Benchmarking COVID 19 Mortality in the United States

On September 22nd the US officially recorded 200,000 COVID-19 deaths. It is unclear how many deaths might have been expected in the case of an early and effective response to the pandemic. We aim to provide a best-case estimate of COVID-19 deaths in the US by September 22nd using the experience of Germany as a benchmark. Our methods accommodate the differences in demographics between Germany and the US. We match cumulative incidence of COVID-19 deaths by age group in Germany to non-Hispanic whites in the US and project the implied number of deaths in this population and among the black and Hispanic populations under observed racial/ethnic disparities in cumulative COVID-19 mortality in the US. We estimate that if the US had been as successful as Germany in managing the pandemic we would have expected 22% of the deaths actually recorded. The number of deaths would have been lower by a further one-third if we could have eliminated racial/ethnic disparites in COVID-19 outcomes. We conclude that almost 80 percent of the COVID-19 deaths in the US by September 22nd could have been avoided with an early and effective response producing similar age-specific death rates among non-Hispanic whites as in Germany. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This project was not funded by any specific mechanism ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: N/A All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data is publicly available. German death rates are from the Robert Koch Institute. US population and deaths by race/ethnicity are from the CDC.