Ever since the COVID-19 pandemic began, it has been difficult to get reliable data on infections and deaths. As Holman Jenkins of the Wall Street Journal has repeatedly emphasized, the actual number of Americans who have been infected with COVID is almost certainly much larger than the “official” number of confirmed cases—and thus, the actual fatality rate is much lower. The official COVID death tally is a more meaningful statistic, although it fails to distinguish between people who died from COVID and people who died with COVID—a crucially important difference.
That caveat aside, America has suffered more COVID-19 deaths than any other country. This is awful and tragic for everyone affected, especially those who have lost multiple family members.
Our national death toll highlights the scale of the grief and suffering. But it does not provide a real global perspective on the virus. After all, to make comparisons between countries, we must adjust for population size.
As of January 5, among nations with at least a million people, Belgium had the most cumulative COVID-19 deaths per capita, followed by Slovenia, Italy, Bosnia and Herzegovina, North Macedonia, Peru, the United Kingdom, the Czech Republic, Bulgaria, Spain, and then the United States, according to data compiled by the Johns Hopkins Coronavirus Resource Center.
If we look at the seven-day rolling average of daily COVID-19 deaths per capita through January 4, Lithuania topped the list, followed by Slovakia, Slovenia, Croatia, the Czech Republic, Hungary, Bulgaria, Panama, Eswatini (formerly Swaziland), Switzerland, the United Kingdom, Latvia, Bosnia and Herzegovina, and then the U.S. Right behind us was Germany, which was once lauded for its “model” response to COVID.
The countries listed above have tried a wide range of public policies to combat the virus, but most have used some version of lockdown.
Peru, for example, imposed one of the earliest and harshest lockdowns in Latin America. As the Guardian reported in May, the Peruvian government “strictly adhered to the World Health Organization’s coronavirus recommendations and mobilised the police and army to enforce a stringent quarantine.”
In Western Europe, countries such as Belgium, Italy, the U.K., and Spain all imposed nationwide lockdowns in March. The Italian lockdown has been described as the toughest in the developed world.
Sweden famously took a more relaxed approach to COVID-19, eschewing lockdowns while encouraging people to practice social distancing voluntarily. Over the summer, many condemned the Swedish model as a failure. In the early fall, some said it had proved at least a partial success. Today, as Sweden introduces new restrictions amid rising caseloads, critics are once again declaring that it should have locked down from the beginning.
The truth about Sweden defies simplistic narratives. Like many U.S. states, the Scandinavian country did a terrible job of protecting the elderly in its nursing homes: As of late November, nursing-home residents made up “nearly half” of Sweden’s COVID-19 deaths, according to Reuters. Still, Sweden was right to keep its schools open last spring and through most of the fall. (In early December, it temporarily moved high-school students to distance learning.)
Sweden has suffered far more COVID-19 deaths per capita than its Nordic neighbors—no question about it. At the same time, it has experienced significantly fewer COVID deaths per capita than several other Western European countries, including Belgium, Italy, the U.K., Spain, and France—all of which imposed nationwide lockdowns when the pandemic first began.
This underscores the limits of what lockdowns can accomplish.
“Nearly half of England is under the nation’s strictest lockdown measures,” the New York Times reported last week, “and people have been ordered to stay at home, but the coronavirus is still spreading at an alarming rate,” with hospitals “treating more patients than at any time during the pandemic.”
Because of the spread—and the emergence of a new, apparently more contagious COVID variant—all of England is now under yet another national lockdown, which British Prime Minister Boris Johnson announced on Monday night.
Like England, California has turned into a major COVID hot spot despite implementing severe lockdowns.
“California has had some of the toughest restrictions in the country to combat the coronavirus, from a complete ban on restaurant dining to travel quarantines and indoor gym closures,” Politico noted on December 23rd. “It hasn’t been enough. America’s most populous state has become one of the nation’s worst epicenters for the disease, setting new records for cases, hospitalizations and deaths almost every day.”
Where does that leave the broader COVID debate? On the most basic level, we must remember that public policy isn’t everything, and that the benefits of lockdowns have been vastly oversold. Factors such as demography, comorbidities, culture, climate, and geography have played a key role in determining the impact of the virus on individual countries, regardless of whether or how those countries imposed a lockdown.
On the subject of geography, a few weeks ago Washington Post columnist Brian Klaas cited Japan, Australia, South Korea, Norway, New Zealand, and Taiwan—countries with far fewer COVID-19 deaths per capita than the U.S.—as evidence that America is an “outlier.”
As Ed Asante responded on Twitter: “Four of the 6 are islands. South Korea is effectively an island since its border with N. Korea is the most militarized in the world.” And Norway? “A country with 5 million people on a peninsula”—one that has dramatically lower levels of adult obesity and adult diabetes than America does.
None of this means public policy is irrelevant to the fight against COVID. Norway, for example, has benefited from ultra-strict border controls.
“Travelers to Norway must produce a negative test to enter the country and must stay confined for 10 days in a certified hotel after arriving,” the Wall Street Journal reported in November. “Violators are subject to high fines or deportation.”
Here in the U.S., certain state-level policy decisions were clearly disastrous. Most notably, states such as New York, New Jersey, Pennsylvania, and Michigan should never have forced nursing homes to admit COVID-19 patients.
As for the Trump administration, it has a mixed record on the virus, though its overall response has been better than critics allow. My former Weekly Standard colleague Chris Caldwell recently offered a balanced take in the New Republic:
“Some of Trump’s choices were sound (such as his prompt decision to restrict air travel from China, carried out, as he was correct to recall, in the face of Democratic and press accusations of xenophobia). Some of his poor choices were constrained by the situation on the ground: the outright discouragement of mask use by his surgeon general, Jerome Adams, may have been due to the fact that the United States was incapable of manufacturing them, leading to shortages among medical professionals.”
Regarding travel bans and border closures, blogger Will Truman—no fan of the Trump administration—raised a good point last month. Reflecting on which government actions could have made the biggest difference at the start of the pandemic, Truman wrote:
“The number one thing we could have done was shut down all incoming flights, subject to strict quarantine. The person that came closest to advocating this was President Trump, but this is one of those full-measure-only things and he didn’t want to do that. Instead he gave Americans abroad, including those with the virus, an opportunity to come home and then shut things down. There was no support for a more comprehensive travel ban from the opposition (quite the opposite) or public health.”
Keep that in mind whenever you hear people say we should have “done more” in early 2020.
The miserable, maddening reality is that a country like the U.S. cannot control a virus like COVID-19 through public policy alone. We can certainly adapt to it and take steps to mitigate its impact. But real control only arrives with mass vaccinations and herd immunity. Blessedly, that process is now underway, thanks in no small part to Operation Warp Speed. As we slog through it, let’s try to maintain perspective and avoid learning the wrong lessons from a truly awful year.