Do Public Health Efforts Matter? Explaining Cross-Country Heterogeneity in Excess Death During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has taken a devastating toll around the world. Since January 2020, the World Health Organization estimates 14.9 million excess deaths have occurred globally. Despite this grim number quantifying the deadly impact, the underlying factors contributing to COVID-19 deaths at the population level remain unclear. Prior studies indicate that demographic factors like proportion of population older than 65 and population health explain the cross-country difference in COVID-19 deaths. However, there has not been a holistic analysis including variables describing government policies and COVID-19 vaccination rate. Furthermore, prior studies focus on COVID-19 death rather than excess death to assess the impact of the pandemic. Through a robust statistical modeling framework, we analyze 80 countries and show that actionable public health efforts beyond just the factors intrinsic to each country are necessary to explain the cross-country heterogeneity in excess death.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Min Woo Sun is funded by the National Library of Medicine (2T15LM00703339). Robert Tibshirani is funded by the National Institutes of Health (5R01 EB001988-16) and the National Science Foundation (19 DMS1208164).

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Data Availability

All data produced are available online at https://github.com/minwoosun/covid-mortality

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