Extra 267,000 Infant Deaths in 2020 as a Result of COVID-19 Economic Downturn

Figures correspond to almost 7% more than expected, according to estimates by the World Bank economist.

According to a pilot study published in the online journal BMJ Open, an additional 267,000 babies are likely to have died in 2020 in low- and middle-income countries as a result of the economic downturn caused by COVID-19.

This toll is 7% higher than expected for the year, the World Bank economist authors say.

The global economy is expected to contract by nearly 5% in the first year of the pandemic, increasing the number of people living in poverty by 120 million.

And unlike economic crises in high-income countries, these shocks in low-income countries generally lead to more deaths among vulnerable groups, such as young children and the elderly.

Previously published projections of the likely impact of the pandemic on indirect deaths – which are not caused by COVID-19 itself – have focused on the magnitude of perceived disruptions to essential health services.

The authors of this study instead looked at the impact of the aggregate “income shock” represented by the projected decline in gross domestic product (GDP) — the total value of a country’s annual goods and services — on survival. ​​of children up to 12 months in low- and middle-income countries.

They linked GDP per capita data to 5.2 million births reported in demographic and health surveys between 1985 and 2018. Most (82%) of these births occurred in low- and lower-middle-income countries.

They then applied the International Monetary Fund’s 2019 and 2020 economic growth forecasts to predict the effect of the 2020 economic downturn on infant mortality in 128 countries.

Their calculations indicated that an additional 267,208 babies died in low- and middle-income countries in 2020, representing a mere 7% increase in the expected number of infant deaths for that year.

The highest number of estimated additional child deaths was in South Asia (8 countries), totaling 113,141, and more than a third of the excess is expected to occur in India (99,642). India has the highest annual birth rate (24,238,000) and a particularly large expected economic deficit of −17.3% for 2020.

The authors note that for Africa after the financial crisis in 2009, 28,000 to 50,000 additional infant deaths were estimated. This compares to an estimated figure of 82,239 for 2020, reflecting the wider estimated GDP deficits caused by the pandemic.

They accept several limitations of their projected figures, including the fact that their calculations were based on retrospective data, and that they only considered the short-term effects of GDP fluctuations on infant mortality rates.

And the difference between the October 2019 and October 2020 economic growth forecasts has been interpreted as reflecting only the effects of the pandemic, although some countries have experienced other major shocks, such as natural disasters or political crises, which may have also impacted the economy. national income level, they explain.

“Regardless of the exact number of expected deaths, the high number of additional infant deaths estimated in our analysis underscores the vulnerability of this age group to negative total income shocks, such as those caused by the COVID-19 pandemic,” they write.

“Several mechanisms are likely driving this increase in mortality among children aged 0-1: impoverishment at the household level will lead to poorer feeding and care practices for infants and a reduced ability to access health services, while the economic crisis may also affect the range and quality of services provided by health systems,” they explain.

While they focused on the likely impact on infant survival, other vulnerable groups are likely also affected, they add.

“As countries, health systems and the wider global community continue to make efforts to prevent and treat COVID-19, we must also consider means to stabilize health systems and strengthen social safety nets to mitigate the human, social and economic impact of the pandemic and its associated lockdown policy,” they conclude.

Reference: “How many babies may have died in 2020 in low-income and middle-income countries as a result of the economic contraction associated with the COVID-19 pandemic? Mortality projections based on predicted declines in economic growth” Aug 23, 2021, BMJ Open.
DOI: 10.1136/bmjopen-2021-050551