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The United States recorded high coronavirus death rates during the pandemic, even compared to other countries with high Covid-19 mortality. This is according to a study published in the medical journal JAMA on Monday.

Alyssa Bilinski, PhD student at Harvard University, and Dr. Ezekiel Emanuel, vice provost of global initiatives and professor at the University of Pennsylvania, compared U.S. coronavirus mortality rates as of September 19 with those of 18 other countries with varying pandemic responses.

They found that the US had more deaths per 100,000 people after May 10 than other high-mortality countries included in the comparison.

Bilinski and Emanuel ranked South Korea, Japan and Australia as low mortality countries, with fewer than 5 coronavirus deaths per 100,000 people. If the US had had mortality rates comparable to Australia since the pandemic began, it would have had 187,661 fewer deaths, the study shows.

Medium mortality countries with fewer than 5 to 25 deaths per 100,000 people included Norway, Finland, Austria, Denmark, Germany, Israel, Switzerland and Canada. Bilinski and Emanuel note that if the US had mortality rates comparable to Canada since the pandemic began, it would have had 117,622 fewer deaths.

High mortality countries with more than 25 deaths per 100,000 people included the United States, the Netherlands, France, Sweden, Italy, the United Kingdom, Spain, and Belgium. The US fared better than some high mortality countries, but only in the early stages of the pandemic. The comparison shows that if the US had mortality rates comparable to France as of May 10, it would have had 96,763 fewer deaths.

Note on the results of the study: One limitation of the study included differences in mortality risk between countries. Bilinski and Emanuel suggest that several factors may have contributed to the US death rate during the pandemic, including poor public health infrastructure and an inconsistent response to pandemics in the US.