scholarly journals Excess Mortality During the COVID-19 Pandemic in Jordan: Secondary Data Analysis (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Mohannad Al Nsour

BACKGROUND All-cause mortality and estimates of excess deaths are commonly used in different countries to estimate the burden of COVID-19 and assess its direct and indirect effects. OBJECTIVE This study aimed to analyze the excess mortality during the COVID-19 pandemic in Jordan in April-December 2020. METHODS Official data on deaths in Jordan for 2020 and previous years (2016-2019) were obtained from the Department of Civil Status. We contrasted mortality rates in 2020 with those in each year and the pooled period 2016-2020 using a standardized mortality ratio (SMR) measure. Expected deaths for 2020 were estimated by fitting the overdispersed Poisson generalized linear models to the monthly death counts for the period of 2016-2019. RESULTS Overall, a 21% increase in standardized mortality (SMR 1.21, 95% CI 1.19-1.22) occurred in April-December 2020 compared with the April-December months in the pooled period 2016-2019. The SMR was more pronounced for men than for women (SMR 1.26, 95% CI 1.24-1.29 vs SMR 1.12, 95% CI 1.10-1.14), and it was statistically significant for both genders (<i>P</i>&lt;.05). Using overdispersed Poisson generalized linear models, the number of expected deaths in April-December 2020 was 12,845 (7957 for women and 4888 for men). The total number of excess deaths during this period was estimated at 4583 (95% CI 4451-4716), with higher excess deaths in men (3112, 95% CI 3003-3221) than in women (1503, 95% CI 1427-1579). Almost 83.66% of excess deaths were attributed to COVID-19 in the Ministry of Health database. The vast majority of excess deaths occurred in people aged 60 years or older. CONCLUSIONS The reported COVID-19 death counts underestimated mortality attributable to COVID-19. Excess deaths could reflect the increased deaths secondary to the pandemic and its containment measures. The majority of excess deaths occurred among old age groups. It is, therefore, important to maintain essential services for the elderly during pandemics.

10.2196/32559 ◽  
2021 ◽  
Vol 7 (10) ◽  
pp. e32559
Author(s):  
Yousef Khader ◽  
Mohannad Al Nsour

Background All-cause mortality and estimates of excess deaths are commonly used in different countries to estimate the burden of COVID-19 and assess its direct and indirect effects. Objective This study aimed to analyze the excess mortality during the COVID-19 pandemic in Jordan in April-December 2020. Methods Official data on deaths in Jordan for 2020 and previous years (2016-2019) were obtained from the Department of Civil Status. We contrasted mortality rates in 2020 with those in each year and the pooled period 2016-2020 using a standardized mortality ratio (SMR) measure. Expected deaths for 2020 were estimated by fitting the overdispersed Poisson generalized linear models to the monthly death counts for the period of 2016-2019. Results Overall, a 21% increase in standardized mortality (SMR 1.21, 95% CI 1.19-1.22) occurred in April-December 2020 compared with the April-December months in the pooled period 2016-2019. The SMR was more pronounced for men than for women (SMR 1.26, 95% CI 1.24-1.29 vs SMR 1.12, 95% CI 1.10-1.14), and it was statistically significant for both genders (P<.05). Using overdispersed Poisson generalized linear models, the number of expected deaths in April-December 2020 was 12,845 (7957 for women and 4888 for men). The total number of excess deaths during this period was estimated at 4583 (95% CI 4451-4716), with higher excess deaths in men (3112, 95% CI 3003-3221) than in women (1503, 95% CI 1427-1579). Almost 83.66% of excess deaths were attributed to COVID-19 in the Ministry of Health database. The vast majority of excess deaths occurred in people aged 60 years or older. Conclusions The reported COVID-19 death counts underestimated mortality attributable to COVID-19. Excess deaths could reflect the increased deaths secondary to the pandemic and its containment measures. The majority of excess deaths occurred among old age groups. It is, therefore, important to maintain essential services for the elderly during pandemics.


Author(s):  
Valérie Courville ◽  
Robert Bourbeau

ABSTRACTA comparative analysis of injury mortality in 24 developed countries during the period 1985–1989 shows the importance of this cause of death among the elderly. One out of four men and one out of two women who dies from injury is aged 65 and over. There is an over-representation of the elderly among injury-related deaths and the risk of death is still increasing after age 65. Some differences can be noted for the elderly as compared to other age groups: a lower male excess mortality ratio and a much larger proportion of violent deaths related to accidental falls. Among developed countries, a wide scope of variations exists in age groups and cause-specific patterns. Hierarchical clustering is used to obtain different aggregations of countries, based on the level, the structure and the causes of violent mortality. Although the classification of countries varies according to a chosen criteria, we often find aggregations of countries belonging to the geographical area.


Stanovnistvo ◽  
2021 ◽  
Vol 59 (1) ◽  
pp. 17-30
Author(s):  
Damir Josipovic

This paper presents new data on the age structure of hospitalised SARI (severe acute respiratory infection) patients, with or without COVID-19, broken down by gender, place of infection, and region. The leading hypothesis that COVID-19 deaths are overestimated despite the high share of excess deaths was confirmed, bringing to light the important issue of the demographic breakdown of the population at risk. Thus, the main reason for the decreasing number of COVID-19 deaths is to be sought within the exhausted demographic pool of the elderly population in 2020, when the mortality rate was 19% higher compared to the previous five-year period (2015-2019). Demographic disparities across regions are immense and statistically explain the differences in the ?infected versus deceased? ratio. The excess mortality in 2020 was unusually high, but the projected value for 2020 based on the mortality pattern across age groups from 2015 to 2019 contributed up to one-third of the surplus. So, for one-quarter of alleged COVID-19 deaths (roughly 600 out of some 3,300 in 2020), death was expected to take place in 2020 anyway.


Author(s):  
Martin Rypdal ◽  
Kristoffer Rypdal ◽  
Ola Løvsletten ◽  
Sigrunn Holbek Sørbye ◽  
Elinor Ytterstad ◽  
...  

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.


2018 ◽  
Vol 146 (16) ◽  
pp. 2059-2065 ◽  
Author(s):  
A. R. R. Freitas ◽  
P. M. Alarcón-Elbal ◽  
M. R. Donalisio

AbstractIn some chikungunya epidemics, deaths are not completely captured by traditional surveillance systems, which record case and death reports. We evaluated excess deaths associated with the 2014 chikungunya virus (CHIKV) epidemic in Guadeloupe and Martinique, Antilles. Population (784 097 inhabitants) and mortality data, estimated by sex and age, were accessed from the Institut National de la Statistique et des Études Économiques in France. Epidemiological data, cases, hospitalisations and deaths on CHIKV were obtained from the official epidemiological reports of the Cellule de Institut de Veille Sanitaire in France. Excess deaths were calculated as the difference between the expected and observed deaths for all age groups for each month in 2014 and 2015, considering the upper limit of 99% confidence interval. The Pearson correlation coefficient showed a strong correlation between monthly excess deaths and reported cases of chikungunya (R= 0.81,p< 0.005) and with a 1-month lag (R= 0.87,p< 0.001); and a strong correlation was also observed between monthly rates of hospitalisation for CHIKV and excess deaths with a delay of 1 month (R= 0.87,p< 0.0005). The peak of the epidemic occurred in the month with the highest mortality, returning to normal soon after the end of the CHIKV epidemic. There were excess deaths in almost all age groups, and excess mortality rate was higher among the elderly but was similar between male and female individuals. The overall mortality estimated in the current study (639 deaths) was about four times greater than that obtained through death declarations (160 deaths). Although the aetiological diagnosis of all deaths associated with CHIKV infection is not always possible, already well-known statistical tools can contribute to the evaluation of the impact of CHIKV on mortality and morbidity in the different age groups.


2012 ◽  
Vol 17 (14) ◽  
Author(s):  
A Mazick ◽  
B Gergonne ◽  
J Nielsen ◽  
F Wuillaume ◽  
M J Virtanen ◽  
...  

In February and March 2012, excess deaths among the elderly have been observed in 12 European countries that carry out weekly monitoring of all-cause mortality. These preliminary data indicate that the impact of influenza in Europe differs from the recent pandemic and post-pandemic seasons. The current excess mortality among the elderly may be related to the return of influenza A(H3N2) virus, potentially with added effects of a cold snap.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11473
Author(s):  
Eliana L. Fernandez-Quiroz ◽  
Lizeth Gonzales-Chachapoyas ◽  
Ana L. Alcantara-Diaz ◽  
Binz Bulnes-Villalta ◽  
Zulmy Ayala-Porras ◽  
...  

Background Overexposure to ultraviolet (UV) radiation has increased skin cancer incidence and the risk of sunburns, especially during the summer months. Objective Identify the frequency and factors associated with sunburns in a sample of beachgoers in the northern coast of Peru. Methods We conducted a secondary data analysis of a previous study that assessed the awareness, behavior and attitudes concerning sun exposure among beachgoers. We included adults between 18 and 59 years who went to a beach in northern Peru during summer (March 2018). Three generalized linear models of the Poisson family were constructed to evaluate the factors associated with having had at least one sunburn last summer. All regression models reported the adjusted prevalence ratio (aPR) with their respective 95% confidence interval (95% CI). Results Of a total of 402 participants, 225 (56.0%) had one to five sunburns and 25 (6.2%) had six or more. Beachgoers who were 1–15 days (aPR: 1.16, 95% CI [1.05–1.27]) or more than 15 days (aPR: 1.22, 95% CI [1.09–1.36]) exposed to the sun on the beach had a higher frequency of at least one sunburn. The non-regular wearing of a hat or cap also increased the frequency of sunburns (aPR: 1.06, 95% CI [1.01–1.12]). In contrast, those who had Skin Phototype III (aPR: 0.94, 95% CI [0.88–0.99]) or IV (aPR: 0.69, 95% CI [0.63–0.75]) had a lower frequency of sunburns. Conclusion Three out of five beachgoers had one or more sunburns in the last summer. The factors associated with a higher frequency were the time of sun exposure at the beach and the non-regular use of a hat or cap. Type III–IV skin phototypes were associated with a lower sunburn frequency.


2021 ◽  
pp. 003335492110415
Author(s):  
Troy Quast ◽  
Ross Andel

Objective COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. Methods We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. Results The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. Conclusions Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250730
Author(s):  
Giorgio Costantino ◽  
Monica Solbiati ◽  
Silvia Elli ◽  
Marco Paganuzzi ◽  
Didi Massabò ◽  
...  

Background During the COVID-19 pandemic, the number of individuals needing hospital admission has sometimes exceeded the availability of hospital beds. Since hospitalization can have detrimental effects on older individuals, preference has been given to younger patients. The aim of this study was to assess the utility of hospitalization for elderly affected by COVID-19. We hypothesized that their mortality decreases when there is greater access to hospitals. Methods This study examined 1902 COVID-19 patients consecutively admitted to three large hospitals in Milan, Italy. Overall mortality data for Milan from the same period was retrieved. Based on emergency department (ED) data, both peak and off-peak phases were identified. The percentage of elderly patients admitted to EDs during these two phases were compared by calculating the standardized mortality ratio (SMR) of the individuals younger than, versus older than, 80 years. Results The median age of the patients hospitalized during the peak phase was lower than the median age during the off-peak phase (64 vs. 75 years, respectively; p <0.001). However, while the SMR for the younger patients was lower during the off-peak phase (1.98, 95% CI: 1.72–2.29 versus 1.40, 95% CI: 1.25–1.58, respectively), the SMR was similar between both phases for the elderly patients (2.28, 95% CI: 2.07–2.52 versus 2.48, 95% CI: 2.32–2.65, respectively). Conclusions Greater access to hospitals during an off-peak phase did not affect the mortality rate of COVID-19-positive elderly patients in Milan. This finding, if confirmed in other settings, should influence future decisions regarding resource management of health care organizations.


2022 ◽  
Author(s):  
Chaiwat Wilasang ◽  
Thanchanok Lincharoen ◽  
Charin Modchang ◽  
Sudarat Chadsuthi

Background: Thailand has recently experienced the most prominent COVID-19 outbreak, resulting in a new record for COVID-19 cases and deaths. To assess the influence of the COVID-19 outbreak on mortality, we aimed to estimate excess mortality in Thailand. Methods: We estimated the baseline number of deaths in the absence of COVID-19 using generalized linear mixed models (GLMMs). The models were adjusted for seasonality and demographics. We evaluated the excess mortality from April to October 2021 in Thailand. Results: We found that the estimated cumulative excess death from April to October 2021 was 14.3% (95% CI: 8.6%-18.8%) higher than the baseline. The results also showed that the excess deaths in males were higher than in females by approximately 26.3%. The excess deaths directly caused by the COVID-19 infections accounted for approximately 75.0% of the all-cause excess deaths. Furthermore, the cumulative COVID-19 cases were found to be correlated with the cumulative excess deaths with a correlation coefficient of 0.9912 (95% CI, 0.9392-0.9987). Conclusions: The recent COVID-19 outbreak in Thailand significantly impacts mortality and affects people for specific ages and sex. During the outbreak in 2021, there was a significant rise in excess fatalities, especially in the older age groups. The increase in mortality was higher in men than in women.


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