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. 2022 Mar 28;12(1):5272.
doi: 10.1038/s41598-022-09286-7.

Global ecological analysis of COVID-19 mortality and comparison between "the East" and "the West"

Ariel Pablos-Méndez  1 , Simone Villa  2 , Maria Cristina Monti  3 , Mario Carlo Raviglione  4 , Hilary Brown Tabish  5 , Timothy Grant Evans  6 , Richard Alan Cash  7
Affiliations

Global ecological analysis of COVID-19 mortality and comparison between "the East" and "the West"

Ariel Pablos-Méndez et al. Sci Rep. .

Abstract

Although SARS-CoV-2 was first reported in China and neighbouring countries, the pandemic quickly spread around the globe. This paper explores national drivers of the pandemic and the radically different epidemiology and response in the West and in the East. We studied coronavirus disease (COVID-19) mortality until 31st December 2020, using an ecological study design, considering baseline characteristics and responses that might account for the uneven impact of the pandemic. A multivariable regression model was developed to explore key determinants. Key variables in the West were contrasted with those in the East, and speed of response was examined. Worldwide, 2.24 million COVID-19 deaths were documented in 2020. Western countries reported a median mortality 114 times that of the East (684 vs. 6.0 per million). Significant correlates of mortality in countries with at least 1 million population were median age, obesity prevalence, and democracy index; political stability and experience of SARS in 2002-2003 were protective; health system variables and income inequality were not associated. Outputs of the model were consistent when adjusted for stringency index, timeliness of stay-at-home requirements, and geographical autocorrelation. The West experiences a much higher COVID-19 mortality than the East. Despite structural advantages in the West, delays in national responses early on resulted in a loss of control over the spread of SARS-CoV-2. Although the early success of the East was sustained in the second half of 2020, the region remains extremely vulnerable to COVID-19 until enough people are immunized.

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Conflict of interest statement

The study was sponsored by the China Medical Board (CMB), an American Foundation in Boston, MA. USA. APM, SV, and HBT received funds from the CMB. There are no further competing financial/non-financial interests to disclose for MCM, MCR, TGE, and RAC.

Figures

Figure 1
Figure 1
Forest plot of the final multivariate OLS regression model of COVID-19 mortality in 2020 adjusted for response measures, with spatial autocorrelation correction. In the figure, three countries (ie, Mongolia, Thailand, Papua New Guinea) were removed because outliers. Additional information can be found in the supplementary results.
Figure 2
Figure 2
Trends in COVID-19 mortality (per 1 million people) in the West and in the East. Displayed mortality rates are unstandardized as data disaggregated by age groups are not available in any public repository. All countries displayed in this figure are those listed in Table S2 of the supplementary methods, including those < 1 million population.
Figure 3
Figure 3
Weekly trend in online searches of “face masks” in Google, expressed in RSV (%), in the West (in red) and in the East (in purple). As extensively explained in the supplementary materials, data from 1st December 2019 to 30th June 2020, accounting for 1-month period of baseline to account for possible confounding for some countries in the East with higher baseline values (ie, Japan and Viet Nam). Additional information on Google Trend RSV can be found in the supplementary methods.
See this image and copyright information in PMC

References

    1. Clark A, Jit M, Warren-Gash C, Guthrie B, et al. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: A modelling study. Lancet Glob. Health. 2020;8(8):e1003–e1017. doi: 10.1016/S2214-109X(20)30264-3. - DOI - PMC - PubMed
    1. COVID-19 to plunge global economy into worst recession since World War II. The World Bank. June 8, 2020. https://www.worldbank.org/en/news/press-release/2020/06/08/covid-19-to-p....
    1. Kampf G, Kulldorff M. Calling for benefit-risk evaluations of COVID-19 control measures. Lancet. 2021;397(10274):576–577. doi: 10.1016/S0140-6736(21)00193-8. - DOI - PMC - PubMed
    1. Scrucca, L., Fop, M., Murphy, T. B. and Raftery, A. E. (2016) mclust 5: Clustering, classification and density estimation using Gaussian finite mixture models, The R Journal, 8/1, pp. 205–233. https://journal.r- project.org/archive/2016/RJ-2016–021/RJ-2016–021.pdf - PMC - PubMed
    1. The Economist. Url: https://www.economist.com/leaders/2021/05/15/ten-million-reasons-to-vacc... (last access June 14, 2021)