Nearly five years after the start of the Covid-19 pandemic, a new study has called for lessons to be learned from the global health crisis, at a time when "the threat of a new pandemic remains very real," according to Arnaud Fontanet, a medical epidemiologist at the Institut Pasteur.

His team compared excess mortality linked to Covid-19 in 13 western European countries between January 2020 and June 2022. The results are clear about the first wave: When it hit, there were still neither enough masks nor vaccines, and the virus' mode of transmission was still a matter of debate. Countries that quickly took measures to restrict social contact – the only effective measures available at the time – fared much better. "Not only did they save more lives, but they also better preserved their economies," said Fontanet, who published these results on Monday, December 9, in the journal BMC Global and Public Health.

Admittedly, the findings on saving lives will come as little surprise to public health experts. However, it had not yet been documented using a rigorous methodology that controlled for the effects of age. While Covid-19 affected the elderly the most, the percentage of the population over 80 varied significantly across countries, ranging from 7.5% in Italy to 3.5% in Ireland, with France at 6.1%. For a meaningful comparison, it was therefore necessary to use a standardized method that removed the impact age could have.

The authors calculated that, between January 2020 and June 2022, Italy was hit the hardest, with excess mortality reaching 2.7 per 1,000 inhabitants. After Italy are, in descending order of magnitude, Belgium, the United Kingdom, the Netherlands, Portugal and Spain, with excess mortality between 2 and 1.7 per 1,000. Next come France, Switzerland and Germany, with excess mortality close to 1.5 per 1,000. The Scandinavian countries (Norway, Sweden and Denmark), along with Ireland, lead the pack, with "only" 0.5 to 1 extra death per 1,000 inhabitants.

The first six months of 2020 are the most instructive. The authors looked at the weekly number of new hospital admissions in each country on the day when restrictive measures were introduced (closures of schools and gathering places, curfews, lockdowns). This invaluable indicator shows how quickly a country reacted (if it had done so before its hospitals were overwhelmed), or how slowly (if they were, in fact, already overwhelmed).

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