Factors determining different death rates because of the COVID-19 outbreak among countries

J Public Health (Oxf). 2020 Nov 23;42(4):681-687. doi: 10.1093/pubmed/fdaa119.


Background: During the coronavirus disease 2019 (COVID-19) pandemic, all European countries were hit, but mortality rates were heterogenous. The aim of the current paper was to identify factors responsible for this heterogeneity.

Methods: Data concerning 40 countries were gathered, concerning demographics, vulnerability factors and characteristics of the national response. These variables were tested against the rate of deaths per million in each country. The statistical analysis included Person correlation coefficient and Forward Stepwise Linear Regression Analysis (FSLRA).

Results: The FSLRA results suggested that 'days since first national death for the implementation of ban of all public events' was the only variable significantly contributing to the final model, explaining 44% of observed variability.

Discussion: The current study suggests that the crucial factor for the different death rates because of COVID-19 outbreak was the fast implementation of public events ban. This does not necessarily mean that the other measures were useless, especially since most countries implemented all of them as a 'package'. However, it does imply that this is a possibility and focused research is needed to clarify it, and is in accord with a model of spreading where only a few superspreaders infect large numbers through prolonged exposure.

Keywords: COVID-19; death rate; measures; public events ban.

MeSH terms

  • COVID-19 / mortality*
  • Disease Outbreaks
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Mortality / trends*
  • Pandemics
  • Physical Distancing
  • Risk Factors
  • SARS-CoV-2