Why is America's COVID death rate so much higher than the UK's?

Why is the United States’ COVID death rate so much higher than the UK’s? Only 62% of Americans are fully vaccinated compared to 70% in Britain – and the sluggish rate may be to blame for mortality rate that now surpasses most of developed world

  • US has exceeded UK in per capita COVID deaths since June despite fewer cases
  • UK had higher death rate in the first wave but the US now exceeds all G7 nations
  • The prevalence of milder Omicron in the UK does not fully explain the difference
  • Key variables could be vaccination rate and the overall health of the populations
  • Excess mortality remains similar in the two countries, suggesting that COVID is killing more Americans who were already likely to die imminently  

The death rate from COVID-19 in the United States remains stubbornly high compared to the United Kingdom and other developed nations, raising questions about why the world’s largest economy hasn’t been able to better rein in mortality.

Considering a variety of factors, it is likely that differences in vaccination rates play a key role in the higher US death rate, with less widespread adoption of vaccines in America fueling more severe illness and death. 

The US overtook the UK in June as the G7 nation hardest hit by COVID deaths on a total per capita basis, and has maintained the ignominious title ever since.

Since November 1, the US has averaged about 3.8 COVID deaths per million people each day, more than double the UK rate of 1.8, according to a DailyMail.com analysis of data from Our World in Data.

The difference has remained consistent even as the UK saw COVID case rates spike well above US levels as the Omicron surge took hold.

Since November 1, the US has averaged about 3.8 COVID deaths per million people each day, more than double the UK rate of 1.8, according to a DailyMail.com analysis

The UK has seen per capita cases soar in comparison to the US as the Omicron variant takes hold, but deaths have yet to rise commensurately 

The UK surpassed the US in vaccination rate in June and has remained higher ever since

British Prime Minister Boris Johnson  is seen with U.S. President Joe Biden in Glasgow, Scotland last month

This could be due to the simple fact that deaths lag well behind new cases, or another indicator that Omicron causes less severe illness and death than prior variants.

But the difference in death rates has been persistent for some time and is not fully explained by variations in the prevalence of Omicron, which spread a few earlier in the UK than in the US and which experts say causes milder symptoms than other variants, including Delta.

On Tuesday, the Centers for Disease Control and Prevention admitted a serious error in calculating the prevalence of the variant, overblowing the figure recorded in mid-December by as much as 50 percentage points and sowing confusion as the nation breaks records for new cases. 

The agency released a revised chart on Tuesday showing that the new variant accounted for 23 percent of all COVID-19 cases for the week ending on December 18, as opposed to the 73 percent it originally reported. 

The chart showed that the Omicron variant accounted for 59 percent of all new cases for the week ending on December 25, meaning the Delta variant has been accounting for far more infections than the agency initially thought, though Omicron is gaining ground quickly. 

In England, which is several weeks ahead of the US in the Omicron wave, the new variant went from zero to 92 percent of all new cases in the four weeks leading up to December 27, according to data from the UK Health Security Agency. 

There are a number of variables that might explain the difference in deaths, including difference vaccination rates and overall health in the two countries. 

In the US, 61.9 percent of the total population is fully vaccinated, compared to 70.4 in the UK. 

That is a difference of some 29 million Americans who are unvaccinated, but would have the shot if the US matched the UK’s vaccine uptake rate.

The US is also an unhealthier country than the UK overall in some key respects, with a higher death rate from cardiovascular disease and a much higher prevalence of diabetes. 

The UK’s pre-pandemic life-expectancy of 81.3, versus 78.9 in the US, is another signal of the better overall health quality in Britain.

Other potential demographic factors, such as age and urban living rate, don’t appear to be at play.   

The number of deaths in the US has surpassed 820,000 since the start of the pandemic. Only 62% of Americans are fully vaccinated

In the UK, where 70% of the population is fully vaccinated, there have been 148,089 covid-related deaths since the start of the pandemic

In 2020, about 83 percent of the total population in the United States lived in cities and urban areas.

That’s comparable to the UK, where the degree of urbanization amounted to 83.9 percent, suggesting that denser living conditions are not the driving factor behind increased deaths.

The US is also a slightly younger country, with a median age of 38.1 years versus 40.5 years in the UK, meaning that America is not more vulnerable to severe illness due to a more elderly population.

Another key statistic offers insight into the discrepancy: the case fatality rate, or the percentage of those infected with COVID who end up dying from the virus.

Before April, the US, the UK and the average of wealthy nations all had roughly the same case fatality rate, meaning the virus killed roughly the same proportion of people it infected in each country.

Then in May, a startling trend developed in which the UK case fatality rate plunged below the wealthy country average, and the US rate soared above it. 

Since April, the US and UK have sharply diverged on case fatality rate, or the percentage of those infected with COVID who end up dying from the virus

That trend has held steady ever since, and it may be no coincidence that the shift coincides with the period in which vaccines became widely, freely available in the two countries. 

Public health authorities have struggled to convince many Americans to take the vaccines, leading to President Joe Biden’s increasingly strict mandates to try to force compliance.

In one puzzling point, the excess mortality rates in the UK and US have remained roughly comparable. The refers to the number of additional deaths above what would be expected from averages over prior years.

In early November, the last data available, the US excess mortality rate (11.3 percent) was actually below the UK (16.8 percent). 

This could suggest that COVID is more likely to kill people in the US who would otherwise imminently die, or there could be some other confounding factor. 

In one puzzling point, the excess mortality rates in the UK and US have remained roughly comparable

The US death rate has exceeded all other G7 nations for the most part since August

The UK is not alone among wealthy nations in maintaining lower deaths rates than the US.

For the first year of the pandemic, per capita daily deaths were spread fairly evenly among the Group of Seven developed nations, with the exception of Japan, which sealed its island borders.

The other G7 nations saw their various surges in deaths as waves of virus came and passed, by turns surpassing each other in the grim statistic.

But starting around early July, daily death rates in all G7 nations converged at less than one. 

A month later, the US began to pull away from the pack, and aside from a brief challenge from Germany earlier this month, has remained on top of the death tally.  

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