The world is a big place, and many parts of it do not possess the fat asses, and other morbid/medical conditions which romp around in the US, which increases the death rate of cv19.
Just a footnote, regarding the Italians, notoriously trim and concerned with clothes but beginning to fatten up because of their sweet tooth - did you ever try Nutella, one of their food obsessions? Just sayin' -- great medical system and overweight population (at least in prosperous Northern Italy), is a growing European/American problem. Complicates discussions of relative death rates. Also, the US has the anomaly of the best high tech medicine (look at the huge strides in covid-19 treatment, for example) but a miserable overall "mistake rate" in that medical miscues are the third leading cause of death (250,000/annually). My guestimate is that our complex system mixing private insurance, huge hospital systems, huge federal involvement (Medicare, etc.) and declining individual physician control complicates our system with no attendant treatment benefit. Add high tech medicine and a pharmacy system increasingly "lend leased" to China and India and other places, and you get the potential for real trouble. Whose in charge is a fair question? Sorry for the rant. Where does B for c fit in?