A comparison of COVID-19 incidence rates across six European countries in 2021

COVID-19 Study group

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


International comparisons of COVID-19 incidence rates have helped gain insights into the characteristics of the disease, benchmark disease impact, shape public health measures and inform potential travel restrictions and border control measures. However, these comparisons may be biased by differences in COVID-19 surveillance systems and approaches to reporting in each country. To better understand these differences and their impact on incidence comparisons, we collected data on surveillance systems from six European countries: Belgium, England, France, Italy, Romania and Sweden. Data collected included: target testing populations, access to testing, case definitions, data entry and management and statistical approaches to incidence calculation. Average testing, incidence and contextual data were also collected. Data represented the surveillance systems as they were in mid-May 2021. Overall, important differences between surveillance systems were detected. Results showed wide variations in testing rates, access to free testing and the types of tests recorded in national databases, which may substantially limit incidence comparability. By systematically including testing information when comparing incidence rates, these comparisons may be greatly improved. New indicators incorporating testing or existing indicators such as death or hospitalisation will be important to improving international comparisons.

Original languageEnglish
Issue number40
Publication statusPublished - 5 Oct 2023

Bibliographical note

Publisher Copyright:
© 2023 European Centre for Disease Prevention and Control (ECDC). All rights reserved.


Dive into the research topics of 'A comparison of COVID-19 incidence rates across six European countries in 2021'. Together they form a unique fingerprint.

Cite this