this hemisphere may soon compare to the hardest hit countries in Europe.

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Stephen G. Bronars, PhD

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Stephen G. Bronars, PhD

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