Excess Deaths Tell A Different COVID-19 Story Than More Direct Measurements

A lot of COVID-19 death statistics are plagued with bad data. But excess death statistics are robust and tell are more true story, especially once you adjust for the age pyramids of the respective populations. 

By that metric, Eastern Europe has responded worst to the pandemic, while countries with better data reporting have not done as bad as it seems.

A year ago, it seemed easy enough to divide pandemic outcomes into three groups — with Europe and the Americas performing far worse than East Asia, which appeared to have outmaneuvered the virus through public-health measures, and much of the Global South, especially sub-Saharan Africa, which looked to have been spared mostly by its relatively young population. Today, a crude count of official deaths, not excess mortality, suggests the same grouping: North America and Europe have almost identical death counts with official per capita totals eight times as high as Asia, as a whole, and 12 times as high as Africa. South America’s death toll is higher still — ten times as high as Asia and 15 times as high as Africa.

The excess-mortality data tells a different story. There is still a clear continent-by-continent pattern, but the gaps between them are much smaller, making the experiences of different parts of the world much less distinct and telling a more universal story about the devastation wrought by this once-in-a-century contagion. According to The Economist, Europe, Latin America, and North America have all registered excess deaths ranging from 270 to 370 per 100,000 inhabitants; excess mortality in Asia is estimated between 130 to 330; in Africa, the range is 79 to 220. These numbers are not identical, but, all things considered, they are remarkably close together. The highest of the low-end estimates is barely three times the lowest; the highest of the high-end estimates is not even twice as high as the lowest.

If you adjust for age, as the Economist database does separately, the differences among continents grow more dramatic — suggesting a reversal of outcomes, rather than a convergence. 

Outside of Oceania, Europe and North America were among the best in the world at preventing deaths among the old, and they were several times better at protecting their elderly, of whom they had many more, than Africa and South Asia. 

East Asia performed better, but only slightly: Canada is in line with China, Germany just marginally worse than South Korea, Iceland in the range of Japan. 

By almost any metric, Oceania remains an outlier: The Economist estimates zero excess deaths among the elderly in New Zealand, for instance, and gives the whole region an excess-mortality range of negative 31 to positive 37 per 100,000 residents, meaning it’s possible fewer people died there than would’ve had we never even heard of SARS-CoV-2.

In the country-by-country data, the divergences grow even bigger. Perhaps most striking, given both self-flagellating American narratives about the pandemic and current events elsewhere on the globe, is that the worst-hit large country in the world was not the U.S., which registered the most official deaths of any country but ranks 47th in per capita excess mortality, or Britain, which ranks 85th, or even India, which ranks 36th. It is Russia, which has lost, The Economist estimates, between 1.2 million and 1.3 million citizens over the course of the pandemic, a mortality rate more than twice as high as the American one.

Russia is not an outlier. While we have heard again and again in the U.S. about the experience of the pandemic in western Europe — sometimes in admiration, sometimes to mock — it has been eastern Europe that, of any region in the world, has the ugliest excess-mortality data. This, then, is where the pandemic hit hardest — in the countries of the old Warsaw Pact and formerly of the Soviet bloc. In fact, of the ten worst-performing countries, only one is outside eastern Europe.

From the New York Intelligencer.