scholarly journals News from the front: Estimation of excess mortality and life expectancy in the major epicenters of the COVID-19 pandemic in Italy

Author(s):  
Simone Ghislandi ◽  
Raya Muttarak ◽  
Markus Sauerberg ◽  
Benedetta Scotti

AbstractExisting studies on the mortality impacts of the COVID-19 pandemic commonly rely on national official reports. However, in a pandemic, deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Official statistics on COVID-19 mortality are sensitive to classification, estimation and reporting practice which are not consistent across countries. Likewise, the reported mortality is often provided at the national level which results in underestimation of the true scale of the human life impact given that the outbreaks are localised.This study overcomes the problem of under-reporting of COVID-19-related deaths by using all cause daily death registrations data provided by the Italian Statistical Office (ISTAT) from January 1 to April 30, 2020 in comparison with official figures reported by the Civil Protection Department. The study focuses on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza) and Lombardy region. We calculate excess mortality in 2020 compared to the average of the years 2015 to 2019 and estimate life expectancy for the first wave of the epidemic and for the rest of the year 2020. Not only is life expectancy a reliable measure of a country’s health status and development, it also allows us to quantify the impact of COVID-19 on human life.The estimated excess deaths show significantly higher mortality than COVID-19 official mortality statistics, particularly during the peak of the epidemic and amongst people aged 60 years and over. We find that for the first wave of the epidemic, life expectancy in the five provinces reduced by 5.1 to 7.8 and 3.2 to 5.8 years for men and women, respectively. For annual life expectancy for the year 2020, in a scenario with no harvesting effect i.e. mortality rates resume to an average level of the years 2015-2019 after the end of the first epidemic wave, the years of life lost is equivalent to 2 to 3.5 years for men and 1.1. to 2.5 years for women in the five provinces.The COVID-19 pandemic posed a substantial impact on population health in Italy as it represents the largest decline in life expectancy after the 1918 influenza pandemic and the Second World War.

Author(s):  
Simone Ghislandi ◽  
Raya Muttarak ◽  
Markus Sauerberg ◽  
Benedetta Scotti

Deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Mortality is often reported at the national level, which can result in the underestimation of the true scale of the impact of the pandemic since outbreaks tend to be localised. This study exploits all-cause daily death registration data provided by the Italian Statistical Office (ISTAT) from 1 January to 31 October to estimate the excess mortality and the corresponding changes in life expectancy during the first wave of the COVID-19 pandemic. Focusing on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza), we calculate the excess mortality in 2020 compared to the average mortality of the years 2015 to 2019. Moreover, we estimate the excess mortality in the first quadrimester of 2020, and the annual life expectancy at birth. The estimated excess deaths show that during this period, mortality was significantly higher than the official mortality statistics for COVID-19. According to our estimates for the first quadrimester, life expectancy in the five provinces declined by 5.4 to 8.1 for men and by 4.1 to 5.8 years for women. In addition, we find that annual life expectancy decreased by 2.4 to 4.1 years for men and by 1.9 to 2.8 years for women compared to the 2015–2019 average. Thus, we conclude that the first wave of the COVID-19 pandemic had a substantial impact on population health in the hardest hit areas in Italy.


2007 ◽  
Vol 104 (18) ◽  
pp. 7588-7593 ◽  
Author(s):  
Martin C. J. Bootsma ◽  
Neil M. Ferguson

During the 1918 influenza pandemic, the U.S., unlike Europe, put considerable effort into public health interventions. There was also more geographic variation in the autumn wave of the pandemic in the U.S. compared with Europe, with some cities seeing only a single large peak in mortality and others seeing double-peaked epidemics. Here we examine whether differences in the public health measures adopted by different cities can explain the variation in epidemic patterns and overall mortality observed. We show that city-specific per-capita excess mortality in 1918 was significantly correlated with 1917 per-capita mortality, indicating some intrinsic variation in overall mortality, perhaps related to sociodemographic factors. In the subset of 23 cities for which we had partial data on the timing of interventions, an even stronger correlation was found between excess mortality and how early in the epidemic interventions were introduced. We then fitted an epidemic model to weekly mortality in 16 cities with nearly complete intervention-timing data and estimated the impact of interventions. The model reproduced the observed epidemic patterns well. In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early. San Francisco, St. Louis, Milwaukee, and Kansas City had the most effective interventions, reducing transmission rates by up to 30–50%. Our analysis also suggests that individuals reactively reduced their contact rates in response to high levels of mortality during the pandemic.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, <1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.


Author(s):  
Arnold S Monto ◽  
Keiji Fukuda

Abstract Seasonal influenza is an annual occurrence, but it is the threat of pandemics that produces universal concern. Recurring reports of avian influenza viruses severely affecting humans have served as constant reminders of the potential for another pandemic. Review of features of the 1918 influenza pandemic and subsequent ones helps in identifying areas where attention in planning is critical. Key among such issues are likely risk groups and which interventions to employ. Past pandemics have repeatedly underscored, for example, the vulnerability of groups such as pregnant women and taught other lessons valuable for future preparedness. While a fundamental difficulty in planning for the next pandemic remains their unpredictability and infrequency, this uncertainty can be mitigated, in part, by optimizing the handling of the much more predictable occurrence of seasonal influenza. Improvements in antivirals and novel vaccine formulations are critical in lessening the impact of both pandemic and seasonal influenza.


1995 ◽  
Vol 2 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Robert S Hogg ◽  
Martin T Schechter ◽  
Julio SG Montaner ◽  
James C Hogg

OBJECTIVE: To assess the impact of asthma on Canadian mortality rates over a 45-year period.DESIGN: A descriptive, population-based study.SETTING: Canada.SUBJECTS: All persons who died from asthma in Canada from 1946 to 1990 as reported to Statistics Canada in Ottawa.MAIN OUTCOME MEASURES: Standardized mortality ratios, age-specific patterns of death, potential years of life lost (PYLL) and life expectancy lost.RESULTS: A total of 12,010 male and 8486 female asthma deaths were recorded in Canada from 1946 to 1990. Mortality rates for both sexes declined from a high of between three to six deaths in 1951 to 1955 to approximately two deaths per 100,000 in 1986 to 1990, with the decline in rates being greater for males than females. Age-specific mortality rates were highest al all ages in 1951 to 1955, except for 15 to 24 years when deaths rates for the 1981 to 1985 period were greater. PYLL exhibit the same pattern as mortality, peaking in 1951 to 1955 and subsequently declining with each period. Loss in life expectancy due to asthma was about one month (not significant) in all time periods.CONCLUSIONS: Asthma mortality rates have declined significantly over the study period. This decline appears to be linked with the convergence of sex-specific rates and with changes in the patterning or age-specific mortality. The impact of asthma on the life expectancy of Canadians is small.


2020 ◽  
Author(s):  
Soumi Ray ◽  
Mitu Roy

AbstractPurposeWe are currently in the middle of a global crisis. Covid19 pandemic has suddenly threatened the existence of human life. Till date, as no medicine or vaccine is discovered, the best way to fight against this pandemic is prevention. The impact of different environmental, social, economic and health parameters is unknown and under research. It is important to identify the factors which can weaken the virus, and the nations which are more vulnerable to this virus.Materials and MethodsData of weather, vaccination trends, life expectancy, lung disease, number of infected people in the pre-lockdown and post-lockdown period of highly infected nations are collected. These are extracted from authentic online resources and published reports. Analysis is done to find the possible impact of each parameter on CoVid19.ResultsCoVid19 has no linear correlation with any of the selected parameters, though few parameters have depicted non-linear relationship in the graphs. Further investigations have shown better result for some parameters. A combination of the parameters results in a better correlation with infection rate.ConclusionsThough depending on the study outcome, the impact of CoVid19 in India can be predicted, the required lockdown period cannot be calculated due to data limitation.


2021 ◽  
Vol 4 (3) ◽  
pp. 191-194
Author(s):  
Hiroshi Bando

The impact of COVID-19 can be shown by life expectancy, excess death and total years of life lost (YLL). United States showed life expectancy minus 1.67 years, excess deaths 375,235 and total YLL 7,362,555. The excess death of Japan has remained minus value for long, in which long-term care facilities (LTCF) may contribute. LTCF has characteristic points as i) mutual interrelationships between hospitals, medical societies and prefectural offices, ii) rapid communication channels for regulatory official authorities, iii) high degree of citizenship and cooperation of all Japanese people for daily life and iv) mild lockdown without any punishment with declaration.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sara Ahmadi-Abhari ◽  
Piotr Bandosz ◽  
Mika Kivimaki ◽  
Lefkos Middleton

Abstract Background To accurately assess the impact of COVID19 on life-expectancy, years of life lost, and prevalence of dementia and disability, a model integrating calendar-trends in cardiovascular-disease, dementia, disability and mortality is required. We estimated these impacts in Austria, Belgium, Czech-Republic, Denmark, Estonia, France, Germany, Greece, Hungary, Italy, The Netherlands, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland, and the UK. Methods Data to inform the ten-state Monte-Carlo Markov-model for the 18 European countries were derived from official-statistics for population-numbers and mortality-rates (age&sex-specific) and from Survey for Health, Ageing and Retirement in Europe for prevalence-estimates and transition-probabilities. Impact of COVID19 was measured comparing the estimates derived from incorporating expected mortality rates assuming calendar-trends in mortality and incidence of dementia, disability, and cardiovascular-disease continue those of the past two-decades, and those incorporating excess COVID19 mortality. Results Assuming COVID-19 vaccination and termination of the pandemic will be accomplished by the end of 2021, the pandemic will have resulted in a loss of 9.3M (95% Uncertainty-Interval 1.3M-29.8M) person-years of life, including 7.1M person-years of dementia-free life and 5.2M person-years of disability-free life among the 289M population (as of 2019) above age-35. The effects on prevalence of dementia, disability and life-expectancy will be presented. Conclusions The impact of the pandemic on disability-free person-years of life lost are devastating, marking a need for more rapid actions to halt the spread of epidemics. Key messages Accurate estimation of future prevalence of dementia and disability to quantify the impact of the pandemic on years of life lost needs to simultaneously account for the declining trends in incidence of dementia and the decline in cardiovascular disease incidence and mortality resulting in increased life-expectancy and a larger pool susceptible to dementia and disability. The COVID19 pandemic is estimated to result in 9.3million person-years of life lost in 18 European countries including a loss of 7.1M person-years of dementia-free life and 5.2M person-years of disability-free life.


2020 ◽  
Author(s):  
Sergi Trias-Llimós ◽  
Usama Bilal

The COVID-19 pandemic is causing substantial increases in mortality across populations, potentially causing stagnation or decline in life expectancy. We explored this idea by examining the impact of excess mortality linked to the COVID-19 crisis on life expectancy in the region of Madrid (Spain). Using data from the Daily Mortality Surveillance System (MoMo), we calculated excess mortality (death counts) for the weeks 10th to 14th in 2020 using data on expected and observed mortality, assuming no further excess mortality during the rest of the year. The expected annual mortality variation was +6%, +21% and +25% among men aged under 65, between 65 and 74 and over 75, respectively, and +5%, +13%, and 18% for women, respectively. This excess mortality during weeks 10th to 14th resulted in a life expectancy at birth decline of 1.6 years among men and 1.1 years among women. These estimates confirm that Madrid and other severely hit regions in the world may face substantial life expectancy declines.


Sign in / Sign up

Export Citation Format

Share Document