Variations of COVID-19 Mortality Are Affected by Economic Disparities Across Countries

23 Pages Posted: 12 Jan 2022

See all articles by Lan Yao

Lan Yao

University of Tennessee, Memphis - Health Outcomes and Policy Research

Lotfi Aleya

University of Burgundy Franche-Comté - Laboratoire Chrono Environnement

Scott C. Howard

University of Tennessee, Memphis - College of Nursing

Yanhong Cao

Harbin Medical University - Center for Endemic Disease Control

Congyi Wang

Huazhong University of Science and Technology - Department of Respiratory and Critical Care Medicine

Sara W. Day

University of Tennessee, Memphis - College of Nursing

J. Carolyn Graff

University of Tennessee, Memphis - College of Nursing

Dianjun Sun

Harbin Medical University - Center for Endemic Disease Control

Weikuan Gu

University of Tennessee, Memphis - Department of Orthopaedic Surgery and Biomedical Engineering

Abstract

Background: When the COVID-19 case number reaches a maximum in a country, its capacity and management of health system face greatest challenge.

Methods: Using data reported by Worldometers and WHO Coronavirus (COVID-19) Dashboard, we compared the case fatality rates (CFRs) and time lags (in unit of day) between the turning points of cases and deaths among countries in different development stages and potential influence factors.

Findings: As of May 10, 2021, 106 out of 222 countries or regions (56%) reported more than 5,000 cases. Approximately half of them have experienced all the three waves of COVID-19 disease. The average mortality rate at the disease turning point was 0.038 for the first wave, 0.020 for the second wave, and 0.023 for wave 3. In high-income countries, the mortality rates during the first wave are higher than that of the other income levels. However, the mortality rates during the second and third waves of COVID-19 were much lower than those of the first wave, with a significant reduction from 5.7% to 1.7% approximately 70%. At the same time, high-income countries exhibited a 2-fold increase in time lags during the second and the third waves compared to the first wave. High rates in the first wave in developed countries are associated to multiple factors. In upper middle- and lower middle-income countries, the decreasing of mortality rates in the second and third waves were subtle or even reversed. In the upper and lower middle-income countries, the time lags were about 50% of the durations observed from high-income countries.

Interpretation: Economy and medical resources affect the efficiency of COVID-19 mitigation and the clinical outcomes of the patients. The situation is likely to become even worse in the light of these countries’ limited ability to combat COVID-19 as the new variant transmission becomes dominant.

Note:
Funding: This work was partially supported by funding from University of Tennessee Health Science Center (R073290109) to WG in Memphis, TN, USA, and grant 90DDUC0058 to CG from the U.S. Department of Health and Human Services, Administration for Community Living.

Declaration of Interests: We declare no competing interests.

Keywords: COVID-19, Economy, Income levels, Mortality, Waves, Turning points

Suggested Citation

Yao, Lan and Aleya, Lotfi and Howard, Scott C. and Cao, Yanhong and Wang, Congyi and Day, Sara W. and Graff, J. Carolyn and Sun, Dianjun and Gu, Weikuan, Variations of COVID-19 Mortality Are Affected by Economic Disparities Across Countries. Available at SSRN: https://ssrn.com/abstract=4006911 or http://dx.doi.org/10.2139/ssrn.4006911

Lan Yao

University of Tennessee, Memphis - Health Outcomes and Policy Research ( email )

Memphis, TN
United States

Lotfi Aleya

University of Burgundy Franche-Comté - Laboratoire Chrono Environnement ( email )

16 route de Gray
Besançon Cedex, 25030
France

Scott C. Howard

University of Tennessee, Memphis - College of Nursing ( email )

Memphis, TN
United States

Yanhong Cao

Harbin Medical University - Center for Endemic Disease Control ( email )

Harbin
China

Congyi Wang

Huazhong University of Science and Technology - Department of Respiratory and Critical Care Medicine ( email )

Sara W. Day

University of Tennessee, Memphis - College of Nursing ( email )

Memphis, TN
United States

J. Carolyn Graff

University of Tennessee, Memphis - College of Nursing ( email )

Memphis, TN
United States

Dianjun Sun

Harbin Medical University - Center for Endemic Disease Control ( email )

Harbin
China

Weikuan Gu (Contact Author)

University of Tennessee, Memphis - Department of Orthopaedic Surgery and Biomedical Engineering ( email )

Memphis, TN
United States

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