The COVID-19 Pandemic: The Case Fatality Rate

Executive Summary

This study, conducted by Kyrill Shraberman, examined the differences between countries in their COVID-related mortality rates out of all confirmed cases (case fatality rate, CFR), and divides the epidemic into two time periods: from March 2020 until August 2020 — the adjustment period in which the CFR was high worldwide; and from September 2020 until May 2022 — the period of stability when the CFR declined and became stable at its country-specific rate. The research showed that after the initial shock in the adjustment period, in the stability period a country’s ability to cope with the pandemic was influenced by the amount of resources available (GDP per capita) and the quality of the healthcare system. As the GDP per capita rises in a country and as the quality of the healthcare system is better, the CFR is also lower.

Israel is among those countries with higher quality healthcare services

During the pandemic (March 2020 until May 2022), Israel had a lower CFR rate than expected. Only three countries had lower rates: Iceland, Qatar, and the UAE. Israel stands out with its positive outcomes, in part, due to its high ranking among the 25 countries with the highest quality of healthcare services.

The study analyzed the differences in CFR for the period of the pandemic in 96 countries (including Israel) using explanatory variables that were divided into four major categories: economic resources; health capital; government effort; and political culture. According to the findings, during the adjustment period, the variable of political culture contributed to a lower CFR, while in the period of stability, the economic and health capital variables were the major explanatory variables. Government effort (the number of weekly new tests for the virus per 1,000 population) contributed to a lower CFR only during the period of stability, and its contribution was modest at best.

Case fatality rates were lowest in countries with a woman at the helm

The study also found that in countries where a woman had served as head of state at some point since 2000 — either as prime minister or as president — the case fatality rate was lower, particularly during the adjustment period but also during the period of stability. Countries with compulsory military service were characterized by lower CFR but only during the adjustment period. This finding supports the claim that compulsory service allows a better response in emergency situations and particularly in times of medical emergencies.

Study findings also show that a country’s healthcare system outcomes over the entire period in terms of preventing death in cases of confirmed virus were also impacted by the quantity of economic resources available prior to the outbreak of the pandemic as well as the healthcare system itself. Thus, in order to improve the future ability to respond to medical emergencies or general emergencies, countries must advance investment in quality healthcare systems as a part of their sustainable growth policy.