June 26, 2020 – This week’s Situation Room dashboard takes a look at the mortality rate of COVID-19 and examines an apparent decline in the numbers. While there is some volatility at the onset of outbreaks, mortality differs most significantly between countries and regions rather than a declining much over time. Thus the change in observed global mortality for COVID-19, can be partly explained by outbreaks growing in different countries with lower mortality rates. A variety of factors contribute to differing mortality rates from one region and country to another and are summarized below. 

• Data Collection Problems: Countries have vastly different data collection abilities when it comes to COVID-19 that are likely a chief factor of varying mortality rates. Most countries continue to have inadequate testing levels which will underreport the true number of cases in a country, but as testing increases mortality will fall. Most egregious is Mexico, where more than half of tests return positive results, ten times as much as the World Health Organization says there should be if testing was sufficient. Additionally, many developing countries do not have accurate reporting of deaths which is exacerbated by the pandemic and overwhelmed healthcare systems. Measures of excess mortality attempt to correct for this underreporting, but is not included in official COVID-19 statistics. 
• Population Demographics: The age distribution of various countries is another significant factor which likely determines lower fatality rates. Older people are at significantly greater risk of dying from COVID-19 thus, a greater percentage of elderly people in a population in a given country, such as Italy, contributes to higher death rates from the virus.
• Healthcare Quality: Access and quality of healthcare, notably the number of beds equipped for intensive care, ventilators and technicians trained to administer care, may impact the risk of death for patients with COVID-19. Factors like healthcare cost and availability also affect the treatment of a COVID-19 patient.
• Underlying Health Conditions: Non-healthy practices such as smoking vary greatly between countries and contributes to a higher rate of death due to COVID-19, according to health experts.
• Human Behavior: Many countries recognize these factors and have altered their pandemic responses to account for the local situation. For example, countries like Turkey and Sweden focused their preventive measures on protecting the elderly while giving younger generations more leeway, which affects the age distribution of confirmed cases and thus the mortality rate. Similarly, As reopening occurs in countries with active outbreaks, older people may take greater precaution to isolate themselves, shifting the age distribution of new cases and also lowering the fatality rate.

Why it Matters: Perceptions that the mortality threat of COVID-19 is not as high as previously thought may lead to stronger pushes for reopening despite high infection numbers. As a result, infection rates may continue to rise, adding to health and safety risks in certain countries since the virus can still lead to significant health issues for people of all ages who contract it. Failure to adhere to preventive measures such as social distancing and wearing masks could also lead to a large spike in cases, overwhelming healthcare systems, which may force some countries and areas to reimpose strict lockdown measures that disrupt economic recovery plans, even if death rates decline.

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