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International comparisons of COVID-19 case and mortality data and the effectiveness of non-pharmaceutical interventions: a plea for reconsideration

Published online by Cambridge University Press:  27 October 2021

Stephen Thomson*
School of Law, City University of Hong Kong, Hong Kong, SAR of People’s Republic of China
Eric C. Ip
Centre for Medical Ethics and Law, The University of Hong Kong, Hong Kong, SAR of People’s Republic of China
Shing Fung Lee
Department of Clinical Oncology, The University of Hong Kong, Hong Kong, SAR of People’s Republic of China Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, SAR of People’s Republic of China
*Corresponding author. Email:


International comparisons of the effectiveness of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) based on national case and mortality data are fraught with underestimated complexity. This article calls for stronger attention to just how extensive is the multifactorial nature of national case and mortality data, and argues that, unless a globally consistent benchmark of measurement can be devised, such comparisons are facile, if not misleading. This can lead to policy decisions and public support for the adoption of potentially harmful NPIs that are ineffective in combating the COVID-19 pandemic and damaging to mental health, social cohesion, human rights and economic development. The unscientific use of international comparisons of case and mortality data in public discourse, media reporting and policymaking on NPI effectiveness should be subject to greater scrutiny.

© The Author(s), 2021. Published by Cambridge University Press

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