Almost 1 Million Extra Deaths Related to COVID-19 Pandemic in 29 High Income Countries in 2020

Including 94,400 more deaths than expected in the UK alone.

Nearly 1 million additional deaths from the covid-19 pandemic occurred in 29 high-income countries in 2020, according to a study published today by The BMJ.

With the exception of Norway, Denmark and New Zealand, all other countries surveyed had more deaths than expected in 2020, especially among men. The five countries with the highest absolute number of additional deaths were the US, UK, Italy, Spain and Poland.

Measuring additional deaths – the number of deaths above the expected number over a period of time – is one way of assessing the impact of the pandemic on deaths in different populations. However, previous studies have not taken into account temporal and seasonal trends and age and gender differences between countries.

To address this problem, a team of international researchers led by Dr. Nazrul Islam from the Nuffield Department of Population Health, University of Oxford, estimated the direct and indirect effects of the covid-19 pandemic on 2020 mortality in 29 high-income countries.

Using a mathematical model, they calculated the weekly additional mortality rate in 2020 for each country, taking into account age and gender differences between countries, as well as seasonal and annual mortality trends in the previous five years.

In total, there were an estimated 979,000 additional deaths in 2020 in the 29 countries analyzed. All countries experienced additional deaths in 2020, except New Zealand, Norway and Denmark.

The five countries with the highest absolute number of additional deaths were the US (458,000), the UK (94,400), Italy (89,100), Spain (84,100) and Poland (60,100). New Zealand had fewer deaths in total than expected (? 2,500).

The total number of additional deaths was largely concentrated among people aged 75 years or older, followed by people aged 65-74, while the number of deaths in children under 15 was similar to the expected level in most countries and lower than in some countries. expected.

In most countries, the estimated number of additional deaths exceeded the number of reported deaths from covid-19. For example, in both the US and the UK, estimated additional deaths were more than 30% higher than the number of reported covid-19 deaths.

However, other countries, such as Israel and France, had a higher number of reported covid-19 deaths than estimated additional deaths. The cause of this variation is unclear, but may be due to access to testing and differences in the way countries define and record covid-19 deaths.

In most countries, age-specific excess mortality rates were higher in men than in women, and the absolute difference in rates between the sexes increased with age. In the US, however, the additional death rate was higher among women than men aged 85 or older.

The researchers point to a number of study limitations, including a lack of data from low- and middle-income countries and on factors such as ethnicity and socioeconomic status, and they recognize that many indirect effects of a pandemic may require a longer period of time to have a measurable effect. have on mortality.

Nonetheless, this was a large study with detailed age- and gender-specific mortality data using robust analytical methods, and as such “adds important insights about the direct and indirect effects of the covid-19 pandemic on overall mortality,” they say.

“Reliable and timely monitoring of excess deaths would help inform public health policy when investigating the sources of excess mortality in the population and identify significant social inequalities in the impact of the pandemic to inform more targeted interventions” , they add.

Future work will also be needed to understand the impact of national vaccination programs on mortality in 2021, they conclude.

These findings confirm the covid-19 pandemic’s massive toll on mortality in high-income countries in 2020, researchers at Imperial College London say in a linked editorial.

But they warn that its full impact may not be apparent for years, especially in lower-income countries, where factors such as poverty, lack of vaccines, weak health systems, and high population density put people at increased risk for covid-19 and related harm. .

And they point out that while mortality is a useful measure, death-based policies are only being overlooked in what could become a huge burden of long-term morbidity due to covid-19.

“There is an urgent need to measure this excessive morbidity, support people with long-term complications from covid-19 and fund healthcare systems worldwide to address the job backlog caused by the pandemic,” they conclude .

References:

“Additional deaths from Covid-19 pandemic in 2020: time-series disaggregated analysis by age and gender in 29 high-income countries” May 20, 2021, The BMJ.
DOI: 10.1136 / bmj.n1137

“Measuring the Impact of Covid-19” May 20, 2021, The BMJ.
DOI: 10.1136 / bmj.n1239