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From the earliest days of the pandemic, the world has struggled to find a balance between epidemiology and economics. Put simply: save lives or save jobs—death or dollars. As we enter year three, the different approaches taken by Canada and the Unites States are becoming glaring.

During the first lockdown in March 2020, then U.S. President Donald Trump articulated what would come to be the overriding American pandemic ethos: “Our country wasn’t built to be shut down. America will, again, and soon, be open for business. We cannot let the cure be worse than the problem itself.”

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Since then, the U.S. has recorded 866,000 deaths from COVID-19 (as of January 2022), by far the highest number of deaths in the world in absolute terms. While President Joe Biden’s administration has taken a tougher stance on vaccinations, keeping the economy open has remained priority No. 1 at both state and local levels. As such, the U.S. has notched the fastest economic recovery in the G7 and, compared to the last pre-pandemic quarter, has grown nearly three times faster than the OECD nation average.

Canada offers a striking contrast on both counts. With Ontario and Quebec, the two largest provinces, implementing some of the strictest COVID measures in the world, Canada’s economy has yet to claw its way back to pre-pandemic levels. But Canada’s official COVID death count, adjusted for population, is one-third that of the U.S.

The gap between the two countries’ approaches grows even starker when using excess mortality—or how many people died from all causes compared to what would be expected in a normal year—as a measure of the pandemic’s death toll. It captures direct COVID deaths, but also those who died as a consequence of the pandemic, be that unreported COVID fatalities, drug overdoses or patients with life-threatening conditions who were unable to get treatment because of hospital overcrowding. As the chart shows, excess deaths in the U.S. have dwarfed those in Canada. (Canadian data for October wasn’t available yet.) It’s a steep price America has seemed more than willing to pay.


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