Benchmarking COVID-19 Mortality in the United States

Etzioni, Ruth; Markowitz, Elan; Douglas, Ivor S

On September 22nd the US officially recorded 200,000 COVID-19 deaths. It is unclear how many deaths might have been expected in the case of an early and effective response to the pandemic. We aim to provide a best-case estimate of COVID-19 deaths in the US by September 22nd using the experience of Germany as a benchmark. Our methods accommodate the differences in demographics between Germany and the US. We match cumulative incidence of COVID-19 deaths by age group in Germany to non-Hispanic whites in the US and project the implied number of deaths in this population and among the black and Hispanic populations under observed racial/ethnic disparities in cumulative COVID-19 mortality in the US. We estimate that if the US had been as successful as Germany in managing the pandemic we would have expected 22% of the deaths actually recorded. The number of deaths would have been lower by a further one-third if we could have eliminated racial/ethnic disparites in COVID-19 outcomes. We conclude that almost 80 percent of the COVID-19 deaths in the US by September 22nd could have been avoided with an early and effective response producing similar age-specific death rates among non-Hispanic whites as in Germany.