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High income countries' excess death toll in 2020

Thursday May 20th 2021

Twenty-nine high-income countries accounted for almost one million extra deaths because of the COVID-19 pandemic in 2020, according to a new study.

The research, published in The BMJ, revealed the five highest were the USA, UK, Italy, Spain and Poland.

All other countries examined, except Norway, Denmark and New Zealand, had higher-than-expected deaths in 2020, particularly in men.

In this international study, led by Dr Nazrul Islam from the Nuffield Department of Population Health at the University of Oxford, researchers examined temporal and seasonal trends, as well as differences in age and sex, across countries to assess the number of excess deaths.

A mathematical model calculated weekly excess deaths in 2020 for each country, including age and sex differences between countries, and also for seasonal and yearly trends in mortality, over the five preceding years.

The team found an estimated 979,000 total excess deaths in 2020, largely among people aged 75 or older, followed by people aged 65-74. Deaths in children under 15 were similar to expected levels in most countries and lower than expected in some countries.

The highest absolute number of excess deaths being 458,000 in the USA; 94,400 in the UK; 89,100 in Italy; 84,100 in Spain and 60,100 in Poland. New Zealand recorded 2,500 lower overall deaths than expected.

In most countries, the estimated number of excess deaths exceeded the number of reported deaths from COVID-19, but in others, such as Israel and France, there were more reported COVID-19 deaths than estimated excess deaths.

The researchers say the variation may result from access to testing and differences in how countries define and record COVID-19 deaths.

The researchers say there were some limitations to their study, including a lack of data from lower and middle income countries and on factors such as ethnicity and socioeconomic status.

However, as it was a large study using detailed age and sex specific mortality data with robust analytical methods, they add it “adds important insights on the direct and indirect effects of the COVID-19 pandemic on total mortality”.

Islam N, Shkolnikov VM, Acosta RJ et al. Excess deaths associated with COVID-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries. BMJ 20 May 2021


Tags: Europe | Flu & Viruses | North America | World Health

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