On Covid deaths, Britain is no outlier

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Once an impression forms in the public’s mind it can be difficult to shake, even long after it ceases to be true. One example of this is the idea that Britain’s Covid death toll has been one of the highest in the world. Even at the start of the pandemic this claim was arguably exaggerated by some. But as subsequent waves arrived it became less and less true as our death toll in each wave was lower than those elsewhere.

According to Statista, Britain has the 26th highest death toll per capita, or the 17th highest in Europe. In truth that probably overstates our rank because we record deaths from Covid more accurately than some of the other countries lower than us in the rankings. It is difficult to get a like-for-like deaths comparison with countries such as Iran, which is ranked 41st, given transparency concerns. And it is notable that South Africa has had several hundred thousand excess deaths during the pandemic but recorded only just over 90,000 Covid deaths, which suggests that its actual death rate from Covid, relative to its population, may be higher.

If our point of comparison is countries such as New Zealand, which was able to seal itself off from the world and lockdown, eliminating the virus domestically (at least for a while), then Britain had a lot more deaths. But we never had the option of doing that. The most relevant comparators for us are probably European countries — among whom we are very much middle of the pack, below countries such as Czechia, Belgium and Italy but above countries such as France, Spain or Ireland.

Ah, you might say, but is being as bad as others really something to celebrate? I don’t know that anyone is celebrating — merely pointing out that Britain’s death rate is neither particularly high nor low by international standards. And it is definitely the case that a lot of people died. In 2020 there were 1,016 deaths per million population in England and Wales, up from 893 in 2019 and the highest figure since 2003 (indeed, worse than 2001): a huge reversal of decades of improvement in the death rate. 

Yet even in absolute terms matters could have been much worse. The highest Covid death rate in the world is in Peru, with several times as high a proportion of its population dying as in the UK. And that is despite very strict and long-lasting lockdowns there. 

There needs to be a better understanding of the different stages of the pandemic, and how they relate to deaths. Many still have in mind the early estimates that Covid killed a little under one percent of those infected. But the alpha variant (which we called the “Kentish variant” at the time) was thought to be up to half as severe again as the original form of the disease and the delta variant nearly twice as severe as the alpha variant. In a population without immunity, with an even attack rate across age groups, the death rate for delta would likely have been much higher than what we got. And whereas the early estimates suggested that perhaps 60 per cent of us would get the original variant, delta was so much more infectious that in an unmitigated epidemic virtually everyone in the country might have got it.

Without modern medical care (and, in particular, without oxygen) the death rate would be several times higher. Once we recognise this, and in light of early predictions of many hundreds of thousands of deaths, the figure of almost 150,000 deaths takes on a different context.

So, yes, in the UK, tragically, there were a large number of Covid deaths. Enough to set us back decades in terms of mortality data. But by international standards our death rate is nowhere near the top and by the standards of our most natural comparators in Europe we are very much average. By absolute standards the deaths we have had could have been much, much worse.

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