Australia has recorded fewer than 100 coronavirus deaths - why do other countries differ so much?

Fewer than 100 people have died in Australia due to the COVID-19 pandemic, but other countries around the world have been much harder hit. SBS News asked health experts why Australia's numbers are much lower.

A gravedigger in Italy

A gravedigger in Italy, where more than 30,000 people have died from COVID-19. Source: AAP

Fatality rates measure how many deaths a country has on a per capita basis.

And when it comes to the COVID-19 pandemic, they differ drastically from one country to another.

Australia's case to fatality ratio is approximately 1.3 per cent. It is low compared to France, which has the highest fatality rate. More than 18 per cent of people who have contracted COVID-19 in France have died.

A little over a month ago, Australia was registering hundreds of new coronavirus cases per day, but now it is down to single figures and some jurisdictions haven't registered a single new case for consecutive days.

Amid more than 6,900 cases, fewer than 100 people in the country have died from COVID-19.

Why is Australia's fatality rate so low?

Dr Tony Blakely is an epidemiologist and public health specialist from the Melbourne School of Population and Global Health. He says Australia’s geographical location and strong leadership is helping its rate stay low.

"It’s good. The fact almost 100 people died isn’t good, but the way to understand this is to take a cascade through it," he told SBS News.
Roadmap to COVIDsafe Australia
PM Scott Morrison talking to NSW Premier Gladys Berejiklian at the National Cabinet Source: AAP
"We are a lucky country ... It was best to cut the in-flow of people coming from China, that was important, but also pure luck of being down the bottom of the world.

"We had more time to plan and react, and we had good leadership in both Australia and New Zealand."

Why are so many people dying in other countries?

Health experts say factors including testing regimes and capabilities, speed of government response, ageing populations and the strength of a country’s health system have an impact on the number of those dying.

Like Australia, Singapore and Taiwan reacted quickly at the beginning of the pandemic.

Speed and preparation from such governments was imperative for many countries with currently low death tolls, giving them the ability to stamp and avoid out early outbreaks spreading.

Many countries don't have effective mechanisms in place to protect people though, particularly when it comes to the elderly.

One of the reasons why Greece has been praised for its handling of the coronavirus pandemic is because the elderly were well protected and cared for from the outset.

Greece has recorded only 151 COVID-19 related deaths, despite being in close proximity to other countries which have recorded thousands, such as Italy where more than 30,000 have died, with a fatality rate of 7.1 per cent.

In the US, approximately 230 people per one million citizens have died from COVID-19, at a fatality rate of almost six per cent.
US President Donald Trump speaks during the daily briefing on the novel coronavirus, COVID-19, in the Brady Briefing Room at the White House on March 27, 2020, in Washington, DC
US President Donald Trump at a daily briefing on COVID-19. Source: AFP
"We have very strong and collaborative leadership," Archie Clements, professor of infectious disease and epidemiology at Curtin University, said of Australia. 

"Our government set up a national cabinet where heads of all the different jurisdictions regardless of their political party were able to come together to manage the epidemic at a national level.

"That is where the failing is in the United States and Europe; lack of collaborative and open government and politicisation of the response."
Professor Catherine Bennett is chair of epidemiology at Deakin University and part of an academic team reviewing Australian and international COVID-19 mortality data.

She said: "another phenomenon that happens when you get large case numbers like in Spain, France, the US and the UK in particular, is it overwhelms the health system and makes it difficult for everybody to get optimal care." 

"There is less true survival in countries where resources are spread thin."

Are the figures being reported accurate?

Professor Bennett says the all-cause death rate is the most accurate way to measure the effects of this crisis, and Australia's annual figures won't be very different compared to the past five years.

"We do think we have captured the direct deaths from COVID-19, we won’t have that sort of missing deaths phenomenon that other countries might see, but we still might see some excess death from the flow-on effects from COVID.

"So the net effect in Australia we are hoping will not be that different to other years, whereas when you go overseas you’ve got COVID deaths which will show as excess deaths."
More than 90 per cent of hospital beds secured for COVID-19 patients in the capital Tokyo have already been occupied.
More than 90 per cent of hospital beds secured for COVID-19 patients in Tokyo have been occupied. Source: SBS
There are several reasons for the variation in statistics, for example, not all nations perform postmortems, some countries only count the deaths in hospitals and some countries don't test for COVID-19 after death.

As a result, Professor Bennett says the reporting of deaths globally is inaccurate.

"At the moment they are probably under-counting, so that means more virus circulating in the community and governments are underestimating how many cases are actually out there.

"Deaths are high because they have more cases in the community, and they’re not doing enough testing.”
Dr Blakely says even government death predictions aren’t fully accurate.

"The percentage of people infected across the world is varying enormously. For example, in the US the modelling suggests they’ll have nearly 80,000 deaths, which they almost do now … but if you look under the hood that was about 2.5 per cent of the population being infected, there’s probably more now.

"Once you become a case you are captured by various systems and there is a chance you will die from it … one per cent of a country’s population will die from it.

"The reason we see variations in the death rate is percentages of infections are critically affected by age, a lot depends on your country’s measures of protecting elderly people."

Will Australia's mortality rate remain low?

Professor Carola Vinuesa from the Centre for Personalised Immunology at the Australian National University says the country's managing of the curve effectively has been positive, but people in Australia should be prepared to keep following safety guidelines for a while longer. 

"It’s clear that Australia has managed to flatten their curve, and this is really good news for our healthcare system," she said. 

"We are not overwhelming our intensive care units, but it does mean the disease will spread over a longer period of time and we might have to really be here for the long haul, trying to keep these numbers low and potentially maintaining a level of social distancing until there is a vaccine."
coronavirus restrictions
Source: AAP
Health experts say countries need to take their testing regimes to the next level to fight the pandemic. 

More than 850,000 Australians have been tested for COVID-19, but Dr Blakely warns testing blitzes can be complicated.

"Testing has so many curveballs, testing is not perfect, there are a lot of false positives, it’s quite a hard jigsaw to fill in.
"Death rates vary enormously by age, symptomatic cases are much higher.

"Those who die could be 10 per cent or 15 per cent of the elderly population in a country.

"The quality of the blood tests will improve soon and be more accurate so we will get a better handle on it.
A nurse tests a patient for COVID-19 at a drive-through Fever Clinic in Caloundra on the Sunshine Coast.
A nurse tests a patient for COVID-19 at a drive-through clinic on the Sunshine Coast. Source: AAP
Professor Bennett recommended downloading the government's COVID-Safe app.

"The COVID-Safe app is about identifying who should be tested and to make sure we don’t miss people. Our case capture now is good but in the early days it was narrow and didn’t come close to counting the cases, when in fact we probably had the most cases in Australia at one time."

People in Australia must stay at least 1.5 metres away from others. Check your state’s restrictions on gathering limits.

Testing for coronavirus is now widely available across Australia. If you are experiencing cold or flu symptoms, arrange a test by calling your doctor or contact the Coronavirus Health Information Hotline on 1800 020 080.

The federal government's coronavirus tracing app COVIDSafe is available for download from your phone's app store.

SBS is committed to informing Australia’s diverse communities about the latest COVID-19 developments. News and information is available in 63 languages at .


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7 min read
Published 13 May 2020 8:46am
By Marcus Megalokonomos



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