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

  1. Bangor Lewis Mehl-Madrona
  2. Maine Orono
  3. François Bricaire
  4. Adrian Cuyugan
  5. Jovan Barac
  6. Asadullah Parvaiz
  7. Ali Bin Jamil
  8. Sajid Iqbal
  9. Ryan Vally
  10. Meryem Koliali
  11. Mohamed Karim Sellier

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Abstract

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 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 lockdown and 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 both 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.

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    SciScore for 10.1101/2021.05.29.21258056: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Their other limitations were short in time. It is possible that by targeting measures for a short time they had better adherence. It is also possible that vitamin D supple-mentation policies helped as well as low density lifestyle. One may also consider that these are relatively isolated countries with limited roaming, tourism, and international travel. Beyond Norway and Finland, lax lockdown policies could lead to people spending more time outdoors and receiving more UV radiation which could have improved vitamin D status. Looking at a broader perspective, there is no indication that strict long measures reduced mortality. The data suggests the opposite. Countries with the least restrictions fared best economically. Surprisingly, some of them also fared well in terms of mortality, even better than neighboring countries with similar social structures and more severe restrictions. Developing countries with little healthcare capabilities and limited ability to enforce restrictions tended to fare well. Countries with treatments, independent of the type of treatment, fared well. Does this mean that a placebo effect was in operation or is any treatment better than no treatment? The mortality rates in the USA, however, may have suffered from very high obesity rates. Norway and the northern European countries have less strict restrictions from the rest of Europe and, also, had lower mortality rates. Was this from the longer summer days and earlier cold winter? Egypt fared well despi...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2021.05.29.21258056v1 on medRxiv