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The U.S. excess mortality rate is better than that of Europe.

Experts say comparing excess mortality rate cannot be relied on as an absolute measure of gauging the impact of coronavirus in different countries.

During the ABC News town hall conducted on Sep. 15, 2020, President Donald Trump, while fielding questions from voters about his administration's handling of the coronavirus crisis, claimed that the U.S. had one of the best excess mortality rates. Trump's claims about the U.S. having low excess mortality have been a part of his election rhetoric to strengthen the narrative that the U.S. government did a commendable job at tackling the pandemic.

By comparing the excess mortality rate, Trump implies that the U.S has handled the pandemic better when compared to Europe. However, this comparison is misleading, as experts say comparing excess mortality rate cannot be relied on as an absolute measure of gauging coronavirus's impact in different countries.

The World Economic Forum opined that research had questioned the usefulness of death rates in judging countries' success in battling COVID-19, and geography and demographics play a significant role in how countries have been affected. In an explainer about the impact of the virus, the BBC wrote that there are no international standards for how death is measured or their causes, making comparisons tricky as deaths are recorded in different ways. It stated that the metric of excess deaths had been one of the most meaningful measures for gauging the impact of COVID-19 in different countries.

Our World in Data, a project of the Global Change Data Lab defines excess mortality as a count of deaths from all causes relative to what would normally have been expected. It states, "In a pandemic, deaths rise sharply, but causes are often inaccurately recorded, particularly when reliable tests are not widely available. The death count attributed to COVID-19 may thus be significantly undercounted. Excess mortality data overcome two problems in reporting COVID-19-related deaths. Miscounting from misdiagnosis or under-reporting of COVID-19-related deaths is avoided. Excess mortality data include 'collateral damage' from other health conditions, left untreated if the health system is overwhelmed by COVID-19 cases, or by deliberate actions that prioritize patients with COVID-19 over those with other symptoms."

A comparative analysis on the excess mortality in U.S. and Europe conducted by FactCheck.org said, according to the U.S. Centers for Disease Control and Prevention, between Feb. 1 and Aug. 8, there have been between 174,930 and 235,728 excess deaths across the country, for a midpoint value of 205,329 deaths. In comparison, through week 33 of this year, or Aug. 16, 204,634, excess deaths occurred in 24 European countries or parts of countries, according to estimates by EuroMOMO, a group monitoring mortality trends in Europe. The analysis revealed that when adjusted for population, there were 665 excess deaths per million people for the covered European area, compared with 622 excess deaths per million in the U.S., using the midpoint value.

Janine Aron and John Muellbauer, experts from the University of Oxford, told FactCheck.org that the comparison itself was misguided. They explained that the U.S. has a much larger, younger, less dense population with a relatively smaller fraction living in big cities than the major European countries. Since the big cities and older populations suffered much worse excess mortality, the comparison was inappropriate.

Aron and Muellbauer published a report titled 'Transatlantic excess mortality comparisons in the pandemic' on the Our World in Data platform. Based on a compilation of the P-scores, or the percentage of excess mortality, the report concluded, "By the P-score, excess mortality in Europe was 22 percent lower than in the U.S.; even on a cruder per capita figure, excess mortality in Europe was 9 percent lower than in the U.S. This is a surprising finding for two reasons. First, the pandemic arrived later in the U.S., giving the policymakers more time to react. Moreover, over time, medical knowledge about Covid-19 has improved. Health and testing capacities have been built up, and practical experience has allowed both citizens' private precautionary responses and public policies to develop. Second, the lower population density, age structure, and degree of urbanization in the U.S. than in Europe should have resulted in lower mortality associated with the pandemic. Our findings contradict claims by the President that Europe had a 33 percent higher rate of excess mortality than the U.S."

Trump's reference to the excess mortality rate is deceptive because various metrics related to the pandemic suggest that the U.S. is one of the worst-hit countries. Barring Spain, all other European countries have a lower case fatality ratio as of Sep. 16, 2020, per data published by the John Hopkins Coronavirus Resource Center. Also, currently, the U.S. has the highest caseload in the world.

The COVID-19 pandemic has given rise to a lot of potentially dangerous misinformation. For reliable advice on COVID-19 including symptoms, prevention and available treatment, please refer to the World Health Organisation or your national healthcare authority.

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