covid 19的负担

In this work we will look at how COVID-19 deaths compare with the expected number of deaths in a country, based on historical mortality data. We define the COVID-19 burden to be the number of COVID-19 deaths as a fraction of the expected number of deaths in a country over the same period of time; that is from the time of the first reported COVID-19 death.

在这项工作中，我们将根据历史死亡率数据，来研究COVID-19死亡人数与一个国家的预期死亡人数相比。 我们将COVID-19负担定义为COVID-19死亡人数占一个国家同一时期预期死亡人数的一部分； 那是从首次报道的COVID-19死亡时算起。

Now, you might ask why we need yet another metric? What does this metric tell us that others, such as the more usual total number of fatalities per capita, do not? Just as the number of fatalities per capita is a better metric than a simple count of fatalities — because it normalises for population, making it easier to compare countries of different sizes — the COVID-19 burden goes one step further, because it also normalises for a country’s natural mortality rate. And by doing so, it combines a whole host of additional mortality factors, from population demographics, healthcare conditions, living standards, food and water security, conflict etc.

现在，您可能会问为什么我们还需要另一个指标？ 该指标告诉我们什么，其他指标(例如，更常见的人均死亡总数)没有？ 正如人均死亡人数比简单地计算死亡人数更好-因为它可以按人口归一化，从而可以更轻松地比较不同规模的国家-COVID-19负担更进一步，因为它可以归一化为一个国家的自然死亡率。 通过这样做，它结合了许多其他的死亡率因素，这些因素包括人口统计，医疗条件，生活水平，粮食和水安全，冲突等。

Thus, we present the COVID-19 burden as providing a more comprehensive account of a country’s experience under the current COVID-19 regime. Using datasets from OWID we will attempt to shed light on the following questions:

因此，我们将COVID-19的负担作为对当前COVID-19体制下一个国家经验的更全面描述。 使用来自OWID的数据集，我们将尝试阐明以下问题：

1. Are countries with higher mortality rates more or less likely to be associated with high numbers of COVID-19 fatalities per capita?
   死亡率较高的国家是否或多或少与人均COVID-19死亡人数高有关？
2. Is it fair to compare official COVID-19 deaths between countries, given differences in reporting policies?
   考虑到报告政策的差异，比较各国之间COVID-19的官方死亡人数是否公平？
3. How does the COVID-19 burden vary by country and continent?
   COVID-19负担如何因国家和地区而异？
4. How does COVID-19 rank against other common causes of death in countries around the world?
   COVID-19如何与世界上其他国家的其他常见死亡原因进行比较？

重大警告 (A Major Caveat)

Before going any further it is worth confronting a key caveat associated with this work, namely inconsistencies in official COVID-19 fatality statistics. It is not that reported numbers are inaccurate per se, rather they mean different things because they arise from many different reporting policies. Some countries only include deaths that arise from a confirmed COVID test, others have limited their focus to hospital settings, while yet others have been far more inclusive, counting suspected and confirmed deaths across all settings. These differences were especially common during the early stages of the pandemic, and while many countries have at least addressed some of the obvious shortcomings in their early counting (e.g. counting hospital deaths only) inconsistencies do remain.

在进一步研究之前，有必要面对与此工作相关的一个重要警告，即官方COVID-19死亡率统计数据的不一致。 并不是说所报告的数字本身是不准确的，而是它们具有不同的含义，因为它们源于许多不同的报告策略 。 一些国家仅包括由已确认的COVID测试引起的死亡，其他国家已将重点放在医院环境上，而另一些国家则具有更大的包容性，在所有环境中计算可疑和已确认的死亡数。 这些差异在大流行的早期尤其普遍，尽管许多国家至少在早期计数(例如仅计算医院死亡数)中解决了一些明显的缺陷，但仍然存在不一致之处。

This is problematic given the central aim of this work, because the COVID-19 burden is, after all, a relative fatility estimate that is based on these inconsistent fatality numbers. However, we can at least shed some light on the the scale of this problem, by comparing official COVID-19 fatality statistics to so-called excess deaths. Excess deaths provide an estimate of the additional deaths this year so far, regardless of cause, by comparing total numbers of deaths in 2020 to historical averages. The problem is that these data are difficult to come by and are only readily available for a small subset of the countries in our dataset. However, enough data is available to at least gain some useful insight into the degree of inconsistency that likely exists.

考虑到这项工作的中心目标，这是有问题的，因为毕竟COVID-19负担是基于这些不一致的死亡人数的相对死亡率估计。 但是，通过将官方的COVID-19死亡人数统计数据与所谓的超额死亡人数进行比较，我们至少可以了解这个问题的严重性。 通过将2020年的死亡总人数与历史平均水平进行比较，过量死亡人数可以估算出迄今为止到目前为止今年的死亡人数，无论原因如何。 问题在于这些数据很难获得，并且仅可用于我们数据集中的一小部分国家/地区。 但是，有足够的数据可用，至少可以了解可能存在的不一致程度。

Ideally, we should expect to find a strong correlation between excess deaths and officially reported COVID-19 deaths. This graph shows this relationship using an OWID dataset of 27 countries with known excess death estimates. It does indicate a reasonably strong relationship with a so-called r-squared value of 0.8, which means that 80% of the variation in the official COVID deaths can be explained by the excess death estimates. Note that excess deaths is measured by OWID as a sum of the daily percentage differences, relative to historical norms. For example, Belgium has a total excess of 380% based on an average daily excess of 2.5% during the duration of its outbreak. This does not mean that there have been nearly 4x as many extra deaths in Belgium, rather it means that there have been approximately 2.5% extra deaths so far during the COVID period.

理想情况下，我们应该期望在超额死亡人数与官方报告的COVID-19死亡人数之间发现强烈的相关性。 该图使用已知超额死亡估计数的27个国家的OWID数据集显示了这种关系。 它确实表明与所谓的r平方值0.8有着相当强的关系，这意味着官方COVID死亡人数变化的80％可以由超额死亡估计数来解释。 请注意，超额死亡人数是由OWID衡量的，是相对于历史标准的每日百分比差异之和。 例如，比利时在疫情爆发期间的平均每日超支量为2.5％，因此其总超支率为380％。 这并不意味着比利时的死亡人数增加了近4倍，而是意味着到目前为止，COVID期间的死亡人数增加了约2.5％。

Most countries fall close to the linear regression line used to estimate the relationship between these two fatality parameters, but Belgium is the obvious outlier. It’s official fatalities (>80 per 100k) are very high in comparison to other countries with similar excess deaths. Given that Belgium is the outlier, this suggests that its official fatality estimate is too high and needs to be reduced (by almost 40%) to bring it into line with the reporting standards of others, and such an adjustment will have a corresponding effect on Belgium’s COVID-19 burden. In a similar way, the official fatality estimate from the UK may be too low and it should be increased by approximately 12%.

大多数国家都接近用于估计这两个死亡参数之间关系的线性回归线，但比利时明显是异常值。 与其他具有类似超额死亡人数的国家相比，它的官方死亡人数(每10万大于80)。 鉴于比利时是异常地区，这表明比利时的官方死亡率估计值过高，需要降低(将近40％)才能使其与其他国家的报告标准保持一致，这样的调整将对比利时的COVID-19负担。 以类似的方式，来自英国的官方死亡率估计值可能太低，应将其增加约12％。

In summary, some variation remains in the way that official COVID-19 fatalities are recorded, and although the degree of this variation between countries is likely to be <20%, this nonetheless highlights the need for caution when comparing countries to one another. This is especially true when official fatality statistics differ by <20%, because such differences may be an artefact of reporting rather than a sign of genuine difference in the number of COVID-19 related deaths.

总而言之，在记录官方COVID-19死亡人数的方式上仍然存在一些差异，尽管各国之间这种差异的程度很可能小于20％，但这仍突显了在相互比较国家时需要谨慎的情况。 当官方死亡率统计差异小于20％时，尤其如此，因为这种差异可能是报告的人工产物，而不是与COVID-19相关的死亡人数真正差异的标志。

定义COVID-19负担 (Defining the COVID-19 Burden)

Given this caveat we can now consider the relationship between official COVID-19 fatalities and historical mortality rates for a dataset of 173 countries. Not surprisingly, there is only a very weak association between COVID-19 deaths per capita and the corresponding expected deaths over the same period —the r-squared value between these two variables is just 0.02— because the former depends on the number of COVID-19 infections in a country, which is not strongly correlated with historical mortality rates. In other words, countries with a higher historical mortality rate are not associated with a higher COVID-19 infection or fatality rate, and vice versa.

有了这个警告，现在我们可以考虑173个国家/地区的数据中官方COVID-19死亡人数与历史死亡率之间的关系。 不足为奇的是，同期人均COVID-19死亡人数与相应的预期死亡人数之间的关联非常微弱(这两个变量之间的r平方值仅为0.02)，因为前者取决于COVID-一个国家有19种感染，与历史死亡率没有密切关系。 换句话说，具有较高历史死亡率的国家与较高的COVID-19感染率或死亡率无关，反之亦然。

We define the COVID-19 burden to be the total number of official COVID-19 deaths divided by the historical number of (all-cause) deaths that would be expected to occur over the same period; for convenience, we will typically express the the COVID burden as a percentage rather than a fraction. For example, at the time of writing it has been 180 days since Ireland’s first reported COVID-19 fatality, and there has been 1,778 COVID deaths reported so far. Ireland’s historical number of annual deaths is just under 30,000 per year. So during the outbreak approximately 14,500 deaths might have been expected; this assumes a uniform distribution of deaths throughout the year, which is certainly not accurate, but likely good enough for our purposes. This means that Ireland’s current COVID-19 burden is just over 12% (or strictly speaking 0.12) of expected deaths over the same period.

我们将COVID-19负担定义为官方COVID-19死亡总数除以预计同期发生的(全因)死亡的历史数； 为了方便起见，我们通常将COVID负担表示为百分比而不是分数 。 例如，在撰写本文时，距离爱尔兰首次报告COVID-19死亡已有180天，到目前为止，已经报告了1778例COVID死亡。 爱尔兰的历史年度死亡人数每年不到30,000。 因此，在爆发期间可能预计会有14,500人死亡。 假设全年的死亡人数分布均匀，这当然不准确，但可能足以满足我们的目的。 这意味着爱尔兰目前的COVID-19负担仅为同期预期死亡人数的12％以上(或严格说来为0.12)。

“ T”图 (The “Tadpole” Plot)

Below, is a plot of COVID-19 deaths versus the expected (historical) deaths over the same period of time. Each country is represented by a single marker (the head) with a tail, just like a tadpole. The size of the head is proportional to the number of confirmed cases per capita, and it is coloured according to its COVID-19 burden, as per the scale shown.

下面是在同一时间段内 COVID-19死亡人数与预期(历史)死亡人数的关系图 。 每个国家都用带有尾巴的单个标记( 头部 )来表示，就像a一样。 头部的大小与人均确诊病例的数量成正比，并根据所示的比例，根据其COVID-19负担为其着色。

The highlighted countries are also annotated with their current COVID-19 burden, as a percentage. An arrow shows whether this is increasing, stable, or falling (compared to 30 days ago) and, in brackets, a separate burden estimate calculated using the total expected number of deaths in a year, instead of the expected deaths so far during the COVID period. For example, Ireland has a current COVID-19 burden of 12%, which is falling, and its COVID deaths so far account for 5% of Ireland’s historical annual total.

突出显示的国家/地区还标有其当前COVID-19负担(以百分比表示)。 箭头显示这是增加，稳定还是下降(与30天前相比)，并在括号中显示了单独的负担估算值，该估算值是根据一年中的预期总死亡人数计算的，而不是到目前为止COVID期间的预期死亡人数期。 例如，爱尔兰目前的COVID-19负担正在下降，为12％，迄今为止，其死亡人数占爱尔兰历史年度总数的5％。

The tails indicate the trajectories of COVID-19 deaths over the previous 30 days. They show whether deaths have been increasing (tails with an upward trajectory) or absent (horizontal tails). For example, upward-facing tails of countries such as Peru, the US, and Israel indicate increasing deaths — the steeper the angle the greater the rate of increase — whereas Ireland, France, and Germany, have horizontal tails, indicating no material increase in COVID deaths over the past 30 days.

尾部表示过去30天内COVID-19死亡的轨迹。 它们显示死亡是在增加(尾巴有向上的轨迹)还是没有增加(水平尾巴)。 例如，秘鲁，美国和以色列等国家的尾巴朝上表示死亡人数在增加-角度越陡越大的增长率就越大-而爱尔兰，法国和德国的尾巴则呈水平尾巴，表明该地区没有实质性增长。过去30天内的COVID死亡人数。

Countries will move from the left to the right on this graph as their expected number of deaths accumulate with each passing day,. They can move upwards when new COVID fatalities are registered, but they cannot move from right to left or downwards. Most countries are associated with outbreaks that have been progressing for 170–180 days and so their current x-axis position reflects approximately 50% of their annual expected annual death toll.

随着预期死亡人数的累积日积月累，各国将在此图表上从左向右移动。 当记录了新的COVID死亡人数时，它们可以向上移动，但是不能从右向左或向下移动。 大多数国家/地区都与爆发持续170-180天有关，因此其当前的x轴位置反映了其年度预期年度死亡人数的大约50％。

As an aside, it is interesting to note that there is quite a bit of variation in these annual figures, even within similar regions. For example, as of 2019 Germany reported an all-cause mortality rate of 1,200 deaths per 100k of population, compared to just 600 per 100k in Ireland.

顺便说一句，有趣的是，这些年度数字即使在相似的区域内也有很大的差异。 例如，截至2019年，德国报告的全因死亡率为每10万人口1200例死亡，而爱尔兰每10万人口只有600例。

Back to the graph: it helps to highlight some of the very different outbreak experiences around the world, even bearing in mind that the vertical (y-axis) position of a country may be subject to an adjustment, depending on how its deaths are counted. Brazil, Mexico, and Peru, all have growing COVID burdens of at least 20%. Peru’s burden of 46% is exceedingly high, by any objective standard, and it is unlikely to be explained away but accounting differences alone.

回到图表：它有助于突出显示世界各地一些非常不同的暴发经历，甚至要记住，一个国家的垂直( y轴 )位置可能会调整，具体取决于其死亡人数的计算方式。 巴西，墨西哥和秘鲁的COVID负担都在增长，至少增加了20％。 从任何客观标准来看，秘鲁46％的负担都非常高，仅凭会计差异就无法解释。

The guidelines on the graph help to highlight different COVID-19 burden trajectories: one represents a burden of just over 8.3%, which corresponds to 1 month worth of annual deaths, and the other is for a burden of just over 16.7%, which corresponds to 2 months’ worth of deaths. Almost 85% of countries have a current COVID-19 burden that is currently less than 8.3% and ~6% (11 countries) have a burden that is greater than 16.7%, 8 of these 11 are in Central and South America.

图上的准则有助于突出显示COVID-19的不同负担轨迹：一个代表的负担刚好超过8.3％，相当于每年死亡的1个月，另一个代表的负担刚好超过16.7％，相当于导致2个月的死亡。 国家的近85％的电流COVID-19的负担是目前不到8.3％和〜6％(11个国家)的负担大于16.7％，这11个8个在中美洲和南美洲。

在COVID-19负担的等级上 (On the Rank of the COVID-19 Burden)

Another way to interpret the COVID-19 burden is to consider it in the light of the historical mortality rates associated with different diseases in each country,. Once again there is a OWID dataset, which specifies the annual number of deaths by cause/disease for countries around the world. We can use a country’s COVID-19 burden to identify where COVID ranks as a cause of death for that country. Once again, some sensible caution is needed here: just because a person died with COVID does not mean that they died because of COVID. Nevertheless it is useful to convert these COVID-19 burden values into rankings.

解释COVID-19负担的另一种方法是根据每个国家与不同疾病相关的历史死亡率进行考虑。 再次有一个OWID数据集，该数据集按原因/疾病指定了世界各国的年度死亡人数。 我们可以使用一个国家的COVID-19负担来确定将COVID列为该国家死亡原因的位置。 再次，一些明智的谨慎这里需要：只是因为一个人与 COVID死亡并不意味着他们死了，因为 COVID 的 。 尽管如此，将这些COVID-19负担值转换为排名还是有用的。

For example, in the case of Ireland’s 30,000 deaths per year, the top-5 causes of death are listed as cardiovascular disease (~9,600 deaths), cancers (~9,500 deaths), dementia (~2,700 deaths), respiratory diseases (~2,225 deaths), and lower respiratory infections (~1,371 deaths). This means that Ireland’s current COVID-19 deaths (1,778) place COVID-19 as Ireland’s 5th highest cause of death.

例如，在爱尔兰每年有30,000例死亡中，排名前5位的死亡原因被列为心血管疾病(〜9,600例死亡)，癌症(〜9,500例死亡)，痴呆(〜2,700例死亡)，呼吸道疾病(〜2,225例)死亡)和下呼吸道感染(约1,371例死亡)。 这意味着爱尔兰目前的 COVID-19死亡人数(1,778)将COVID-19列为爱尔兰第五大死亡原因。

At the risk of piling too much information into a single visualisation, the graph below summarises many different aspects of COVID-19 outbreaks by continent as follows:

冒着将太多信息汇总到单个可视化图中的风险，下图总结了按大陆划分的COVID-19暴发的许多不同方面，如下所示：

1. The bar graph below shows the mean cause-of-death rank of COVID-19 averaged over all countries in a given continent. Technically speaking the bars show the relative rank, which is the computed as the actual rank divided by the total number of causes of death for that country; a relative rank of 0 indicates the top-ranking cause and a relative rank of 1 indicates the lowest-ranking cause. We do this because different countries have different numbers of causes of death.

   下面的条形图显示了给定大陆上所有国家/地区的平均COVID-19死因平均排名。 从技术上讲，条形图显示相对等级，该等级通过实际等级除以该国家的死因总数来计算； 相对等级0表示排名最高的原因，相对等级1表示排名最低的原因。 我们这样做是因为不同国家的死亡原因数量不同。

2. For completeness, the bars are annotated with the average actual rank and average number of causes of death. The mean COVID burden is also shown as a percentage — the colour of the bars reflects this too— alongside an arrow to indicate whether this burden is increasing or decreasing on average.
   为了完整起见，在条形图上标注了平均实际等级和平均死因数。 平均COVID负担也显示为百分比-条形的颜色也反映了这一点-带有箭头指示该负担是平均增加还是减少。
3. The position of the markers on the line graph indicates the average duration (days) of the outbreaks in a given continent.
   折线图上标记的位置指示给定大陆爆发的平均持续时间(天)。
4. The number outside and above the marker is the number of countries in our dataset for that continent.
   标记上方和上方的数字是我们数据集中该大洲的国家/地区数量。
5. The size of the line-graph markers is proportional to the average outbreak size (cases per 100k population) which is also indicated as the larger number in the centre of each marker.
   线图标记的大小与平均爆发大小(每10万人口的病例数)成正比，平均爆发大小也表示为每个标记中心的较大数字。

6. Finally, the fraction in brackets in the centre of each marker is the average case fatality rate, calculated as the average number of deaths divided by the average number of cases.

   最后，每个标记中心括号中的分数是平均病死率，计算方法是平均死亡人数除以平均病例数。

For example, we can see how hard South America has been hit. Its outbreaks have been proceeding for about 175 days and its 12 countries have an average case load of 993 case per 100k of population, with a corresponding case fatality rate of 0.04. Deaths in South America represent approximately 14% of the historical deaths during the period of these outbreaks, which positions COVID-19 as the 9th highest cause of death out of 30 common causes of death. Moreover, South America’s COVID-19 burden is increasing at almost three times the average rate of increase for all other continents; over the last 30 days South America’s burden has increased by 75%.

例如，我们可以看到南美遭受的打击有多严重。 它的爆发已经持续了大约175天，其12个国家/地区的平均病案率为每100k人口993例，病死率为0.04 。 在这些暴发期间，南美的死亡人数约占历史死亡人数的14％ ，这使COVID-19成为30种常见死亡原因中的第9大死亡原因。 此外，南美的COVID-19的负担是在近三倍的增加对于所有其他大洲的平均速率增加 ; 在过去30天里，南美的负担增加了75％。

The scale of Europe’s outbreak is less than that of North America — 498 cases per 100k vs. 607 cases per 100k, respectively — but Europe’s average case fatality rate is higher — 0.04 vs 0.03, respectively — even though its COVID-19 burden is lower, 4% vs 5%, respectively. There have been more COVID-19 deaths in Europe, per capita, than in North America, but these represent a smaller fraction of historical European deaths over the COVID period; on average Europe has over 1,000 deaths per year per 100k of population compared with just 670 in North America. This positions COVID-19 as the 10th highest cause of death in Europe, compared with the 12th highest cause of death in North America. It is worth noting that Europe is the only continent where there has been an average decrease (-2%) in the COVID-19 burden over the last 30 days, meaning that the COVID-19 fatality rate has has been falling in Europe. During same period North America’s burden has increased by 65%.

欧洲爆发的规模小于北美-分别为498例每10万例和 607例每10万例-但欧洲的平均病死率更高-分别为0.04和0.03，尽管其COVID-19负担较低，分别为4％和5％。 在欧洲，人均死于COVID-19的人数比北美多，但在历史上欧洲死于COVID的人数所占的比例较小。 平均而言，欧洲每10万人口每年有1000多人死亡，而北美只有670人。 这使COVID-19成为欧洲排名第十的最高死因，而北美排名第十二。 值得注意的是，欧洲是过去30天内COVID-19负担量平均下降 (-2％)的唯一大陆，这意味着欧洲的COVID-19死亡率已经下降。 在同一时期，北美的负担增加了65％。

The numbers from Africa tell a very different COVID-19 story, compared with most of the rest of the world. African outbreaks have been progressing for about 150 days, with an average of 134 confirmed cases per 100k people and lower case fatality rates of just 0.02; indeed it is likely that these confirmed cases reflect more conservative accounting of infection rates than elsewhere which, if true, would suggest an even lower fatality rate. COVID-19 deaths in Africa account for less than 1% of the historical deaths over the same period — although this burden has been increasing at a rate of 21% over the past 30 days — positioning COVID-19 as the 25th highest cause of death in Africa.

与世界上大多数其他国家相比，非洲的数字讲述了一个完全不同的COVID-19故事。 非洲疫情已持续发展约150天，每10万人中平均134例确诊病例，病死率较低，仅为0.02； 确实，这些确诊病例可能比其他地方反映出更为保守的感染率统计，如果属实，则表明病死率更低。 非洲的COVID-19死亡人数不到同期历史死亡人数的1％-尽管在过去30天内这种负担以21％的速度增长，但COVID-19的死亡人数排名第25位在非洲。

Why is this? Have countries in Africa really done such a better job of containing the virus? There appears to be a consensus that this is not just a reporting issue, although there is likely to be a wider reporting margin of error than elsewhere. One hypothesis is that Africa’s success is sue in part to population age: we know that COVID-19 fatalities are far more common in older age groups and the median age in Africa is just under 20 years old compared with 39 for the US. Another hypothesis is that it may be because Africa has learned from many previous pandemics, and people have acted to protect themselves more effectively.

为什么是这样？ 非洲国家真的在控制病毒方面做得更好吗？ 尽管可能存在比其他地方更大的报告误差范围，但似乎已经达成共识，这不仅是报告问题。 一种假设是，非洲的成功部分取决于人口年龄：我们知道，COVID-19死亡在老年人群中更为普遍，非洲的中位年龄不到20岁，而美国为39岁。 另一个假设是，这可能是因为非洲从以前的许多流行病中吸取了教训，人们采取了更加有效的自我保护措施。

COVID-19负担和国家排名 (COVID-19 Burden & Rank by Country)

To complete this analysis the graphs below show the COVID-19 burden and ranks for individual countries around the world and also, separately, for Europe. Each country is colour-coded based on its COVID-19 burden and most are also labeled with their COVID rank.

为了完成此分析，下图显示了COVID-19的负担和排名，分别针对全球各个国家以及欧洲。 每个国家/地区都根据其COVID-19负担进行了颜色编码，并且大多数国家/地区还标有其COVID等级。

We can see, for example, that there are some countries in South America that are doing better than others. For examplem Uruguay and Paraguay have COVID-19 ranks of 23 and 14, respectively, and burdens less than 5%; it’s not clear whether the data from Venezuela, which also appears to be weathering the pandemic very well, can be trusted.

例如，我们可以看到，南美有一些国家的表现要好于其他国家。 例如，乌拉圭和巴拉圭的COVID-19等级分别为23和14，负担不到5％； 尚不清楚委内瑞拉的数据是否也值得信任，委内瑞拉的数据似乎也很好地抵抗了大流行。

In Europe we see a tale of two pandemics. The large-scale early outbreaks, which all but overwhelmed healthcare systems in many Western/Southern European, resulted in much higher COVID-19 burdens (≥10%) than is the case in Eastern/Northern Europe (≤5%). Consequently, in the former, COVID-19 now ranks as the 4th or 5th highest cause of death, compared with much more favourable rankings, often in the teens, in other parts of Europe.

在欧洲，我们看到了两个大流行病的故事。 在许多西欧/南欧，几乎不堪重负的大规模医疗暴发使东欧和北欧(≤5％)的COVID-19负担(≥10％)高得多。 因此，在前者中，COVID-19现已成为欧洲第四大或第五大死因，而在欧洲其他地区，这种情况通常在十几岁时更为有利。

结论 (Conclusions)

We have introduced the COVID-19 burden as a novel metric, with which we can better understand the fatality rate associated with the disease, in a way that is normalised with respect historical mortality rates. Even though there are discrepancies in the way that deaths are counted around the world, this metric, and the corresponding COVID-19 rank, helps to shed some useful additional light on the current state of the outbreak.

我们已经将COVID-19 负担作为一种新颖的指标进行了介绍，通过该指标，我们可以更好地了解与疾病相关的死亡率，并且可以相对于历史死亡率进行标准化。 即使在全世界计算死亡人数的方式存在差异，该指标和相应的COVID-19 等级也有助于阐明当前的疫情状况。

The data show that South America has been particularly hard hit, even allowing for possible reporting inconsistencies, and there is no sign of any improvement as yet. In North America, the US has a relatively high COVID burden (13%) but at least its growth has begun to level off. In Europe, COVID burdens appear to have stabilised, for now, and in the EU in particular, they are trending downwards strongly (there has been a 6% decrease in the average EU COVID-19 burden over the past 30 days).

数据显示，南美受到的打击尤其严重，甚至可能导致报告不一致，而且目前尚无任何改善的迹象。 在北美，美国的COVID负担相对较高(13％)，但至少其增长已开始趋于平稳。 在欧洲，COVID负担目前似乎已稳定下来，尤其是在欧盟，这种趋势正在急剧下降(过去30天中，欧盟COVID-19的平均负担减少了6％)。

One thing is for sure, this picture could look very different in a few weeks time. In Europe, recent increases in cases have not yet been matched by any material increase in deaths, probably due to the continued shielding of vulnerable groups, lower dosing effects due to mask wearing, and some therapy improvements. But as we return to indoor living during the winter months it will be even more important to follow all public health guidelines if we are to continue to contain COVID-19 fatalities.

可以肯定的是，这张图片在几周后看起来可能会非常不同。 在欧洲，近期病例的增加尚未与死亡人数的任何实质性增加相提并论，这可能是由于对弱势群体的持续屏蔽，戴着口罩引起的剂量降低以及某些治疗方法的改善。 但是，随着我们在冬季重新回到室内生活，如果我们要继续遏制COVID-19的死亡人数，那么遵守所有公共卫生准则将变得更加重要。

翻译自: https://medium.com/data-in-the-time-of-corona/the-burden-of-covid-19-64cdcd7a9c3f