What a Single Metric Tells Us About the Pandemic

Metadata

Author: David Wallace-Wells
Full Title: What a Single Metric Tells Us About the Pandemic
Category: #articles
URL: https://nymag.com/intelligencer/2022/03/covid-excess-mortality.html

Highlights

But the unsteady narratives of COVID-19 are reminders that, as sure as we might have been about how to interpret our experience of it, the stories we told ourselves about what we were dealing with and what we should be doing to protect ourselves were often incomplete, clouded by much more uncertainty and ignorance, wishful thinking and reflexive panic, than we were ever comfortable acknowledging.
The basic math yields some striking results, as shown by a recent paper in The Lancet finding that 18.2 million people may have died globally from COVID, three times the official total. As skeptical epidemiologists were quick to point out, the paper employed some strange methodology — modeling excess deaths even for countries that offered actual excess-death data and often distorting what we knew to be true as a result. A remarkable excess-mortality database maintained by The Economist does not have this problem, and, like the Lancet paper, the Economist database estimates global excess mortality; it puts the figure above 20 million.
Early in the vaccine-distribution phase, with the U.K. and U.S. moving most quickly, it was striking how so few of the countries that had done well in preventing spread in 2020 were doing well in providing vaccines quickly. Over the course of 2021, many of those gaps disappeared, with countries across East Asia and Oceania eventually accelerating their vaccine distribution and parts of Europe that were slow at the outset starting to catch up too. But the U.S. took the opposite course. In 2020, the U.S. had done a bit worse than average among its OECD peers. In 2021, when pandemic outcomes were often determined by the relative uptake of American-made vaccines, the U.S. did much, much worse than that. In country after country in Europe, the pandemic killed a fraction as many last year as it had the year before. In the U.S., it killed more. A year ago, it was possible to defend the American record as merely below average — worse than it should have been but not, judging globally, cataclysmically bad. Today, it is cataclysmically bad, which is both outrageous and ironic, given that it is largely American vaccine innovation that has changed the pandemic landscape for the rest of the world — the rest of the rich world, at least.
On February 1, 2021, just after the inauguration of Joe Biden, the U.S. had registered, according to The Economist, 178 excess deaths per 100,000 inhabitants, quite close to Britain’s 166, Belgium’s 162, and Portugal’s 201. Fast-forward a year and those gaps have exploded. The U.S. has now registered 330 excess deaths per 100,000 — meaning our total has roughly doubled. In Britain, the excess mortality grew only 30 percent; in Portugal, it was 17 percent.
About two-thirds of Americans have received two shots of vaccine, a level that is in line with Israel and not far off from the U.K., though below many other wealthy countries. (And even in the U.K., vaccination was more effectively directed toward the old.) But over the last six months, the country has had an opportunity to make up that gap with boosters and has simply not taken it. Only 29 percent of Americans have had a booster shot of vaccine, which puts us behind Slovenia, Slovakia, and Poland and means that less than half of those people happy to be vaccinated a year ago have chosen to get a third shot through Delta and Omicron. Booster campaigns seem like an obvious opportunity for easy public-health gains, yet remarkably few Americans seem to think it’s worth the trouble. Why? For everything we think we know about the pandemic and how people have responded to it, that one remains a maddening mystery.