Covid: How do UK pandemic death rates compare?

The UK had one of the worst increases in death rates of major European economies during the Covid pandemic, BBC analysis has found.

Death rates in the UK were more than 5% higher on average each year of the pandemic than in the years just before it, largely driven by a huge death toll in the first year.

That was above the increase seen in France, Spain or Germany, but below Italy and significantly lower than the US.

Back in April and May 2020, the UK was seeing one of the worst waves of Covid deaths in the world.

But Prof Sir Chris Whitty, England's chief medical officer, warned against international comparisons of Covid deaths too early in the pandemic.

Instead, he recommended looking at deaths for any reason, since they do not depend on what a country calls a Covid death.

And he said analyses should take account of the age profile of each country, which can explain a lot of differences in death rates.

We have built a database of those figures, collecting data for the last eight years from a range of European countries, as well as the US and New Zealand.

Now the UK's long-awaited Covid inquiry is under way and Sir Chris is about to give evidence for the first time.

And as the World Health Organization has declared an end to the global health emergency, we have looked back at three years of pandemic deaths, starting in March 2020.

We compared countries by measuring how much their death rates rose from those seen in the five years before the pandemic.

Over the three years to February 2023, the UK's death rates went up by more than 5%, which is more than France, Germany and Spain (all up between 3% and 4.5%), but by less than Italy's (up more than 6%).

The US and Eastern European countries like Poland were even harder hit, with death rates more than 10% above their pre-pandemic levels over the three years to February 2023.

In contrast, death rates fell in countries like Sweden and Norway and also New Zealand, who contained the virus successfully before its vaccination programme took off.

The year-by-year figures tell different stories for each country.

For the UK, they point to early losses followed by significant success in 2022.

The UK was one of the worst-hit countries in the first year of the pandemic, with death rates running 15% above those before it started.

The combination of a terrible first wave and the rapid spread of the alpha (or Kent) variant just as the vaccine rollout was getting going contributed to a huge death toll.

Many eastern European countries like Poland avoided the spring 2020 wave but overtook the UK in numbers of deaths in the winter of 2020-21.

The US continued to have steadily increasing death rates during the summer of 2020 and by the end of the year, it passed the UK's total.

Death rates fell in many European nations in the second year of the pandemic as vaccine programmes got under way.

The UK's vaccine rollout is regarded as a "global exemplar", says Prof Devi Sridhar of University of Edinburgh.

That is not just number of doses, it was also getting them to the people most at risk.

And the UK looked better than any major European economy bar Spain in that second year - with death rates below historical averages.

In the third year, death rates rose in many countries as they opened up again.

Some of the largest rebounds we found were in countries like Germany, New Zealand and Norway, who had fared better in the first two years of the pandemic (and well overall).

Norway had far fewer deaths than Sweden in the first year of the pandemic but over the three years the two countries look more similar.

It is hard to read straight across from Scandinavian countries to the UK, cautions Prof Sridhar, arguing "we'd never look like either Sweden or Norway", and describing them as "healthier, wealthier and more equal" countries that are very different to the UK.

It would take many inquiries to tease apart the effect of all the possible reasons behind every nation's pandemic outcomes: preparedness, population health, lockdown timing and severity, social support, vaccine rollout and health care provision and others.

But some argue that there are lessons for the UK that need to be learned even before we think about future pandemics.

The UK's heavy pandemic death toll "built on a decade of lacklustre performance on life expectancy" says Veena Raleigh, of the King's Fund, a health think tank. She argues that government action to improve population health and turn that around has "never been more urgent".

We collected data on deaths in five-year age groups and population estimates/projections from Eurostat, the Office for National Statistics, National Records of Scotland, the Northern Ireland Statistics Research Agency, the Centre for Disease Control, United States Census Bureau and Stats NZ.

We calculated the death rate in each age group and combined them to form an age-adjusted death rate using the 2013 European Standard Population.

Some nations did not have the full set of age bands. For example, US figures used 10-year age bands between five and 24 and above 55. Broader age bands can exaggerate excess mortality figures like the ones we calculated, in the order of a percentage point.

Additional journalism by Callum Thomson, Isabella Worth, Jana Tauschinski, Liana Bravo and Wesley Stephenson