Population age structure only partially explains the large number of COVID-19 deaths at the oldest ages

Anthony Medfod; Sergi Trias-Llimos

We suspect that there may be some effects related to the predominant model of eldercare delivery within a country. For example, in the Netherlands there is a high number of nursing care homes whereas in Italy and Spain much care is provided at home by children and grandchildren. Second, we could be observing the outworking of country-specific cohort effects where particular cohorts are impacted differently between different countries. Third, differences may be reflective of different levels in old age frailty between countries. The countries with the most robust individuals at a given age group would be less likely to succumb to COVID-19. Finally, underlying medical conditions which are exacerbated by the presence of COVID-19 and viceversa may be more prevalent in some populations compared to others. This would result in more severe illness and ultimately, higher deaths in one country versus the other.