On six separate occasions, President Donald Trump has claimed that Europe’s excess mortality during the COVID-19 pandemic is 33% to 40% higher than America’s. But that’s only possible when cherry-picking numbers or ignoring Europe’s larger population.
It’s a meaningless comparison anyway, experts say, given differences in population age and density, a later arrival of the coronavirus on American shores, and a still raging epidemic in the U.S.
The president recited the misleading statistic in three consecutive press briefings, starting on Aug. 11, when he said, “Europe has experienced a nearly 40% higher excess mortality rate than the United States.”
The following day, he dropped the caveat of “nearly,” and declared that “Europe has experienced a 40% higher excess mortality than the United States.” And on Aug. 13, he iterated the point again.
Trump then repeated the claim for a fourth time on Aug. 17 in a speech in Mankato, Minnesota, after touting a decline in the fatality rate for the elderly.
“Europe by contrast has experienced a 40% higher rate of excess mortality than the United States,” he said, before referencing Minnesota Republican Rep. Tom Emmer. “Think about that, you don’t hear those stories, they don’t tell you that Tom, do they? You don’t hear that in Congress, right?”
Then, in a fifth reprisal during an Aug. 19 briefing, Trump lowered the number. “Excess mortality in Europe this year is 33% higher than the United States — evidence that the tragic cost of this virus is higher in other Western nations,” he said. Trump then repeated the lower figure in an Aug. 23 briefing.
The recurring statistic is part of a larger effort to cast the U.S.’s experience with the coronavirus in a better light than that of its European counterparts. But, as we have written, Trump has erred on these types of comparisons before, falsely claiming that the U.S. per capita death rate is lower than “most” of Western Europe and leaving the misleading impression that America is doing better than other countries experiencing recent upticks in cases.
Uncertain Statistic
It’s unclear how the president arrived at his 40% higher excess mortality figure. We asked the White House repeatedly for a source for the statistic and for more information on how it was being calculated, such as how Europe was being defined, but we did not receive a reply.
So we dug into available estimates of excess mortality and also asked experts at the University of Oxford, Janine Aron and John Muellbauer, who had written a primer on excess mortality for the website Our World in Data.
The data we found do not support the president’s claim — at least not in any fair comparison of excess mortality. And an independent analysis triggered by our query revealed that when the most comparable part of the U.S. is stacked up against the hardest-hit countries in Europe, America fares worse — not better — on measures of excess mortality.
First, it’s useful to explain what excess mortality is and why it’s important during a pandemic such as COVID-19. As the Our World in Data primer details, excess mortality refers to the actual number of deaths, regardless of cause, minus a “normal” or expected number of deaths during a given time period. Because reporting of COVID-19 deaths may be spotty and incomplete, especially early on, statisticians can instead look at excess mortality to get a sense of the impact of the virus.
As Aron and Muellbauer write, “Excess mortality data can be used to draw lessons from cross- and within-country differences and help analyse the social and economic consequences of the pandemic and relaxing lockdown restrictions.”
Not all of the excess deaths during a pandemic period are from people who succumbed to COVID-19, although many of them likely are. Excess mortality also captures the indirect effects of the pandemic, including people who may have died from other causes because they avoided seeking medical attention or from overwhelmed hospitals, as well as increases in suicide.
Similarly, excess mortality factors in the benefits of pandemic conditions, such as a reduction in deaths from car accidents as well as fewer deaths from other communicable diseases that may have declined as a result of COVID-19-inspired physical distancing and other public health measures.
U.S. vs. Europe
As a first crude approximation, we turned to data from the Centers for Disease Control and Prevention, which publishes estimates of excess mortality during the pandemic. According to the agency’s calculations, between Feb. 1 and Aug. 8, there have been between 174,930 and 235,728 excess deaths across the country, for a midpoint value of 205,329 deaths.
In comparison, through week 33 of this year, or Aug. 16, 204,634 excess deaths occurred in 24 European countries or parts of countries, according to estimates by EuroMOMO, a group monitoring mortality trends in Europe.
The two numbers — which are about equal — are meaningless on their own, but when adjusted for population, there are 665 excess deaths per million people for the covered European area, compared with 622 excess deaths per million in the U.S., using the midpoint value.
That works out to Europe having around 7% more excess deaths per capita than the U.S. The percentage rises as high as 26% if the lower U.S. value is used, and the roles reverse — with the U.S. having a 7% higher excess mortality rate than Europe — if the upper-end CDC estimate is used.
The comparison is by no means perfect. The time ranges for the calculations differ; the two estimates aren’t using the same methodology, and the data do not capture all of Europe. As Muellbauer told us, the estimate favors the U.S. because the areas of Europe in the EuroMOMO network tend to include those most affected by the virus and omit countries that weren’t hit as hard.
Still, the result suggests that Trump is off-base to claim Europe’s excess mortality is 33% to 40% higher than America’s. The only plausible way to get close to such a number requires one to select the lower-bound of the CDC estimate, and Trump would still be exaggerating.
For a better approximation, we also compiled data from the Human Mortality Database, which has been tracking weekly death counts for 29 countries — including most of Europe and the U.S. — as a result of the pandemic.
At Muellbauer’s suggestion, we used the visualization tool to pull data for the number of excess deaths in 2020 for each country over the same time period, using the same reference years of 2015-2019 whenever possible (Germany’s reference range was 2016-2019). We chose to analyze deaths through June 21 (week 25) because that was the latest available data for France — and would make the fairest comparison for the U.S. (Slovenia was excluded because it lacked data past week 13.)
Over the Jan. 1 through June 21 period, we found the U.S. had 183,570 excess deaths, while Europe had 242,739. Using the sheer numbers, Europe’s raw excess mortality is 32% higher than the U.S.’s — similar to Trump’s downwardly revised claim of 33%.
But if that is the origin of Trump’s statement, it’s a distortion because it doesn’t account for the larger population of Europe, or the fact that compared with the expected number of deaths, Europe’s rate of excess mortality is in fact lower than that of the United States.
Indeed, by this analysis, U.S. mortality is 13.3% higher than normal, versus just 10.1% for Europe. In other words, compared to what is expected, Europe’s death rate is not as elevated — and in fact, America’s excess mortality rate is 32% higher than Europe’s, not the other way around.
Misleading Comparison
While we sought to answer the question of how America’s excess mortality fares in comparison with Europe’s, experts cautioned that the comparison itself was misguided.
Calling Trump’s claim of 40% higher excess mortality “highly suspect,” Aron and Muellbauer said the fundamental concern is that the U.S. is very different from Europe.
“Whether he means all of Europe or particular countries, President Trump is not comparing like-for-like,” they said in an email. “First, the U.S. as a whole has a much larger, younger, less dense population with a rather smaller fraction living in big cities than the major European countries, and we know that big cities and older populations suffered much worse excess mortality. Second, the pandemic is still raging in many states in the South and the West so that it is premature to compare the whole of the U.S. with the main European countries.”
A better comparison, Aron and Muellbauer said, is to see how well the Northeastern U.S. stacks up with the major European countries, since the timing of the pandemic and population characteristics, including population density, are more similar.
In an analysis shared with FactCheck.org, the two economists calculated P-scores, or the percentage of excess mortality, during the 11 peak weeks of the pandemic for a variety of Western European countries and the Northeastern U.S., which includes Maine, New York, New Jersey, Vermont, Massachusetts, Rhode Island, Connecticut, New Hampshire and Pennsylvania.
The duo found mortality to be 76% higher than normal in the Northeastern U.S. — well above the level of any other European country. Spain was closest, with a 55% increase, followed by England and Wales (54%), Scotland (41%), Italy (40%), Belgium (38%), the Netherlands (30%), Sweden (28%), France (22%) and Germany (6%).
On a per capita basis, the Northeastern U.S. had 142 excess deaths per 100,000 people — again more than any of the analyzed European countries. Spain had the highest per capita excess mortality in Europe, with 103 excess deaths per 100,000.
All plausible measures of excess mortality, they said, are “substantially worse” in the Northeast than in the worst-affected countries in Europe. “This is despite the later arrival of the pandemic in the Northeast,” they added, “which gave U.S. policy-makers three more weeks warning than European countries such as Italy and Spain.”
Moreover, Aron and Muellbauer expect that as more time elapses, the U.S. is likely to fare worse in comparison with Europe because of its larger ongoing epidemic.
Other than cherry-picked or misleading figures, we find no evidence to back Trump’s claim, and using a more appropriate comparison with Europe shows that the opposite is true — that even with multiple advantages, the U.S. has experienced a higher rate of excess mortality.
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The post Trump Touts Misleading and Flawed Excess Mortality Statistic appeared first on FactCheck.org.
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