Last April, one of us (DS) wrote an article saying it was too soon to compare how lethal the pandemic had been in different countries. Nearly a year later, has the time come?

Unfortunately, countries have different ways of counting; Sciensano in Belgium counts both suspected and confirmed deaths from Covid-19, while Hungary counts only hospital deaths within lab confirmation. So the Office for National Statistics ignores these labels and just looks at excess mortality compared with the 2015-2019 average, standardising the figures to a “standard European” population, so accounting for differences in population size and age structure.

When it did this last June, England topped the table with the highest “relative age-standardised mortality rate” (7%) among 21 European countries. In Spain and Italy, the epidemic in spring 2020 was like an explosion, with an epicentre with the blast dissipating outwards. For England, the mortality impact was broader, longer and more equal across the country, so of the 20 areas in Europe with the highest peaks in excess mortality, only four were in England (Brent, Enfield, Ealing and Thurrock). At that time, Scotland was third (5%) behind Spain (6%).

But by the end of the year, positions had changed. Poland, which did not see increased mortality in the spring, suffered large fatalities from October onwards and now topped the table (total relative rate of 12%), with Spain second (11%). Other eastern European countries also endured outbreaks in autumn and winter and England and Scotland had fallen to seventh (8%) and 10th (6%) respectively in this macabre league table.

This year has seen a steady decline in deaths in the UK, while the Covid death rate in Italy and France is 10 times that of the UK. Vaccines are racing against the virus and Dr Maria Van Kerkhove of the World Health Organization has said: “We are in a critical point of the Covid-19 pandemic now.”

So it’s still too soon to say where we will end up in the final rankings, but whatever happens we will have done badly.

David Spiegelhalter is chair of the Winton Centre for Risk and Evidence Communication at Cambridge. Anthony Masters is statistical ambassador for the Royal Statistical Society

This content first appear on the guardian

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