Excess and Covid-19 death rates

Last month the Daily Mail had an article on excess deaths against Covid deaths over 12 months for 30 countries. This was based on a more detailed article in the Economist. What I found surprising that the countries making the headlines here in the UK for Covid deaths – UK, USA & Brazil – were well down the list in terms of excess deaths per 100,000 population. Since then the Economist has extended the data set to include 78 countries and the cities of Istanbul and Jakarta. The time period also varies, from around 180 to 400 days, though mostly for about a year.

Given this limitation. there are number of observations that can be made.

  • Overall the 78 countries account for well under half the global population. Notable absences from the Economist data set are China, India, Indonesia (except Jakarta), Pakistan, Bangladesh and Nigeria.
  • Total excess deaths are around 50% higher than than reported Covid deaths overall. That is 3.64 as against 2.43 million.
  • Excess deaths are slightly negative in a small number of countries. Most notably are Japan, South Korea, Taiwan, Malaysia and Philippines. Is this a cultural issue or a policy issue?
  • The worst country for excess deaths is Peru with 503 deaths per 100,000 for the period Mar 30th 2020-May 2nd 2021. Even allowing for the longer period, Peru is well above any other country. Covid deaths at 62,110 are just 38% of the excess deaths.
  • Next on the list with excess deaths per 100,000 and covid deaths as a percentage of excess deaths in brackets are Bulgaria (433, 53%), Mexico (354, 45%), Russia (338, 20%), Serbia (320, 24%), Lithuania (319, 43%), Ecuador (319, 34%), North Macedonia (304, 50%), Czechia (300, 81%) and Slovakia (270, 64%). Britain and USA, for comparison, are respectively 26th (180, 126%) and 25th (182, 93%).
  • All countries in the top 10 are either in Central / South America or Eastern Europe. Of the top 20, only South Africa (14th) and Portugal (20th) are outside these areas.
  • If countries are separated in excess death rankings by geography, maybe comparisons should be made between similar countries? In Western Europe the five large countries are Italy in 23rd (197, 74%) Britain in 26th (180, 126%), Spain in 28th (170, 100%), France in 37th (126, 125%) and Germany in 57th (63, 155%). Why should Germany be so much lower on excess and Covid deaths? Might it be that the Germans lead in following instructions, whilst the Italians & Spanish ignore them and the British tend more to think rules apply to people in general, but with many worthy exceptions for themselves and their immediate peers?
  • Peru not only has the highest excess death rate in the world, but some of the most draconian anti-covid policies. Could it be that some of the high excess deaths are the result of the policies? In Brazil, where lockdown policies are determined at state level, in some areas people are both deprived of a means to earn a living and get no assistance from the state.

There are many ways to look at the data. The Economist excess and covid deaths data gives far more insights than just crude deaths totals. Superficially it would suggest that problem areas are not, like early last year, in Western Europe, but in the Eastern Europe & South America. With the lowest death rates in the Far East, globally there are huge disparities that cannot be explained by differences in policy responses. It is more likely cultural factors play the greater role, although it is perfectly understandable why policy-makers would poo-poo what strongly suggested by the data. Moreover, with a lack of data from much of the world, and likely under reporting of Covid deaths in many countries, the true scale of the pandemic is likely vastly understated.

Kevin Marshall

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