by George J. Dance
Today's question: Which country has suffered the most deaths per capita from or with COVID-19 up to now? Is it the United States, which despite mostly locking down at the state level has had over 150,000 deaths? Brazil, which did the same, but has 90,000 dead in a smaller population? The United Kingdom, which locked down nationally but suffered 45,000 deaths in an even smaller population? Or Sweden, which never locked down at all?
The answer is None of the Above. According to
Worldometer's world coronavirus dashboard, the U.S. has suffered the most deaths, but in a population of 330 million that comes to just 467 deaths per million (467/M) only 10th highest. Brazil's per capita rate is even lower; it had only 425/M deaths, bad enough only for 12th place. The UK was hit rather hard, suffering 677/M deaths; but that was only bad enough for third highest.
No, the COVID death capital of the world – the country with far and away the most deaths per capita – is San Marino. San Marino, a microstate in (and completely surrounded by) northern Italy, has no active cases of the virus. It reported 699 cases in the spring, from which 652 people recovered, and 42 died. However, San Marino's population is just 33,000 – meaning that the country suffered a whopping 1,238/M deaths.
Just behind the UK, with the fourth highest death rate per capita, is Andorra, another microstate on the France / Spain border. Andorra has had 922 cases and 52 deaths. However, given Andorra's population of just 77,000, that equals 673/M deaths.
Another European microstate, Lichtenstein, reported only one death; but that one death equals a per capita rate of 26/M deaths. In contrast, India (where more than 36,000 people have died to date from COVID-19) also has a death rate of 26/M.
There is a reason to report deaths per capita. Giving only raw numbers can exaggerate death tolls in larger countries – can can make them seem worse than they are – and giving per-capita deaths as well is a way to correct for that bias. However, as I hope my examples show, reporting only deaths per capita – counting Lichtenstein's one death as equal to India's 36,000 – similarly exaggerates the death toll for smaller countries.
I was reminded of that this month, in the context of the ongoing online debate over Sweden. That country, as I am sure all know by now, never locked down, something lockdown advocates predicted would lead to mass death; ever since, many of them have been trying to prove that mass death has, in fact, occurred there. In May that took the form of misleading assertions that Sweden had "
the highest number of deaths per capita in Europe;" in June, that the country had "
the fifth highest death rate per capita in the world." Since both statistics were debunked, the comparison with America has risen to take their place. Some recent examples:
- "Since the deniers held Sweden up as an example, deaths exploded to 137% of US per capita deaths. They are now fifth in the world with COVID-19 deaths dwarfing those in the US with 512 deaths per million." (Eureporter, June 30)
- "Yet, the Swedish death rate is unnerving. Sweden has a death toll greater than the United States: 564 deaths per million inhabitants compared with 444, as of July 27." (U.S. New & World Report, July 27)
- "[Sweden] ranks eighth among countries with the highest number of COVID-19 deaths per 100,000 people. It outranks the U.S. and Brazil, which are the world's first and second worst-hit nations in terms of total cases, according to Johns Hopkins University." (Newsweek, July 30)
Does Sweden have more or less deaths than the United States? If one looks at total deaths, the U.S. clearly has more, over 25 times more. But if one instead looks only at deaths per capita, Sweden appears to be doing much worse. For a fairer comparison, one should give both totals; which, to its credit, one source of the 'per capita' statistic was fair-minded enough to do:
More than three months later, the coronavirus is blamed for 5,420 deaths in Sweden, according to the World Health Organization. That might not sound especially horrendous compared with the more than 129,000 Americans who have died. But Sweden is a country of only 10 million people. Per million people, Sweden has suffered 40 percent more deaths than the United States. (New York Times, July 15)
As of today Sweden has experienced 5,739 deaths, or 568/M. The U.S. 7-day average of COVID-19 deaths is currently, 1,058 per day. The United States has suffered more deaths from COVID-19 in the last 6 days than Sweden has during the entire pandemic. Yet reporting only the per-capita figures, without context, gives a misleading impression that the much smaller country – Sweden – is doing worse. Which is all that the comparison does, and all that it is designed to do.
There is a second way that reporting only national per capita deaths exaggerates the death toll in smaller countries over larger. The smaller the country, the greater the chance that everyone in it gets infected in a short time. (That is the sad fate that befell San Marino.) However, in a larger country like the United States or Brazil, the virus must take a longer time to spread through it; meaning that there will be regions of the country where it has never showed up, parts where it has passed, and parts where it is still raging. A national death figure will be an average of all three types of region, understating the actual death toll in the areas affected.
As an example, Canada has a seemingly lower death toll of 8,929 or 236/M. However, giving only that figure hides the real impact of the virus on one province, Quebec, which suffered 5,673 deaths or 667/M: almost as many deaths as Sweden, and more deaths per capita.
Similarly, according to
Worldometer's U.S. coronavirus page, six American states have more deaths, and more deaths per capita, than Sweden:
New Jersey – 15,888 – 1,789/M
New York – 32,754 – 1,684/M
Massachusetts – 8,595 – 1,247/M
Michigan – 6,443 – 645/M
Illinois – 7,670 – 605/M
Pennsylvania – 7,289 – 569/M
Another three states have more deaths, but not more deaths per capita, than Sweden:
California – 9,003 – 228/M
Texas – 6,703 – 231/M
Florida – 6,587 – 307/M
A further six states have more deaths per capita, but less deaths, than Sweden:
Connecticut – 4,431 – 1,243/M
Rhode Island – 1,007 – 951/M
Louisiana – 3,929 – 845/M
Delaware – 581 – 597/M
Maryland – 3,488 – 577/M
Mississippi - 2,693 - 569/M
Did someone mention Brazil? According to the
New York Times, three Brazilian states also have more deaths, and more deaths per capita, than Sweden:
Rio de Janeiro – 13,198 – 770/M
Ceará – 7,643 – 840/M
Pernambuco – 6,484 – 680/M
I hope these statistics put Sweden's death toll – 5,739 deaths, or 568/M – into proper perspective. Unfortunately, I do not expect them to end the online debate. Fortunately, though, I expect the debate to end soon anyway.
As the American death toll continues to rise, it becomes increasingly obvious that the state lockdowns did not stop the disease, but merely slowed it down, and that they have not prevented deaths so much as merely postponed them. With America adding more deaths per week than Sweden experienced in total, it is only a matter of time – a month, if the current death rate holds – before U.S. deaths per capita exceed those of Sweden. At which time, the per capita comparison will no longer be to Sweden's disadvantage, and I expect lockdown lovers to quickly and quietly drop it.
