Comparisons Between Countries

Comparison between countries

In order to gain an understanding of any possible effect of the draconian measures that are being undertaken, one cannot use direct comparisons between countries to conclude whether the individual country’s measures are more effective than the other. This is a untenable argument given the large physiographic and demographic differences between countries. To understand this, one must look at differences in excess mortality without the interventions that now take place by comparing excess mortality between countries over time. Here one sees that excess mortality varies. When comparing, for example, the excess mortality figures between England and Canada in recent times, one sees significant differences.

Time series of monthly mortality from pneumonia and influenza in Canada (A) and England and Wales (B) from 1950 to 1972
Time series of monthly mortality from pneumonia and influenza (P&I, represented as death rate/100,000) from 1950 to 1972 in A) Canada and B) England and Wales. Black line: observed deaths, Red line: baseline deaths predicted by a seasonal regression model. Note the 2 arrows for the 1968 pandemic in England, representing the 2 waves of the smoldering A/H3N2 pandemic (1968–69 and 1969–70, respectively) 

When we look at excess mortality in 2020 in Norway compared to Sweden and 8 other EU countries (Portugal, Spain, England, Scotland, Northern Ireland, Italy, France and the Netherlands) for the last three years before the outbreak of Covid-19 – so had all these countries except Norway and Northern Ireland a greater excess mortality in the years prior to the Covid-19 outbreak and which was particularly pronounced in the somewhat more powerful Influenza season in 2017-2018. Neither Norway and Northern Ireland saw no increase in excess mortality in 2020. Data from Euromomo show that Sweden has a more marked excess mortality than other nodirdc countries in the years before the Covid-19 outbreak. These observations can be made with most countries in Europe where those with more significant mortality in the previous season of influenza have a corresponding but even more marked mortality in 2020-2021.

Excess Mortality in four Nordic Countries (Euromomo )

As we see above one exception is Sweden that had a somewhat greater excess mortality than its nordic neighbours compared to previous years. . This cannot be explained by the interventions taken as is confirmed in recent population studies. These difference must take into account by the significant differences between countries related to physiography, population composition and distribution between city and country, ethnic variations, size and composition and distribution of the country’s immigrant population, organisation of health and care services, elderly care etc. It is these individual factors together that become the most important factors that affect variations in morbidity and mortality from each known or new viral outbreak in a population and as reflected in the variations in age standardized mortality rates between countries.

In the U.S. states had very different strategies for interventions with minimum to severe restrictions and lockdowns. Although many factors need to be controlled – all in all It became clear that states that did not lock down were not shown to have greater Covid-19 disease load or mortality.