The Impact of COVID-19 on Mortality in Spain: Monitoring Excess Mortality (MoMo) and the Surveillance of Confirmed COVID-19 Deaths

Measuring mortality has been a challenge during the COVID-19 pandemic. Here, we compared the results from the Spanish daily mortality surveillance system (MoMo) of excess mortality estimates, using a time series analysis, with those obtained for the confirmed COVID-19 deaths reported to the National Epidemiological Surveillance Network (RENAVE). The excess mortality estimated at the beginning of March 2020 was much greater than what has been observed in previous years, and clustered in a very short time. The cumulated excess mortality increased with age. In the first epidemic wave, the excess mortality estimated by MoMo was 1.5 times higher than the confirmed COVID-19 deaths reported to RENAVE, but both estimates were similar in the following pandemic waves. Estimated excess mortality and confirmed COVID-19 mortality rates were geographically distributed in a very heterogeneous way. The greatest increase in mortality that has taken place in Spain in recent years was detected early by MoMo, coinciding with the spread of the COVID-19 pandemic. MoMo is able to identify risk situations for public health in a timely manner, relying on mortality in general as an indirect indicator of various important public health problems.

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Risk assessment at work and prevention strategies on COVID-19 in Italy

PLoS ONE ◽

10.1371/journal.pone.0248874 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248874

Author(s):

Sergio Iavicoli ◽

Fabio Boccuni ◽

Giuliana Buresti ◽

Diana Gagliardi ◽

Benedetta Persechino ◽

...

Keyword(s):

Public Health ◽

Occupational Safety ◽

Health Workers ◽

Risk Mitigation ◽

Risk Index ◽

Health And Safety ◽

Epidemiological Surveillance ◽

Risk Of Infection ◽

Set Up ◽

The Impact

The COVID-19 pandemic has spread worldwide, with considerable public health and socio-economic impacts that are seriously affecting health and safety of workers, as well as their employment stability. Italy was the first of many other western countries to implement extended containment measures. Health workers and others employed in essential sectors have continued their activity, reporting high infection rate with many fatalities. The epidemiological trend highlighted the importance of work as a substantial factor to consider both when implementing strategies aimed at containing the pandemic and shaping the lockdown mitigation strategy required for sustained economic recovery. To support the decision-making process, we have developed a strategy to predict the risk of infection by SARS-CoV-2 in the workplace based on the analysis of the working process and proximity between employees; risk of infection connected to the type of activity; involvement of third parties in the working processes and risk of social aggregation. We applied this approach to outline a risk index for each economic activity sector, with different levels of detail, also considering the impact on mobility of the working population. This method was implemented into the national epidemiological surveillance model in order to estimate the impact of re-activation of specific activities on the reproduction number. It has also been adopted by the national scientific committee set up by the Italian Government for action-oriented policy advice on the COVID-19 emergency in the post lockdown phase. This approach may play a key role for public health if associated with measures for risk mitigation in enterprises through strategies of business process re-engineering. Furthermore, it will make a contribution to reconsidering the organization of work, including also innovation and fostering the integration with the national occupational safety and health (OSH) system.

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Quantifying the impact of nonpharmaceutical interventions during the COVID-19 outbreak: The case of Sweden

Econometrics Journal ◽

10.1093/ectj/utaa025 ◽

2020 ◽

Vol 23 (3) ◽

pp. 323-344 ◽

Cited By ~ 5

Author(s):

Sang-Wook (Stanley) Cho

Keyword(s):

Public Health ◽

Excess Mortality ◽

Time Lag ◽

Synthetic Control ◽

Framework Analysis ◽

Control Approach ◽

Percentage Points ◽

Elderly Cohort ◽

Nonpharmaceutical Interventions ◽

The Impact

Summary This paper estimates the effect of nonpharmaceutical intervention policies on public health during the COVID-19 outbreak by considering a counterfactual case for Sweden. Using a synthetic control approach, I find that strict initial lockdown measures play an important role in limiting the spread of the COVID-19 infection, as the infection cases in Sweden would have been reduced by almost 75 percent had its policymakers followed stricter containment policies. As people dynamically adjust their behaviour in response to information and policies, the impact of nonpharmaceutical interventions becomes visible, with a time lag of around 5 weeks. Supplementary robustness checks and an alternative difference-in-differences framework analysis do not fundamentally alter the main conclusions. Finally, extending the analysis to excess mortality, I find that the lockdown measures would have been associated with a lower excess mortality rate in Sweden by 25 percentage points, with a steep age gradient of 29 percentage points for the most vulnerable elderly cohort. The outcome of this study can assist policymakers in laying out future guidelines to further protect public health, as well as facilitate plans for economic recovery.

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Unprecedented increase of West Nile virus neuroinvasive disease, Spain, summer 2020

Eurosurveillance ◽

10.2807/1560-7917.es.2021.26.19.2002010 ◽

2021 ◽

Vol 26 (19) ◽

Author(s):

Lucía García San Miguel Rodríguez-Alarcón ◽

Beatriz Fernández-Martínez ◽

María José Sierra Moros ◽

Ana Vázquez ◽

Paula Julián Pachés ◽

...

Keyword(s):

Public Health ◽

West Nile Virus ◽

Vector Control ◽

Epidemiological Surveillance ◽

West Nile ◽

Surveillance Network ◽

Vector Borne Diseases ◽

Health Measures ◽

Neuroinvasive Disease ◽

National Public Health

Cases of West Nile neuroinvasive disease (WNND) in Spain increased in summer 2020. Here we report on this increase and the local, regional and national public health measures taken in response. We analysed data from regional surveillance networks and the National Epidemiological Surveillance Network, both for human and animal West Nile virus (WNV) infection. During the 2020 season, a total of 77 human cases of WNV infection (median age 65 years; 60% males) were detected in the south-west of Spain; 72 (94%) of these cases developed WNND, presenting as meningoencephalitis, seven of which were fatal. In the previous two decades, only six human cases of WNND were detected in Spain. Reduced activities for vector control this season, together with other factors, might have contributed to the massive increase. Public health measures including vector control, campaigns to raise awareness among physicians and the general population, and interventions to ensure the safety of donations of blood products, organs, cells and tissues were effective to reduce transmission. Going forward, maintenance of vector control activities and an update of the vector-borne diseases response plan in Spain is needed.

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Assessing impact of Omicron on SARS-CoV-2 dynamics and public health burden

10.1101/2021.12.12.21267673 ◽

2021 ◽

Author(s):

Epke A. Le Rutte ◽

Andrew J. Shattock ◽

Nakul Chitnis ◽

Sherrie L. Kelly ◽

Melissa A Penny

Keyword(s):

Public Health ◽

Immune Evasion ◽

Health Benefit ◽

Critical Time ◽

Epidemiological Surveillance ◽

Transmission Model ◽

Public Health Burden ◽

Novel Treatments ◽

Health Burden ◽

The Impact

SARS-CoV-2 variant Omicron (B.1.1.529) was classified as a variant of concern (VOC) on November 26, 2021. The infectivity, severity, and immune evasion properties of Omicron relative to the Delta variant will determine 1) the probability of dominant future transmission, and 2) the impact on disease burden. Here we apply an individual-based transmission model to identify thresholds for Omicrons potential dominance, impact on health, and risk to health systems; and identify for which combinations of viral properties, current interventions would be sufficient to control transmission. We show that, with first-generation SARS-CoV-2 vaccines and limited physical distancing in place, the threshold for Omicrons future dominance will primarily be driven by its degree of infectivity. However, Omicrons potential dominance may not necessarily lead to increased public health burden. Expanded vaccination that includes a third-dose for adults and child vaccination strategies is projected to have the biggest public health benefit for a highly infective, highly severe variant with low immune evasion capacity. However, a highly immune evading variant that becomes dominant will likely require alternative measures for control, such as strengthened physical distancing measures, novel treatments, and second-generation vaccines. These findings provide quantitative guidance to decision-makers at a critical time while Omicron properties are being assessed. We emphasize the importance of both genomic and population epidemiological surveillance.

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Impact of the COVID-19 pandemic on life expectancy in Madrid (Spain)

10.31219/osf.io/s53jx ◽

2020 ◽

Author(s):

Sergi Trias-Llimós ◽

Usama Bilal

Keyword(s):

Life Expectancy ◽

Surveillance System ◽

Excess Mortality ◽

Daily Mortality ◽

Life Expectancy At Birth ◽

The World ◽

Using Data ◽

The Impact ◽

Mortality Surveillance ◽

Annual Mortality

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.

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The impact of the 2003 heat wave on daily mortality in England and Wales and the use of rapid weekly mortality estimates

Eurosurveillance ◽

10.2807/esm.10.07.00558-en ◽

2005 ◽

Vol 10 (7) ◽

pp. 15-16 ◽

Cited By ~ 65

Author(s):

H Johnson ◽

S Kovats ◽

G McGregor ◽

J Stedman ◽

M Gibbs ◽

...

Keyword(s):

Heat Wave ◽

Excess Mortality ◽

Heat Waves ◽

Mortality Data ◽

Daily Mortality ◽

England And Wales ◽

National Statistics ◽

The United Kingdom ◽

The Impact ◽

Mortality Estimates

This paper describes a retrospective analysis of the impact of the 2003 heat wave on mortality in England and Wales, and compares this with rapid estimates based on the Office for National Statistics routine weekly deaths reporting system. Daily mortality data for 4 to 13 August 2003, when temperatures were much hotter than normally seen in England, were compared with averages for the same period in years 1998 to 2002. The August 2003 heat wave was associated with a large short-term increase in mortality, particularly in London. Ozone and particulate matter concentrations were also elevated during the heat wave. Overall, there were 2139 (16%) excess deaths in England and Wales. Worst affected were people over the age of 75 years. The impact was greatest in the London region where deaths in those over the age of 75 increased by 59%. Estimated excess mortality was greater than for other recent heat waves in the United Kingdom. The estimated number of deaths registered each week is reported by the Office for National Statistics. The first clear indication of a substantial increase in deaths was published on 21 August 2003. This provided a quick first estimate of the number of deaths attributable to the heat wave and reflected the pattern of daily deaths in relation to the hottest days, but underestimated the excess when compared with the later analysis.

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Excess Mortality in England during the 2019 Summer Heatwaves

Climate ◽

10.3390/cli9010014 ◽

2021 ◽

Vol 9 (1) ◽

pp. 14

Author(s):

Natasha Rustemeyer ◽

Mark Howells

Keyword(s):

Public Health ◽

United Kingdom ◽

Excess Mortality ◽

Summer Period ◽

The Public ◽

National Statistics ◽

The United Kingdom ◽

The Impact ◽

Excess Deaths ◽

Related Mortality

There is increasing evidence that rising temperatures and heatwaves in the United Kingdom are associated with an increase in heat-related mortality. However, the Public Health England (PHE) Heatwave mortality monitoring reports, which use provisional death registrations to estimate heat-related mortality in England during heatwaves, have not yet been evaluated. This study aims to retrospectively quantify the impact of heatwaves on mortality during the 2019 summer period using daily death occurrences. Second, using the same method, it quantifies the heat-related mortality for the 2018 and 2017 heatwave periods. Last, it compares the results to the estimated excess deaths for the same period in the PHE Heatwave mortality monitoring reports. The number of cumulative excess deaths during the summer 2019 heatwaves were minimal (161) and were substantially lower than during the summer 2018 heatwaves (1700 deaths) and summer 2017 heatwaves (1489 deaths). All findings were at variance with the PHE Heatwave mortality monitoring reports which estimated cumulative excess deaths to be 892, 863 and 778 during the heatwave periods of 2019, 2018 and 2017, respectively. Issues are identified in the use of provisional death registrations for mortality monitoring and the reduced reliability of the Office for National Statistics (ONS) daily death occurrences database before 2019. These findings may identify more reliable ways to monitor heat mortality during heatwaves in the future.

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Comprehensive evaluation of the impact of sociodemographic inequalities on adverse outcomes and excess mortality during the COVID-19 pandemic in Mexico City

10.1101/2021.03.11.21253402 ◽

2021 ◽

Author(s):

Neftali Eduardo Antonio-Villa ◽

Luisa Fernandez-Chirino ◽

Julio Pisanty-Alatorre ◽

Javier Mancilla-Galindo ◽

Ashuin Kammar-García ◽

...

Keyword(s):

Population Density ◽

Mexico City ◽

Excess Mortality ◽

Social Inequalities ◽

Adverse Outcomes ◽

Epidemiological Surveillance ◽

Vulnerable Groups ◽

Ambulatory Setting ◽

Increased Risk ◽

The Impact

ABSTRACTThe impact of the COVID-19 pandemic in Mexico City has been sharp, as several social inequalities coexist with chronic comorbidities. Here, we conducted an in-depth evaluation of the impact of social, municipal, and individual factors on the COVID-19 pandemic in working-age population living in Mexico City. To this end, we used data from the National Epidemiological Surveillance System; furthermore, we used a multidimensional metric, the social lag index (DISLI), to evaluate its interaction with mean urban population density (MUPD) and its impact on COVID-19 rates. Influence DISLI and MUPD on the effect of vehicular mobility policies on COVID-19 rates were also tested. Finally, we assessed the influence of MUPD and DISLI on discrepancies of COVID-19 and non-COVID-19 excess mortality compared with death certificates from the General Civil Registry. We detected vulnerable groups who belonged to economically active sectors and who experienced increased risk of adverse COVID-19 outcomes. The impact of social inequalities transcends individuals and has significant effects at a municipality level, with and interaction between DISLI and MUPD. Marginalized municipalities with high population density experienced an accentuated risk for adverse COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts across marginalized municipalities. Finally, we report an under-registry of COVID-19 deaths and significant excess mortality associated with non-COVID-19 deaths closely related to MUPD/DISLI in an ambulatory setting, which could be a negative externality of hospital reconversion. In conclusion, social, individual, and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.

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Excess Mortality in England During the 2019 Summer Heatwaves.

10.20944/preprints202011.0718.v1 ◽

2020 ◽

Author(s):

Natasha Rustemeyer ◽

Mark Howells

Keyword(s):

Public Health ◽

United Kingdom ◽

Excess Mortality ◽

Cumulative Number ◽

Summer Period ◽

The Public ◽

The United Kingdom ◽

The Impact ◽

Excess Deaths ◽

Related Mortality

There is increasing evidence that rising temperatures and heatwaves in the United Kingdom are associated with an increase in heat-related mortality. This study aims to retrospectively quantify the impact of heatwaves on mortality during the 2019 summer period using daily death occurrences. Second, it compares excess mortality during the 2019 heatwaves to excess mortality during the 2018 and 2017 heatwave periods. Lastly, it compares the excess mortality in the 2017-2019 heatwaves to the estimated excess deaths for the same period in the Public Health England (PHE) Heatwave mortality monitoring Reports. The cumulative number of excess deaths during the summer 2019 heatwaves were minimal and were substantially lower than during the summer 2018 heatwaves (1,700 deaths) and summer 2017 heatwaves (1,489 deaths). All findings were at variance with the PHE Heatwave mortality monitoring reports which estimated cumulative excess deaths to be 892, 863 and 778 during the summer period of 2019, 2018 and 2017 respectively using provisional death registrations. Issues have been identified in the use of provisional death registrations for mortality monitoring and the reduced reliability of the ONS daily death occurrence database before 2019. These findings may identify more reliable ways to monitor heat mortality during heatwaves in the future.

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Subnational mortality estimates for India in 2019: a baseline for evaluating excess deaths due to the COVID-19 pandemic

BMJ Global Health ◽

10.1136/bmjgh-2021-007399 ◽

2021 ◽

Vol 6 (11) ◽

pp. e007399

Author(s):

Chalapati Rao ◽

Amrit Jose John ◽

Ajit Kumar Yadav ◽

Mansha Siraj

Keyword(s):

Excess Mortality ◽

National Level ◽

Age Groups ◽

Uttar Pradesh ◽

The Elderly ◽

Registration System ◽

Infant Deaths ◽

Civil Registration ◽

The Impact ◽

Mortality Estimates

BackgroundEstimates of excess mortality are required to assess and compare the impact of the COVID-19 pandemic across populations. For India, reliable baseline prepandemic mortality patterns at national and subnational level are necessary for such assessments. However, available data from the Civil Registration System (CRS) is affected by incompleteness of death recording that varies by sex, age and location.MethodsUnder-reporting of CRS 2019 deaths was assessed for three age groups (< 5 years, 15–59 years and ≥60 years) at subnational level, through comparison with age-specific death rates from alternate sources. Age-specific corrections for under-reporting were applied to derive adjusted death counts by sex for each location. These were used to compute life expectancy (LE) at birth by sex in 2019, which were compared with subnational LEs from the Global Burden of Disease (GBD) 2019 Study.ResultsA total of 9.92 million deaths (95% UI 9.70 to 10.02) were estimated across India in 2019, about 2.28 million more than CRS reports. Adjustments to under-five and elderly mortality accounted for 30% and 56% of additional deaths, respectively. Adjustments in Bihar, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh accounted for 75% of all additional deaths. Adjusted LEs were below corresponding GBD estimates by ≥2 years for males at national level and in 20 states, and by ≥1 year for females in 12 states.ConclusionsThese results represent the first-ever subnational mortality estimates for India derived from CRS reported deaths, and serve as a baseline for assessing excess mortality from the COVID-19 pandemic. Adjusted life expectancies indicate higher mortality patterns in India than previously perceived. Under-reporting of infant deaths and those among women and the elderly is evident in many locations. Further CRS strengthening is required to improve the empirical basis for local mortality measurement across the country.

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