The impact of coronavirus and the effectiveness of national attempts to tackle the outbreak are a matter of significant debate.
Total numbers for those killed by the virus are regularly reported and rapidly changing but there are questions over how useful they are for assessing how badly Covid-19 is affecting different countries.
So, how successful has Scotland and the rest of the UK been in controlling the virus? And how does the impact of the virus on Scotland compare to other similar countries in Europe?
The Scottish Government reported that Scotland has had 2,442 deaths from coronavirus as of 12 June 2020. The estimated population of the country is 5,463,300 according to the latest figures published in 2019, by the National Records of Scotland (NRS). This equates to 447 deaths per one million of the population.
This data only includes those who have tested positive for coronavirus and died within 28 days, so is likely to be an underestimate.
There is also a weekly report on coronavirus by NRS which includes all deaths where Covid-19 was mentioned on the death certificate. This includes cases where “suspected or probable coronavirus infection” was involved in the death. On this measure, Scotland had 4,000 deaths up until 7 June.
According to data from the Worldometers website, which uses official statistics, the highest Covid-19 death rate in Europe is Belgium, which has 832 deaths per million population. This is followed by the UK with 608 deaths, Spain with 580 deaths, Italy with 564, Sweden with 477, and France with 449. The US death rate on this measure is 351 deaths per million.
This list excludes small countries such as San Marino and Andorra, which have populations under 100,000 – making meaningful comparisons difficult.
Comparing the coronavirus statistics of different countries is fraught with difficulties, and experts have cautioned that comparing deaths between countries may not be particularly useful.
Writing in The Guardian, statistician David Spiegelhalter warned that numbers used in calculated Covid-19 death rates are “still deeply unreliable”.
Covid-19 deaths or excess deaths?
Different countries record coronavirus deaths differently, including Belgium, which has a much wider definition of what constitutes a Covid-19 death. Some statisticians have suggested Belgium is over counting, while the government insists its statistics are in fact the most accurate. The UK was criticised earlier in the pandemic for not including care home deaths, which made up a significant number of Covid-19 related deaths. Official statistics were later improved to include care home deaths.
Another problem with such comparisons is they do not necessarily reflect how long a country has been dealing with coronavirus, and whether it has passed its peak. For example, the US has the highest number of deaths in the world, and currently has around the 8th worst official death rate per million. But while most countries higher up the list appear to be well past the peak of daily deaths, the US still regularly suffers around 1,000 deaths per day.
Many experts have suggested that looking at the ‘excess deaths’ a country has, may be a better way to assess how much a country is being affected by coronavirus.
A report by The Health Foundation argued that excess deaths was a better measure as it was not “as skewed by differences in defining and reporting Covid-19 deaths across countries”. It also allows us to look at deaths which may be indirectly related to Covid-19.
This compares to the number of deaths in a given period compared to the average number deaths over that period in previous years. If there are more deaths in a given period, these are considered excess deaths. This can be adjusted for population or demographic changes.
Around the world, countries count deaths and cases of coronavirus in different ways and with varying time lags. However, there are a number of countries that produce data on Covid-19 deaths which is sufficient to allow national comparisons of excess deaths
How is Scotland doing?
Since the start of Scotland’s period of excess deaths, our calculations found there have been around 4,810 excess deaths from all causes in Scotland. In isolation this figure does not tell us a great deal, other than it is significantly higher than the regularly reported Scottish Government figure for deaths from coronavirus.
Using a calculation, we can look at how this number looks in context. Scotland’s excess deaths rate is around 880 per million of population, which is lower than the UK’s overall excess death rate of 961. Scotland has the second highest rate among UK nations, after England where the excess deaths are just under one thousand excess deaths per million. Wales has an excess death rate of just over 700 and Northern Ireland’s rate is slightly under 500, although their statistics are less up-to-date.
However, it seems Scotland’s excess death rate is higher than many countries with comparable data.
Our analysis of selected countries found Scotland’s excess deaths rate higher than that of Belgium, which has the highest rate of official Covid-19 deaths.
The UK has the highest excess death rate per million in the world at 961 deaths per million of population, followed by Spain with 919, Belgium with 709 and Italy with 706. If you were to replace the UK with its constituent nations, England would be at the top of the list, while Scotland’s excess death rate would be lower than Spain’s, but significantly higher than Belgium or Italy.
Compared with Nordic nations such as Denmark, Norway or Sweden, Scotland appears to be faring rather worse.
Sweden, which did not go into a full lockdown like many other European countries, has the worst excess death rate of the Nordic countries but it’s excess death rate of 467 is significantly lower than Scotland’s.
However, it is important to note that Sweden’s coronavirus case and death rate is not slowing as fast as many countries including Scotland, suggesting the spread of the virus in Sweden is not slowing as much as in other countries.
Scotland’s excess deaths are reducing, with the latest NRS figures reporting just four per cent more deaths, 37, were registered in the week ending 7 June 2020 compared to the average of the previous five years.
There are caveats to these comparisons. Excess death data is not similarly up to date in every country, and there is often a lag in reporting. This means some countries may be facing higher excess death rates than reported.
Total excess death comparisons also do not tell you where a country is in dealing with the pandemic. The number of cases peaks at different times in different countries so excess deaths may have reached an initial peak in one country, but not another. Italy and Spain, for example, have stemmed their death rates significantly. Looking at weekly excess deaths may give a clearer picture of the current state of play. It should be noted that we are referring to the current wave of the virus, as a ‘second wave’ of Covid-19 could cause further increases in excess deaths.
It is too soon to conclude what the eventual totals of excess deaths may be, and it may take months if not years to analyse exactly how well different nations were able to handle the pandemic. The excess death measure arguably gives a clearer indication of how badly affected countries are by Covid-19 than total figures, or death rates purely from the virus itself.
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