In 6 countries, most COVID deaths occurred in seniors, men with seasonal patterns


Center for Infectious Disease Research and Policy

By Mary Van Beusekom, MS

An analysis of the evolution of COVID-19 deaths in six countries in 2020 and 2021 identifies substantial inter-country differences, with variations by age, sex, and season.

In the study, published late last week in the International Journal of Infectious Diseases, French researchers parsed data on deaths by age and sex from the Demography of COVID-19 Deaths and the Human Mortality databases from March 2020 to February 2022. The included countries were Belgium, England and Wales, France, Scotland, Sweden, and the United States, although France had no available data after Dec 24, 2021.

Highest total deaths were in US

The first wave of the pandemic began in March 2020 and peaked in April 2020, with a standardized weekly death rate (SDR) of 164 per 1 million in Belgium, 149 in England and Wales, 127 in Scotland, 90 in France, 70 in Sweden, and 62 in the United States. Fewer deaths occurred in summer and early fall 2020, except in the United States, which saw a new wave beginning in June.

During the second wave, the SDR rose rapidly in Belgium, climbing from 8 per 1 million in September 2020 to 120 in November. England and Wales had the highest SDR, reaching 162 per 1 million in January 2021.

In spring and summer 2021, SDRs stabilized, and that fall and winter, the rate slowed substantially in all countries except the United States. While the US SDR didn’t surpass 100 during the study period, it didn’t decline to near 0 in the summer, unlike in European countries. The SDR was highest in all countries in winter, and a larger proportion of men died than women.

By February 2022, the United States had the highest total death toll, which was during the Omicron-dominant period, followed by England and Wales. Among residents aged 44 years and younger, distinct wave patterns were seen only in England, Wales, and the United States. SDR peaks occurred in those aged 75 and older in all countries.

By February 2022, the United States had the highest total death toll.

“The United States was more heterogeneous in terms of each wave’s beginning as well as the types and timing of public health strategies implemented by local governments to contain the spread of the virus,” the authors wrote.