People are seen in a hair salon in Haarlem, the Netherlands, on Dec. 14, 2020. (Photo by Sylvia Lederer/Xinhua / MANILA BULLETIN) According to the study, lower mortality rates occurred in countries with more socialized and equitable health systems. Researchers noted there were exceptions, including in Germany and Sweden which saw a much smaller decrease than comparable countries such as the Netherlands, which achieved nearly a 16-fold decrease in deaths. According to the authors, the main factors contributing to the difference were that first-wave deaths disproportionately affected the elderly, and second-wave infections tended to affect younger people, as well as first wave case numbers being underestimated in Europe and the capability of health care systems to respond.