New Zealand was the only country in the OECD to have fewer deaths than expected in pandemic-hit 2020, a new analysis has found.
Researchers in Europe and the US looked at mortality data from 29 of the wealthy bloc's countries - those with complete data tracking weekly deaths from not just COVID-19, but all causes.
Excess mortality rates are often used in research to measure the true impact of epidemics and pandemics - they pick up deaths from the disease in question that might not have been officially recorded, as well as indirect deaths, for example people who couldn't get treatment because of overloaded health systems.
The US, Italy, England and Wales, Spain, and Poland came off worst in the new analysis, with tens to hundreds of thousands more people dying than expected.
The US had the biggest excess death toll in 2020 of 458,000 - about 35 percent more than was officially recorded as being due to COVID-19. In Poland, there were 122 percent more excess deaths than recorded as being due to COVID-19.
Most of the excess deaths were recorded in men and the elderly.
Only three countries didn't have any more deaths than usual - Norway, Denmark and New Zealand. Of those, only New Zealand had fewer than expected - 2500.
"New Zealand stood out as the only country that had a lower than expected mortality across all the age groups, in both men and women, with no sex difference in excess death rates, which could potentially be attributed to the country's elimination strategy early in the pandemic," the study, published this week in the British Medical Journal, said.
The nationwide lockdown from March to May in 2020 virtually wiped out community transmission of the deadly virus, which has killed millions around the world in places which failed to eliminate it, or hardly even tried.
But it also had the bonus effect of severely limiting the spread of other communicable diseases, such as the flu, which normally kills hundreds of Kiwis every year.
"We've had 86 people across the year who've come in with a presumptive diagnosis of influenza, compared to 1300 last year at the same time," Counties Manukau DHB director of population health Dr Gary Jackson told Newshub in September.
"Drops in the number of deaths happen from time to time, despite a growing and aging population," Statistics NZ reported. "However, the latest fall coincided with lockdown restrictions as a result of the COVID-19 pandemic. Alert level restrictions, including stay-at-home instructions, limits on road and air travel, and temporary business closures may have played a part in the reduced number of deaths."
In an editorial published in the BMJ alongside the research, scientists said focusing on deaths alone "gives only a partial picture of the impact of COVID-19... particularly among younger people in whom death from covid-19 is rare.
"The importance of 'long COVID' for example, has recently been highlighted, but the true burden of this condition has yet to be quantified, and policies are urgently needed to overcome its long term challenge...
"[The study confirms] the huge toll of the COVID-19 pandemic on mortality in high-income countries in 2020. However, its full impact may not be apparent for many years, particularly in lower income countries where factors such as poverty, lack of vaccines, weak health systems, and high population density place people at increased risk from COVID-19 and related harm."