COVID-19: The Post-Mortem

By Neil Lock

Dr John Campbell, among others, has recently drawn attention to the large numbers of excess deaths (compared with the same time of year in pre-pandemic years), which have been happening in the UK, and in other European countries, since the beginning of 2021.

The data junkie in me led me to give my “magic spreadsheets,” which I have used to analyze the COVID pandemic over the last three years and more, one last run-out. And to try to deliver a post-mortem report on the pandemic in Europe, with particular reference to excess mortality, and to vaccinations, side-effects of which some see as a possible reason for the excess deaths.

New omicron variants and media scares about them notwithstanding, the three-word summary of where COVID is today is: “It’s dead, Jim.” Of the 50 reporting European countries, only Russia and Czechia are reporting any significant number of either daily new cases or daily COVID deaths. (By significant, I mean at least 1 new case, or 0.0025 deaths, per million population per day).

Excess Mortality

So, let’s look at some graphs of the excess mortality figures (from all causes), which have triggered the recent attention. The data came from Our World in Data’s COVID data feed, and ran up to 21st September. I divided the 50 countries into four groups, and plotted each group.

The UK has been among the countries in the geographical core of Western Europe with the most consistently high excess mortality figures since the middle of 2021. But it isn’t the only one to be high; and even now, there are still more countries generally above the zero line than generally below it.

That’s a similar picture to further west. If anything, a bit worse, at least until very recently.

These countries got hit really hard by several waves of COVID in the first two years of the epidemic, so perhaps it isn’t surprising that things have been quieter recently on the excess mortality front.

These are mostly small countries, which explains the variability of individual lines. But the graph still gives a general impression of above-zero excess mortality, persisting for a long period.

I assembled all these into a “league table” of average excess mortality since the day I counted as the start of the pandemic (24th January 2020). The averaging was done simply by averaging all the individual excess mortality figures given by each country, which should give a reasonably accurate picture given that most countries report weekly; though some report monthly, and some less often still. And I chose to exclude any countries which had not reported an excess mortality figure in the last 90 days prior to the cut-off date (they appear at the top of the histogram).

The Nordic countries are, notably, concentrated towards the bottom of the list. Whether due to cold temperatures, low population densities, a greater trust between the people and governments, or some other cause, I cannot tell.

The UK is in 13th place among 35 reporting excess mortality. Among Western European countries, only Italy is worse.

Luxembourg, Denmark, France and Germany have also done, relatively speaking, well. Compared to all its neighbours, the UK has performed atrociously.

COVID cases and deaths

I created a “league table” of COVID cases per million throughout the epidemic. Cases per million is not by any means a perfect metric, because it does rather depend on the amount of testing, and on how well the cases are counted. Nevertheless, here it is.

Notice that those near the top of the list tend to be mainly smaller countries. The UK, despite having used more tests per head than most other countries, comes 28th out of 50. Suggesting that the counting wasn’t all that good.

Here’s a corresponding “league table” of COVID deaths per million throughout the epidemic, for the same countries. Deaths per million, I think, will tend to be a less accurate metric in many countries than excess deaths, because there is a judgement involved on what constitutes a COVID death, the basis for which may vary from country to country.

The UK is 17th out of 50 – again, a poor performance.

As you might expect, many of the same countries that counted many COVID deaths have also had high excess mortalities. But not all. Russia, for example, is second highest in excess mortality, but only 22nd out of 50 in COVID deaths. And Hungary, third from the top in deaths per million, is in the bottom half of those reporting excess mortality.

One metric of the general quality of health care systems, which I have found useful, is cumulative deaths per case. A high score here shows either a failure to count cases accurately, or a failure to treat those cases properly, or both.

Once again, the UK is near the wrong end of the table, at 15th out of 50. Even Italy is some way below. We all know the NHS is a failing, if not already failed, system; and it shows on this metric.


Here is the league table of percentage of the population fully vaccinated. (The Swiss seem to have withdrawn their previously published figures, perhaps because “fully vaccinated” is not as precise a concept as they might like. Liechtenstein and the Vatican have never published this figure).

The strange number for Gibraltar is, perhaps, explained by their choosing to vaccinate many who live in Spain, but cross the border to work in Gibraltar. Of the others, it looks as if the Catholic countries like to vaccinate as many as they can, while the majority-Protestant countries (except Denmark) tend to be a bit more relaxed. Towards the bottom of the list, lack of resources may also be a factor in low vaccination rates.


OK, now it’s time to put together a scatterplot or six, and see if we can discern any trends. One useful thing to plot against is the UN’s Human Development Index (HDI). Wikipedia describes this as “a statistical composite index of life expectancy, education (mean years of schooling completed and expected years of schooling upon entering the education system), and per capita income indicators, which is used to rank countries into four tiers of human development.” Almost all the countries listed here are currently in the “very high” tier (above 80%).

The HDI data I captured refers to 2019, but countries do move up or down. (The UK, for example, dropped three places from 15th to 18th in the world in 2021).

First, here’s average excess mortality against UN HDI:

As you might expect, the higher the level of development, the lower the average excess mortality. Countries around the 80% mark tend to have about three times as many excess deaths as those around the 95% mark.

And here’s the corresponding plot of COVID deaths per million against HDI:

The trend here has the same sign as that for the excess mortality, but is less steep. As the countries move from 95% HDI down to 80%, the deaths per million go up by a factor of about 1.8.

Lastly, the percentages fully vaccinated versus the HDI:

The higher the HDI, the higher the vaccination level – as you might have expected.

Next, let’s have a look at the efficacy of the vaccines, in terms of controlling cases per million:

Hmmm… The story we were originally fed, that the vaccines would prevent transmission of the COVID virus, has to have been a lie. There might, I suppose, be some effect of people being more willing to take the vaccine if the statistics in their country are bad, than if they are relatively good. But that vertically spread cluster of countries between 40% and 80% fully vaccinated suggests to me that the amount of testing, and the differences in case assignment rates to COVID, in different countries far outweigh any effects the vaccines might have had in controlling cases.

Next, COVID deaths per million versus percentage fully vaccinated:

There is a negative trend here, but it isn’t as big as I would have expected if the vaccines were doing the job they were claimed to. Moving the percentage fully vaccinated from 40% to 80% reduces the number of deaths assigned to COVID by around a third.

And last, but not least, average excess mortality against vaccination levels:

Moving the percentage fully vaccinated to 80% decreases the average excess mortality by more than half, to about 41.5% of what it was at 40%. So, very strangely, the positive effects of vaccination on all-cause mortality seem to be bigger than the positive effects of vaccination on COVID deaths! Not at all what you would expect a vaccine specifically against COVID to do. At least, though, this seems to go against the hypothesis that vaccines are a significant cause of the increases in all-cause mortality.

But let’s compare this last scatterplot with the first one, of average excess mortality against HDI. A lowering of the HDI from 95% to 80% roughly triples the average excess mortality. A lowering of the vaccination rate from 80% to 40% – in this selection of countries, the two changes leave roughly the same number of outliers outside the ranges – increases it by a factor of 2.4. This suggests, to me, that the vaccines haven’t achieved much, if any, savings in all-cause mortality when compared to the benefits of having a higher HDI in the first place.

A few more scatterplots

After first publishing this article, I had the idea of also plotting COVID deaths per million and average excess mortality against cumulative deaths per case. The rationale being that the latter is as good a proxy as we have for the general awfulness of a country’s health care system. The results were most interesting.

That looks like a pair of pretty good positive correlations, and with the ratios between slope and Y-axis intercept not so far from each other, either. Leading to the very common-sense conclusion: Bad health care systems kill.

In conclusion

The UK’s and the NHS’s performance against the COVID virus, compared with its neighbours, and even compared with the other countries of Europe as a whole, has been atrocious.

There is no evidence that the vaccines have had any significant effect in controlling transmission of the virus. Differences in testing rates and counting of cases seem to make more difference than vaccinations.

There are negative correlations between both COVID deaths per million and average excess mortality, and vaccination rates. Though the first is, unexpectedly, less strong than the second.

It doesn’t look as if the vaccines can be among the causes of the high recent excess mortalities in many countries. On the other hand, it also doesn’t look as if they have done as much to reduce mortality as people were led to expect. The general level of human development in a country, as measured by the UN’s Human Development Index, seems to correlate better with reduced mortality than vaccine uptake does.

Plotting COVID deaths per million and average excess mortality separately against cumulative deaths per case (a proxy for poor quality in health care systems) leads to a very simple and common-sense conclusion: Bad health care systems kill.

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