Along with recording the most deaths from COVID-19 of any country in the world, the US has ranked highest among leading OECD countries in deaths per capita from the infectious disease, according to a recent study published in the Journal of the American Medical Association (JAMA) by researchers from Harvard University and the University of Pennsylvania. 

The United States also has experienced consistently high COVID-19 mortality rates since the country saw its first surge of cases in May, more so than other countries with high mortality rates. 

The JAMA study last week suggests that the comparatively higher death rates may be linked to the US’ weak public health infrastructure and a decentralized and inconsistent pandemic response. 

An additional factor may be the high level of pre-existing conditions among Americans who have comparatively high rates of obesity, hypertension and diabetes as compared to other developed countries.  

The authors compared US COVID-19 related deaths and excess all-cause mortality across 18 countries in the Organization for Economic Co-operation and Development, from the start of the pandemic until September 2020. 

The best performing countries in the study were South Korea, Japan and Australia, with fewer than 5 deaths per 100,000 people. Countries with moderate death rates included Norway, Finland, and Austria, with 5-25 deaths per 100,000 people. The worst performing countries with the highest mortality rates were the United States, Belgium, and Spain – with over 25 deaths per 100,000. 

The study also examined excess all-cause mortality, per capita, during the pandemic period to capture indirect pandemic effects. 

US Rates Were Initially Low – But Consistently High Since May

The US’ mortality rate in the early spring was lower than other high mortality countries, with 60.3 deaths per 100,000 compared to 86.8/100,000 in Belgium and 65.0/100,000 in Spain. 

However, by mid-May, the US had exceeded all countries in deaths per 100,000, with 36.9 compared to 12.4 in Belgium and 8.6 in Spain. In September, the US’ death rates (60.3/100,000) were more comparable with other high morality countries, including Italy (59.1/100,000) and Belgium (86.8/100,000). 

In May and June, the US had death rates more than double most other high mortality countries, despite the implementation of prevention measures. The patterns observed in the study were also found for excess all-cause mortality, with the US leading in excess all-cause mortality since May. 

Since September, death rates have increased in several countries, with Peru now leading in COVID-19 deaths per 100,000 (105.35), compared to Spain (72.29), and the US (67.14). 

Image Credits: Flickr – National Guard, Journal of American Medical Association, Johns Hopkins.