Transatlantic excess mortality comparisons in the pandemic

In a previous article, we considered key issues for comparing rates of excess mortality between countries and regions, with an application to European countries. This article compares the U.S. with Europe, and U.S. regions with the main European countries. The U.S. policy-makers had multiple advantages over European countries, such as Italy and Spain, in responding to the first wave of the Covid-19 pandemic: more time to react, with excess deaths lagging three weeks behind, and a younger, less densely-populated, less urban population. With the further passage of time, medical knowledge about Covid-19 has improved, health and testing capacities have been built up and practical experience has allowed both the private precautionary responses of citizens and of public policies to develop. This should have given countries and regions, for example, the U.S. South, the West and the Midwest, together accounting for 83 percent of the U.S. population, and where the spread of virus occurred later, a further advantage over those caught up in the first pandemic wave. Despite this, a comparison for the whole of the U.S. with Europe, excluding Russia, shows that the cumulative rate of excess mortality in 2020 was higher in the U.S.. And for the U.S. Northeast, the most comparable U.S. region, being closest to major European countries in the timing of the pandemic, and in population-density, age and urbanisation, the plausible measures of excess mortality prove substantially worse than for the worst-affected countries in Europe. These findings contradict recent claims by the U.S. President.