The Group of Seven (G7) club of countries consists of Canada, France, Germany, Italy, Japan, the United Kingdom and the United States. Its members are among the world’s richest countries. Despite their relative similarity, the G7 shows huge diversity in terms of how COVID-19 has affected mortality outcomes. In what follows, we highlight the experience of the two countries at opposite extremes: Japan and the US.
The chart below shows over the course of the pandemic the evolution of the cumulative COVID-19 mortality rate. This expresses reported deaths with COVID-19 as the underlying cause relative to population size (per 100,000 people).
A few results are immediately obvious when looking at this chart. We can see the effect of different waves when the slope of the curve steepens. We can also see the huge variety in outcomes across G7 countries.
Let’s focus in what follows on the extremes: the US and Japan. It is astonishing how different the outcomes are of these two high-income countries. The cumulative COVID-19 mortality rate in the US is currently 12 times larger than in Japan.
We can also look at excess mortality, which captures the gap between the total number of deaths that occur for any reason and the amount that would be expected under normal circumstances. Given the massive undercounting of the mortality toll both directly and indirectly attributed to COVID-19, excess mortality provides a useful way to get a glimpse of the true mortality toll.
Below we show the cumulative estimated excess mortality rate, where the estimates are the mid-points of the excess death model produced by The Economist. They are estimates on the basis of a machine learning algorithm that compensates for the lack of (timely) available data on excess mortality. The results of the model are discussed here.
Here’s one whopping results: the differences across G7 countries are even starker when we look at excess mortality rates. Again the US and Japan stand out. The cumulative excess mortality rate in the US is currently 10 times higher than that of Japan.
In the table below, we provide the latest data on COVID-19 and excess mortality both in absolute and relative terms. Because of its large population size, we expect that the US has a larger absolute death toll. However, even on a relative basis, the US has high numbers both for reported COVID-19 mortality and estimated excess mortality.
The reason why the ratio between US and Japanese mortality rates is so much greater for excess deaths than COVID-19 deaths is two-fold. First, the US excess death rate is considerably larger than the reported COVID-19 one, as per the estimates of The Economist. Second, the opposite is true for Japan, where excess mortality is in fact lower than COVID-19 mortality.
What might explain the stellar performance of Japan? The country has a long and well-established tradition of wearing masks, which has been proven to be effective in mitigating the spread. The general health profile of the population is likely to have helped as well: low prevalence of obesity; low intake of red meat, especially saturated fatty acids; high intakes of fish, specifically n-3 polyunsaturated fatty acids, plant foods such as soybeans, and non-sugary beverages such as green tea.
One could point to other factors that may have played a role. But the overall point here is that Japan’s performance has been remarkable when placed in international perspective. Japan’s demographic profile (chart above) makes this performance all the more remarkable: Japan has the 2nd oldest population in the world (after Monaco) and COVID-19 is an age-discriminating disease.