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A Covid patient receiving treatment in hospital in California
As coronavirus cases continue to rise in the US, there are competing narratives about the impact of the disease.
President Trump claims the country has one of the lowest death rates from the virus in the world.
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I heard we have one of the lowest, maybe the lowest, mortality rate anywhere in the world.
He’s also said excess deaths are significantly lower than elsewhere – that’s the number of extra deaths above what would be expected.
But others say the US has been hit worse than other countries, pointing out it has the most recorded Covid deaths of any country in the world.
“More than 170,000 Americans have died – by far the worst performance of any nation on earth,” Democratic presidential contender Joe Biden has said.
We’ve looked at three different ways you can measure the rate of Covid-19 deaths, two of which show that while the US is not the worst affected, it’s among those most badly hit.
1. The number of excess deaths
First, there is no international standard for how you measure deaths, or their causes. And making comparisons is tricky as countries record deaths in different ways.
But experts say one of the most telling measures is how many extra deaths a country experiences above the number who would have been expected to die.
This “excess” death data captures some potentially unrecorded coronavirus deaths, and other deaths that might be the result of strain on healthcare systems and other indirect effects of the epidemic.
It can therefore provide a more complete picture of how a country has been affected overall.
Most developed countries publish excess death data, but they do it less frequently than the daily coronavirus death totals they provide.
The US experienced almost 200,000 excess deaths from the start of the outbreak up to 11 July, according to the latest data available.
That’s an 18% increase on previous years.
Although the time periods are different, looking at the latest data from the world’s leading industrialised nations, we can see the US has a lower proportion of excess deaths so far than Italy and the UK.
The UK has been one of the hardest hit countries, with around 26% more deaths than expected in a typical year up to the start of August.
So on this measure with the data available so far, the US is not the hardest-hit country, but this figure could change.
While weekly deaths in the UK and Italy have gone back to expected levels, the US could move up the rankings if it continues to see above-expected numbers of deaths each week.
2. The case fatality rate
Another measure is the case fatality rate. This is the ratio of deaths to confirmed cases – of those who tested positive for coronavirus, how many have died?
President Trump has said: “Our case fatality rate has continued to decline, and is lower than the European Union, and almost everywhere else in the world.”
The US rate is relatively low compared with most major European countries, including the UK, although it isn’t the lowest in the world.
Percentage of coronavirus cases which lead to deaths
But different countries are testing to find coronavirus cases in different ways, meaning this is a hard comparison to make.
A low case fatality rate could mean that widespread testing identifies lots of mild cases who were unlikely to die in the first place.
3. Death rates per capita
The US has recorded the most deaths from coronavirus in the world, but it has a larger population than many other countries.
When you look at deaths per capita – as a proportion of each country’s population – the US is no longer top of the list, but remains in the top 10 worst-hit countries.
10 countries with most coronavirus deaths per capita
The US has recorded more than 52 coronavirus deaths per 100,000 people – there are a number of countries that have recorded more.
The US continues to regularly report more than 1,000 new coronavirus deaths a day, which is one of the highest daily death rates per capita in the world, according to the UK-based Our World in Data website which compiles global figures for coronavirus.
However, there are important differences in how countries count coronavirus deaths, making exact comparisons difficult.
Additional reporting by Becky Dale and Nassos Stylianou.
