Covid-19: Comparisons by Country and Implications for Future Pandemics

Mehl-Madrona, L. E.; Bricaire, F.; Cuyugan, A.; Barac, J.; Parvaiz, A.; Jamil, A. B.; Iqbal, S.; Vally, R.; Koliali, M.; Sellier, M. K.

Background. We set out in this paper to compare Covid-19 results by country to better understand the factors leading to the differing results found internationally. Methods. We used publicly available large datasets to explore differences by the country for Covid-19 mortality statistics. We continuously challenged our projections with reality and numbers from countries around the world, allowing us to refine our models and better understand the progression of the epidemic. All our predictions and findings were discussed and validated from a clinical viewpoint. Results. While no lockdown resulted in higher mortality, the difference between strict lock-down and a lax lockdown was not terribly different and favored lax lockdown. Only one of the top 44 countries had long and strict restrictions. Strict restrictions were more common in the worst-performing countries in terms of Covid mortality. The United States had the largest economic growth coupled with the largest rate of mortality. Those who did well economically had lower mortality and less pressure on their population. Yet they had less mortality than average and less than their neighbors. Conclusions. Countries with the least restrictions fared best economically. Some of them fared well in terms of mortality, even better than neighboring countries with similar social structures and more severe restrictions. The mortality rates in the USA, however, appeared to suffer from very high obesity rates. Norway and the northern European countries have less strict restrictions from the rest of Europe and had lower mortality rates. COVID-19 mortality was associated with vitamin D status.