The Radical Center
Published in

The Radical Center

America vs Europe: Covid, Public Health, and Health Care

This won’t be a polemic, it won’t even really be ideological. It’s the facts and pretty much just the facts. Covid tests two different categories of what we generally refer to as health care. The first is it tests public health measures. Public health measures are those actions taken to prevent the creation of health problem. Health care are those actions taken to treat the patient after they are already ill. In the United States public health measures are a government function, as they are in most countries, while health care is more a private function, unlike some places in Europe. The idea that Europe is a monolith of state-controlled health systems is a myth, they vary considerably from country to country.

You can have nations with excellent public health measures preventing the spread of the virus yet doing a very poor job caring for patients once they are infected. Similarly you can have nations where the health measures are poor and the health care doing a good job, where both are failures or where both are successes.

Roughly speaking the infection rate is a crude measure of public health measures. The more efficient the measures the lower the infection rate and the less efficient, the higher they are. Similarly the infection rate is a rough gage of how well the health system works—high fatalities indicate failure, lower fatalities success. Here I compare the United States statistically to 31 European nations, including the largest nations. All numbers are per 100,000 population. These are ranked from the most infectious nations to the least.

INFECTION RATES PER 100,000 Population

United States 260.84
Belgium 251
Czechia 230
Spain 223.8
Netherlands 163.4
France 161.9
United Kingdom 122.65
Switzerland 120.95
Iceland 120.71
Bosnia Herzegovina 119.6
Ireland 114.41
Portugal 112.94
Sweden 108.11
Romania 106
Austria 88.1
Croatia 83.7
Italy 83.5
Slovakia 74.75
Albania 66.26
Poland 63.72
Hungary 57.4
Denmark 57.29
Serbia 55.68
Bulgaria 52.17
Germany 50.89
Lithuania 34.28
Norway 32.91
Estonia 32.76
Greece 27.98
Finland 26.59

Comparatively speaking the United States is an utter failure when it comes to public health measures to prevent the spread of the virus. Of course, there are other factors at play, which is precisely why I say this is a crude measure but it does convey information—how much can be debated but the facts shouldn’t be overlooked or forgotten. The largest European nation with a good record in preventing infections is Germany and the worst of them is Beligium, with Spain and France not far behind.


Our next measure is the percentage of Covid-19 patients in each country who die from the virus. This doesn’t indicate public health measures as much as how well the health system in each country copes with the virus. Again there are other factors involved so this is only a crude measure but it conveys some useful information. This is the percentage of infected patients who die from the virus, from worst to best.

Italy 7.38%
Sweden 5.36%
United Kingdom 5.23%
Belgium 3.7%
Ireland 3.35%
Spain 3.32%
France 3.16%
Romania 3.07%
Bulgaria 2.95%
Bosnia Herzegovina 2.7%
United States 2.62%
Albania 2.51%
Hungary 2.48%
Netherlands 2.47%
Finland 2.41%
Germany 2.34%
Serbia 2.03%
Switzerland 2.01%
Portugal 1.98%
Greece 1.88%
Poland 1.8%
Denmark 1.78%
Estonia 1.68%
Norway 1.58%
Croatia 1.26%
Austria 1.24%
Czechia .83%
Slovakia .39%
Lithuania .32%
Iceland .25%

In terms of the percentage of deaths the three big losers are Italy, Sweden and the United Kingdom while Slovakia, Lithuania and Iceland do best. The United States falls near the middle of the pack in terms of percentages. Three nations have rates above 5%, five have rates above 3% but under 4%, nine are above 2% but below 3%—and the U.S. is one of them—while eight nations have more than 1% fatalities but under 2% and four are under 1%.

American Vs. the Big Five

One problem with any type of service is it’s easier to cope with smaller numbers than larger numbers. Large population countries have problems unique from those with small populations. It’s easier to be efficient with a population of 4 million than 100 million. So how does the U.S. compare to the five most populated European nations. First, the infection rate or our crude measure of public health.

United States 260.84
Spain 223.77
France 108.46
United Kingdom 85.70
Italy 50.45
Germany 42.74

Compared to the largest European nations America’s preventative measures were a total failure. Only Spain approaches the number of infections per 100,000 population. Germany did quite well in this regard.

As for the percentage of Covid patients who died, we have a different pattern emerge. Here are worst fatality rates to the best comparing America to the Big Five.

Italy 7.38%
United Kingdom 5.23%
Spain 3.3%
France 3.16%
United States 2.62%
Germany 2.34%

Compared to other large nations in Europe the United States did fairly well in treating Covid patients and very poorly in regard to preventing infection. In a nutshell the public sector, or the government, failed miserably. This has been obvious for a long time and is partially due to the utter lack of national leadership of any substance starting at the White House and down.

When it comes to health care Englands public health service did a very poor job in treating patients with almost twice as many deaths as America’s more privatized system. Of the largest nations only Germany did well in both preventing infections and treating them.


Your support to fund these columns is important, visit our page at Patreon.

Our only support for this work is your donations via Patreon — even $1 a month adds up. Please consider signing up to make a monthly donation, but you can also make one time donations.



Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store
James Peron

James Peron

James Peron is the president of the Moorfield Storey Institute, was the founding editor of Esteem a LGBT publication in South Africa under apartheid.