A core question regarding the Covid-19 pandemic is why mortality rate varies considerably across countries. This study aims to identify factors associated with cross-country variation in Covid-19 mortality rates. By retrieving data from the Worldometer, Worldwide Governance Indicators, World Development Indicators and Logistics Performance Indicators databases, we analyzed 7.8 million Covid-19 patients in 169 countries. 

The multiple regression analysis shows that Covid-19 test numbers, the government effectiveness score, and number of hospital beds were negatively associated with Covid-19 mortality rates. In addition, Covid-19 mortality rate was positively associated with proportion of population aged 65 or older and transport infrastructure quality. Overall, predicted mortality rates were highly associated with observed mortality rates (r = 0.77; P<0.001). Furthermore, the negative association between Covid-19 mortality and test number was stronger among low-income countries and countries with lower government effectiveness scores, younger populations and fewer hospital beds. 

To conclude, increasing Covid-19 test numbers and improving government effectiveness have the potential to reduce Covid-19 mortality. The potential benefit of testing varied with country characteristics. The results of this study will contribute to pandemic-related policymaking at the country level, such as open public testing.

Source: Taiwan Research Highlight