Was compared the US to Organisation for Economic Co-operation and Development countries with populations exceeding 5million and greater than $25 000 per capita gross domestic product.

For each country, was calculated the COVID-19 per capita mortality rate and grouped countries by mortality: (1) low (COVID-19 deaths, <5/100 000), (2) moderate (5-25/ 100 000), and (3) high (>25/100 000).

Was calculated the difference in COVID-19 deaths between each country and the US through September 19, 2020 (week 38) under 3 scenarios: if the US had a comparable per capita COVID-19 mortality rate to each country from the start of the pandemic (February 13) or if the US mortality rate became comparable to other countries beginning May 10 or June 7, to allow lag time for policy interventions.

Was also considered all-cause mortality per capita for countries with publicly available data through July 25, 2020 (week 30). Was estimated excess all-cause mortality (the difference between mean 2020 deaths and deaths in correspondingweeks of 2015-2019) for each country and the US, compared rates across countries using Poisson regression with country and week fixed effects and estimated the difference in excess all-cause mortality between each country and the US.

On September 19, 2020, the US reported a total of 198 589 COVID-19 deaths (60.3/100 000), higher than countries with low and moderate COVID-19 mortality but comparable with high-mortality countries.

For instance, Australia (low mortality) had 3.3 deaths per 100 000 and
Canada (moderate mortality) had 24.6 per 100 000.

Conversely, Italy had 59.1 COVID-19 deaths per 100 000; Belgium
had 86.8 per 100 000.

If the US death rates were comparable to Australia, the US would have had 187 661 fewer COVID-19 deaths (94% of reported deaths), and if comparable with Canada, 117 622 fewer deaths (59%).
While the US had a lower COVID-19 mortality rate than high-mortality countries during the early spring, after May 10, all 6 high-mortality countries had fewer deaths per 100 000 than the US.

For instance, between May 10 and September 19, 2020, Italy’s death rate was 9.1/100 000 while the US’s rate was 36.9/100 000. If the US had comparable death rates with most high-mortality countries beginning
May 10, it would have had 44 210 to 104 177 fewer deaths

If the US had comparable death rates beginning June 7, it would have had 28% to 43% fewer reported deaths (as a percentage overall).
In the 14 countries with all-cause mortality data, the patterns found for COVID-19–specific deaths were similar for excess all-cause mortality.

In countries with moderate COVID-19 mortality, excess all-cause mortality remained negligible throughout the pandemic.

In countrieswith highCOVID-19 mortality, excess all-cause mortality reached as high as 102.1/ 100 000 in Spain, while in the US it was 71.6/100 000.

However, since May 10 and June 7, excess all-cause mortality was
higher in the US than in all high-mortality countries.

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