A Sad Puzzle: Which Five Countries Have the Highest Total COVID-19 Deaths?

|The Volokh Conspiracy |

Keep in mind that this is naturally biased in favor of larger countries, and doesn't necessarily reflect the per capita death rate (which is of course the better measure of the impact of the disease on the nation). Only one of these five countries is in the top 5 by death rate, even if one sets aside tiny San Marino and Andorra.

Also, keep in mind that different countries may have different reporting practices, both in what counts as a COVID-19 death, and more generally in how many deaths are properly categorized and reported.

The answers are here.

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  1. Keeping in mind that,

    1) China is lying about their numbers.
    2) The US has the world’s third largest population after China and India.
    3) Many of the countries less populous are likely some combination of lying and/or just not recording Covid 19 deaths.
    4) Total deaths is a really, really stupid measure to compare countries by. San Marino comes off pretty well on total deaths.

    But, yeah, we’re not doing as well as I would like. Thanks a lot, Cuomo!

    1. Yeah, don’t think anyone believes either China’s or Russia’s numbers.

      Better comparison would be US to Europe as a whole, or individual states to countries. And again, per capita we’re squarely in the middle of the pack, and would be significantly better if not for the nursing home catastrophes in NY/NJ.

      I’m not really sure what the purpose is of showing the aggregate totals since it paints a very incomplete picture. Maybe just wanting to make the US look bad as possible?

      1. Variant,
        Well, all countries would be significantly better off if not for ____ [fill in the type of worst-case for each particular country.]

        1. Well, yes, but you care whether the blank is filled in with, “lying about their numbers”, “total deaths being a stupid metric”, or “majorly screwing up”.

          There’s no question that there’s a component of “majorly screwing up” pushing our numbers up. But, the US is a federal country, with heterogeneous policies, so mushing the numbers together as one country really throws out a lot of important information about WHO screwed up.

          It wasn’t the entire country, it was a half dozen states. Most of the country did better than, say, Canada.

          NY and NJ together have 9% of the US’s population, and 23% of our Covid 19 deaths. If you treated them as countries, they’d both be just under San Marino for deaths per 1M population. The remainder of the US would move down to 14th place, not 10th.

          If we could have quarantined just those two states, our numbers would look phenomenally good: Most of the Covid 19 deaths in the rest of the country are traceable to travelers from there.

          Well, that’s life in a federation: A few members out of 50 screw up, and the entire federation gets the blame.

          1. “Most of the country did better than, say, Canada.”

            How so? Canada’s current death rate is 240 per million. Only 19 states, accounting for 50 million people, have lower rates than that.

            1. My sources say 24. But I suppose you’re right, most of the country did “about as well as” Canada, not better. Should have counted, instead of eyeballing it.

          2. It wasn’t the entire country, it was a half dozen states. Most of the country did better than, say, Canada.

            False.

      2. And again, per capita we’re squarely in the middle of the pack,

        Per capita we are near the very top, not squarely in the middle of any pack.

    2. Sure, blame Cuomo.

      Take out the 33,000 deaths in NY and the US still leads by a lot.

      Maybe look at numbers since Memorial Day, as policies changed. Thanks a lot, Kemp and DeSantis.

      But hey, whatever you do, don’t criticize Dear Leader’s total bungling at every turn.

      1. The US doesn’t lead at all, by any honest metric. Nobody who’s trying to run comparisons between countries fails to normalize by population.

        And, as I point out in the more detailed comment above, the US comes off pretty good on the normalized by population numbers, if you treat NY/NJ as a separate country. “We” didn’t respond badly to the virus, a half dozen states in the NE did.

        The US has a federal form of government, which means that most decisions, legally, are supposed to be made at the state level. It’s kind of hilarious watching Trump being attacked as a “dictator” AND being attacked for not dictating what states do.

        1. Brett,

          The NE got hit hard, early, in part because it is heavily urbanized, because NYC is a major landing place for people coming from abroad – remember when Trump decided to crowd the airports for hours and hours? – in part because it got hit early, and in part because there were some bad decisions.

          But guess what? The NE states adopted sensible policies and the pandemic has greatly ebbed there. Meanwhile, places like TX, GA, and FL, operating under Trump’s influence, insisted on being stupid, including doing shit like trying to stop municipalities from requiring masks – decentralized government , anyone?

          So the cases in those places have grown and continue to grow.

          Those three states, with population of about 60 million, had 441 deaths yesterday. NJ and MA, population 9 and 7 milion respectively, had 9 and 13 deaths. NY hasn’t put up its numbers yet, but it’s been running 10-20/day for a population of 19 million.

          As for Trump, it’s not a question of him not dictating state policy, it’s a question of him lying about the threat – do you think that affected some people’s attitudes early – and generally mocking refusing to do anything at all.

          You want some insight into the magnitude of his fuckups?
          Read this.

          I know you’re a dedicated cultist, so nothing will change your mind, but read it anyway.

          1. Almost entirely because of some bad decisions: Forcing the nursing homes to take contagious people killed enough people to entirely account for NY and NJ being outliers.

            “The NE states adopted sensible policies and the pandemic has greatly ebbed there.”

            I keep saying this: If you burn your house to the ground, a week later the ashes will be cold. The NE states haven’t ebbed because of sensible policies, they’ve ebbed because they screwed up so badly that they essentially burned through everybody who was going to get it, and have now achieved herd immunity.

            Well, great, they’re going to look good going forward, because all the bodies are now buried. But it was the worst possible way to achieve good numbers now.

            1. Oh right, Brett.

              There aren’t any more vulnerable people in the NE.

              What color is the sky on your planet?

              1. That is a silly mental model, because it even would apply if there was a 90% effective vaccine that 90% of people got (so theoretically 81% would be immune, way above theoretical herd immunity). But even in that case there still will be some spread, because each immune person is like closing off a lane of traffic. And just like in traffic, some people (lanes) are more important. If you cut out a lane on I-95 that is going to affect the flow more than I-83, which is moreso than some other highways, which is moreso than some rural pathway that theoretically gets you from DC to New York.

                And that’s, seemingly, what happens with Covid, the people at high risk of contracting C19, are also high risk spreaders, so they get it first, but then that pathway is cut off. That’s why everytime something opens up you see an increase, then a leveling, then a reduction. The increase and plateau are where you reach saturation with the more common spreaders.

            2. Oh, and what did happen in GA and FL and TX after Memorial Day?

          2. Graph Texas and California. Just do it. Enter “texas coronavirus trend” into Google or Bing. Then do the same for California.

            You notice something interesting? Once you normalize for population, the two curves are practically identical. The major inflection point was around 6/15 in both states, despite wildly different policies. This is doubly weird since Texas began its reopening process in early May.

            Therefore, saying that it’s “stupid policies” is willfully ignorant, a clear and deliberate lie by the media to disingenously put the onus on conservative policies while ignoring that the trend is the same in extremely Democratic ones.

            1. Texas and California made many of the same mistakes in reopening. But California recognized them sooner and did more to remedy them. That’s the reason why California now has 307 deaths per million while Texas has 404 (and the gap between them is widening) even though Texas’s deaths per million were lower than California’s at the beginning of the summer.

  2. I’m struggling to see what the point of this post is.

    Highest death count is not really a puzzle. You can logic yourself half way there as the answers obviously tend toward highly populous countries but an exact answer a priori is a trivia question for all but extremely intelligent people who haven’t prevented this pandemic for some reason.

    And as the OP admits its for a barely useful statistic that really doesn’t say much at all due to variations in testing, methodology, and political considerations. Not only is it not very useful, its even less useful than many other still kinda useless available alternatives one of which the OP mentions.

    You might as well post ‘Chilling Puzzle: Which Five Countries Are Most Dangerous According to the Number of Scowling Mugshots in their Computer Databases?’

  3. Also we are overcounting because of the financial rewards to hospitals.

    1. My neighbor worked in a facility that did hospice. She told me hospice deaths were being put down to corona virus to get more government money. Our numbers are definitely inflated.

      1. Part of the first response to the virus was to increase payment from Medicare/medicaid for coronavirus cases – up to three times over what would otherwise apply. Hospital administrators would never find excuses to go after this extra cash.

        1. It’s a lot worse than that.

          So far there have been two rounds of federal relief funding for “high-impact” hospitals, as described by HHS here.

          In the first round, each hospital with at least 100 cumulative COVID-19 admissions between January 1 and April 10 got $76,975 of federal funding for each admission.

          In the second round, each hospital with at least 160 cumulative COVID-19 admissions between January 1 and June 10 (or an “abnormally high” COVID-19 admission ratio of about .55 cumulative cases for each available bed) got $50,000 of federal funding for each admission (probably offset by the first-round payments, though it’s not crystal-clear about this).

          That’s of course in addition to any payment the hospital was able to collect from the patients or their insurance.

          Pretty good money, particularly for milder cases.

    2. Please stop making things up, Ed. Just for one day, pretty please?

  4. The real story is that we are seeing a rapid decline in new cases in the last 2 weeks from a 7 day moving average of about 70k new cases a day to 50k. Deaths are also in decline from the 7 day moving average down from about 1165 to 1022 in the past 2 weeks also which is also half the peak death rate back in March and April when covid was raging in the NE.

    1. Where are you getting this historical data?

      I’m not questioning it, just would like to find it.

      1. Try Don’t Worry About the Vase, that guy has done a great job of collecting detailed information. As well, if you just google “Covid 19 deaths” and the name of a state, Google’s top result is their own graph of how that state is doing.

      2. Probably from Worldometer, the link in the OP.

        1. Worldometer doesn’t seem to provide its daily data for past weeks, unless I’m missing something.

    2. The real story is that we are seeing a rapid decline in new cases in the last 2 weeks from a 7 day moving average of about 70k new cases a day to 50k.

      I mean, that’s true, but it kind of ignores the fact that 50K is incredibly high, and it looks good only in comparison to 2 weeks ago.

      1. A new, unique covid virus.

        Yet you have determined that some random number is “incredibly high”

        Love the way you “science”

  5. If you want to compare across countries, you should be looking at deaths per capita, not raw numbers.

    1. In the UK they never have understood the size of the US, most of them that have visited the US only having gone to New York or Miami. There are those who thing Devon and Oregon are about the same size.

      1. Very true, and that applies to geography as well as population.

        I got my bachelors degree from Milwaukee School of Engineering.

        While I was there, I shared one class with a couple of women who were exchange students from the UK.

        On one particular day, the class given some free time by the instructor got to talking about weekend plans. The two women from the UK wanted to drive to New York and back over the weekend. They compared it to going from London to Paris.

        The rest of the class, all of us native to the US were incredulous. They didn’t understand the distance involved. London to Paris is only a couple of hours. Milwaukee to New York is almost 14 hours of solid driving time one way. And that’s not allowing any time for re-fuel the vehicle, potty breaks, eating, or rest for the driver.

        Best case scenario, they would have about 20 hours in NYC and they would have to spend about half of that sleeping.

  6. Seeing how these numbers are compiled and the lack of any uniform standard I don’t trust any of them. And it doesn’t really matter how many people have died of it. This isn’t a competition to have the least deaths, it is a race to purge community spread. We know how it spreads. We have more effective treatment protocols for it. Science is pushing a vaccine fast. Let’s get rapid testing. Get people to wear masks and hope maybe winter slows it down some. Stop the politics and just get people to realize the sooner we get this out of the population, the sooner the economy returns, and the sooner we all get back to our lives.

    1. No Jimmy, it’s to reduce mortality and morbidity.

      We are doing more testing than anyone else, hence we are going to find more than anyone else. Imagine a city that stopped *every* vehicle and searched for drugs. It’s find more drugs, even though there would be less in that city due to all the seizures.

      1. Are we doing more tests per capita? Or more in terms of raw numbers? As others have noted, per capita is probably a more useful metric than raw numbers for all the usual obvious reasons.

        1. SM811…If you sort by total population descending, and you look at the top 10 countries by total population, that per capita metric really jumps out. The US blows everyone else away, except Russia. It is not even close. That was my takeaway from Worldometer.

          1. Which metric? There are three per-capita columns, Total cases per 1M pop, Deaths per 1M pop, and tests per 1M pop.

            All of these columns are sortable.

            US standing:
            Total Cases per 1M pop: 9th
            Deaths per 1M pop: 10th
            Tests per 1M pop: 18th

          2. if you take the percentage of deaths /1m pop / total cases per 1/m pop the US drops to 64th.

            So the US has lots of cases but relatively few deaths.

      2. Ed stopping community spread will do exactly that – reduce mortality and morbidity. And it can be done without crashing the economy or locking everyone in their houses for months on end.

        1. I was told, “by experts”, in March, all the protocols to slow community spread, would not save lives, only reduce the strain on health care infrastructure.

          Lying then, or now?

    2. Stop the politics and just get people to realize the sooner we get this out of the population, the sooner the economy returns, and the sooner we all get back to our lives.

      Sure, but don’t forget it was Trump who politicized mask-wearing.

      1. Explain Sweden and other countries that use HCQ and no Nazi mask policy.

        1. Sweden has done terribly, so what exactly do you want to explain?

      2. The CDC did that first, when they said first to wear no masks to keep them for the medical folks, only to do a 180 reversal.

        1. Yeah, my wife is a medical professional, she’s really pissed about the mask policy. Says that anything short of N-95 is basically useless, and the single layer cloth masks are just fashion accessories.

          I had to explain to her the concept of “security theater”.

        2. A factual screw up like that doesn’t politicize anything.

          1. A factual screw up like that

            Come on. It never was claimed to be a “factual screw up” — even back in March it was already being spun as a noble lie. And even this super-righty NYT article talks about how that lie severely impacted the credibility of government agencies in general.

          2. Back in February the media portrayed you as literally Hitler if you went out and bought an N-95. They said you were stupid and depriving healthcare workers of PPE. Then three months later they wanted everyone to start wearing masks. Given the media has no credibility it isn’t surprising that no one believes them now.

            1. Health care workers dealing with infectious patients need to protect themselves, and anything less than N-95 is ineffective doing that, so they really do need them.

              The recommendation for the public to use multilayer cloth masks is to reduce transmission from an asymptomatic wearer to others, and was made after asymptomatic transmission was verified. The authorities still recommend you leave the N-95s to the people who need them more.

              https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-mask/art-20485449

              1. Except media was talking about asymptomatic transmission back in January. The timeline just doesn’t work for these explanations.

                1. Ben, these recommendations don’t come from “the media”, they come from the CDC and the WHO, and the Mayo Clinic apparently agrees. Even if “the media” were “talking about” asymptomatic transmission in January, how would that have influenced these organizations?

    3. This isn’t a competition to have the least deaths,

      It kind of is. Though grammarians would say “fewest.”

  7. Excluding Iran, China, and Russia, who are all lying to a greater or lesser extent, we’re #8 in deaths per capita, excluding the micro countries of San Marino and Andorra.

    I was surprised to see Belgium so high up. Nobody really talks about them.

    1. India is in no position to accurately report medical data, even with the best intentions.

      1. They are doing the best they can, unlike the first three countries I listed.

  8. That’s a sly way to try to make me look at a denigrated site.

    The case definition has been corrupted in many different ways. Traditionally a case definition requiring reporting is based on symptoms, now, corruptly, requesting a test (which Ag or Ab?) will be listed as a ‘case’.

    #Resist. Do Not Comply

    1. now, corruptly, requesting a test (which Ag or Ab?) will be listed as a ‘case’.

      The antibody tests are the least of the problem. The CDC now freely acknowledges that the so-called gold standard PCR test can continue to generate a positive result for months after replication-competent virus is no longer present in a person’s respiratory tract (point #4 and reiterated in the first paragraph of the “Assessment” section here).

  9. I wonder what that would look like if you isolated out four or five Democrat shitholes and their murderous senior facility policies?

  10. Total deaths in the U.S. is an unreliable and misleading statistic. As others noted, there are perverse financial incentives to book a death as covid-19 related. And there are perverse political incentives to count or not count a death as covid-19 related. Finally, sometimes the cause of death, especially for those in high-risk groups, is very difficult to determine. The issue there is: death “caused by” versus death “with” covid-19.

    Finally, the following is not true: “. . . per capita death rate (which is of course the better measure of the impact of the disease on the nation).” The better measure is case-fatality ratio — which, as this Hopkins study notes, ranks the U.S. as 12th. (Case-fatality is also skewed by the points noted, above.) https://coronavirus.jhu.edu/data/mortality

  11. There’s no question there’s some confusion if not chaos when it comes to reporting cases and deaths. The open secret is they’re attributing Covid-19 as a death even if it was a secondary issue. In other words, people with a co-mobordity (the number one being hypertension) who die get tagged as a Covid-19 death. This has been a suspicion going back to the early days in Italy when a couple of head doctors sounded the alarm on that.

    This pads the numbers in favour of deaths. On top of that, the nursing homes fiasco (which points, to me, to the fact we have a huge problem of incompetence in some countries and especially in North America), from my observations, distorted case fatality rates. To me, this is a sunk cost situation. We’re still acting like the virus is a killer but it isn’t to the degree first thought and is indeed much more in line (slightly higher) with the flu. It’s worth noting Dr. Fauci and his colleagues after studying the Diamond Princess incident asserted once all is said and done, the virus will end up being slightly more aggressive than the seasonal flu. Sounds like he was on cue. Not sure why he shifted from that (like he did pushing for masks despite the weak evidence to back those stupid things up).

    So public health officials seem to be acting like ‘hey, we had all these deaths so let’s play it up just in case’ to drive policy. I think this nursing trauma was an anomaly not likely to repeat itself (though Australia bafflingly didn’t seem to pay any attention to what happened elsewhere as their death spikes came from the same area! Then they OVER-REACT with a hyper-draconian lockdown. At what point does this incompetence become criminal negligent?)

    This is why, in part, deaths have dropped significantly. That and the average age of infection has dropped. And as that happens, you march towards immunity as the survival rate is in the neighbourhood of 99.8%. Fricken basic stuff.

    Not to mention treatments like RFL-100, HCQ (around since the 1960s) and plasma transfusions (used since the Spanish flu) which work. But for some reason the CDC/FDA decided the last two needed more research and shut down trials and even prevented doctors from using them. Fauci will have some explaining to do because there’s no doubt once the fog of fear is lifted and the novelty of this virus (perhaps with a weaker mutation), I submit his decision on HCQ will prove to have led to spikes and even deaths.

    So yes, I DO think politics is now driving the pandemic. Funny how suddenly empirical evidence is needed for those treatments but they turn around and ignore this with mask mandates with its flimsy evidence. I thought we wanted to ‘save every life’.

    It’s spectacularly foolish to obsess over cases. Those onto themselves mean NOTHING. And it’s misleading or also foolish to let deaths drive policy. We still die from car accidents, heart and stroke and other diseases much more than the Wuhan (in fact, this isn’t even the worst pandemic on record in the last 100 years).

    It’s less a puzzle and more a game of keeping track. I find it helpful to be skeptical of every single thing public officials say from now on.

    They pretend to be ‘pro-active’ but are in fact reactive.

    I’m also sounding the alarm on mandatory vaccines. There’s just too much noise about that. We rolled over with the masks and that was a mistake (Fauci even admitted he’s viewing this as a trial run to use them during flu season thus IGNORING 100 years of masks studies for that very reason that prove they’re inconclusive) because they will feel they can push a mandatory vaccine onto a very scared population. The perception is the virus has a 10% death rate.

    The government has the people right where it wants it if you’re so inclined to be of the ‘globalist agenda’ persuasion.

    Anyway, here’s a much better metric to interpret the death rate:

    https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

    If you notice, the USA is not the worst despite total numbers. In fact, it does better than my home country of Canada who is over praise for its handling of this mess.

    I stand by Sweden did it right.

    *My apologies. I posted the same link twice in the same post. So I’m resubmitting my comment.

    1. By the way, as someone who hails from a family of entrepreneurs and education, what I’m witnessing with how we’re handling a return to school is appalling and borderline child abuse.

      This has nothing to do with science or the children but all about politics and projecting fears onto them.

      I’ll stop here lest I really reveal what I think of such adults (parents, politicians and teachers alike).

      Hint: It’s not nice.

  12. The lion’s share of the US’s score is people in nursing homes, who would have been safe had governors not forced them to accept Covid positive people. Those governors need to go on trial for murder immediately.

    1. Or at least face an investigation.

      It’s simple really. Italy (and then Spain) was ground zero. The first thing that should have gone off in the heads of Governors was to move to protect the vulnerable and elderly particularly in nursing homes. FIRST. THING.

      Instead, it was politics from the get-go and they got distracted and by the time they realized they messed up they then went with an unproven method based on flawed models to LOCKDOWN thus potentially exacerbating the problem due to its unintended consequences.

      Did they learn? Nope. Then they decide mass masks are going to stop the spread based on VERY WEAK – astonishingly weak – evidence and data. This is a problem because it could actually lead to more spikes, delay herd immunity and form a bad habit based on specious logic.

      It’s worth noting, Whitmore in Michigan declined to take the recommendation of the head of nursing homes to isolate the elderly if I recall correctly.

      As if that’s not enough, Australia and New Zealand are, in my view, engaging in human rights abuse with their appalling lockdowns. Last week I heard a report where they said 22 of 25 deaths came from….get this…..NURSING HOMES.

      FIVE MONTHS after what we saw in: Belgium, Sweden, Italy, UK, Spain, NY, NY, MI, ONT and Quebec regarding nursing homes and Australia still FAILED to protect them!?!? Does anyone in the Aussia power structure READ THE BLOODY NEWS?

      This is completely UNACCEPTABLE.

      The idea we can lockdown are way out of this based in the suppression model is idiotic. Supremely so. So is the belief we can only move on with a vaccine. Here in Canada, just to show you where all this can go, the Dr. Tam (another person who should have resigned long ago) said we may to wear masks even if there’s a vaccine.

      This is not a life. We have to stop listening to public health officials or else they’ll squeeze the worth out of what it means to be HUMAN.

      Again. Just my thoughts. We have to become realistic and realize this virus isn’t going away and we have to learn with it.

      WITHOUT non-phama measures like social distancing and masks.

      I mentioned on top I sounded the alarm on mandatory vaccines. Just today the health commissioner of Virginia said he would mandate people get one based on preposterously weak logic.

      Health before liberty is NOT an excuse or reason to take away civil liberties.

      1. learn to live with it.

      2. I’d like to clarify my comment about public health officials. What I mean is we should be taking their advice, parsing it and setting policy accordingly based on trade-offs. Not that we should ignore them. Though I have detected a split between public health officials and private doctors. But that’s for another discussion.

        Instead, I perceive we’re letting them directly control policy particularly on economic matters (ie of course they’ll support lockdowns. It’s not their jobs to consider cost/analysis calculations). It’s the job of elected officials to say ‘thank you. I’ll take it under advisement’ and lead.

        I get feeling we gave the keys to the Cadillac to medical bureaucrats.

        I’m done with my rants.

        Cheers.

  13. Funny how many folks who nodded approvingly when Trump took Putin’s word over American intel agencies’ know that Russia’s COVID numbers can’t be trusted.

  14. One interesting piece of the puzzle is that, in the US, the rate of CoViD deaths per month is roughly the same as the rate of [1918] Spanish Flu deaths per month. Yes, both the 2020/2021 and 1918/1919 measures are fuzzy at best, but they are fuzzy in the much same way. If the similarity continues, we are more than 1/4th of the way to the end of the perceived crisis. (The 1918 numbers are in an Appendix to a CDC document, so you have to drill down a bit.)

    Another piece of the puzzle is that the (very few) models from February which have actually proven accurate all assumed that most responsive measures would have no effect: unsurprisingly, wrapping your head in gauze has the same effect in 2020 that it had in 1918. China suggested the best response (eliminating super-spreading by, among other things, terminating public ground transportation such as subway and bus systems for 21 days).

    1. I’ve seen this argument made.

      Perhaps.

      But I don’t trust the death numbers. We KNOW people are dying with underlying conditions so this may be inflating death numbers.

      My guess?

      It’s possible the world case rate is 10x higher and deaths half of what’s reported.

      I’m using the USA as a base. The CDC claims 50 million Americans may have been infected. The number of deaths stays the same. This lowering the death RATE. Add if they count a death strictly from Covid and it drops further. And still to keep in mind, the Spanish flu killed across all age groups. This one preys on the 70+ and people with compromised health.

      1. I personally am concerned about my health, so I bought myself Amazon’s fitness monitor. I think that you need to improve your immunity and be in good physical shape, and then even if I get sick, I will quickly recover.

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