Delays in Death Reports and their Implications for Tracking the Evolution of COVID-19

Gutiérrez, Emilio; Rubli, Adrian; Tavares, Tiago

doi:10.2139/ssrn.3645304

Cited by 18 publications

(23 citation statements)

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“…In developed countries like Germany where the COVID-19 pandemic management has been considered a success story, the estimated excess number of deaths during the first wave of pandemic was lower than the reported number of COVID-19 deaths (+ 8071 estimated excess deaths vs. 8674 reported COVID-19 deaths) [ 36 ]. The low proportion of COVID-19 deaths out of total excess deaths could be driven by low COVID-19 testing rates in the country [ 4 ], delays in reporting COVID-19 deaths [ 38 ], diagnostic delays for fatal conditions such as cancer [ 39 ], issues related to the sensitivity of reverse transcriptase-PCR (RTPCR) test [ 40 ], disruption of routine health care owing to the collapse of the health system, or intentional choices of not visiting health facilities due to fear of contracting the virus, and exacerbating the effects on the health of vulnerable groups [ 41 ]. Moreover, the pandemic triggered a mental health crisis that has given rise to an increase in self-harm and suicide [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

et al. 2021

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Background Low testing rates and delays in reporting hinder the estimation of the mortality burden associated with the COVID-19 pandemic. During a public health emergency, estimating all cause excess deaths above an expected level of death can provide a more reliable picture of the mortality burden. Here, we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico. Methods We obtained weekly mortality time series due to all causes for Mexico, and by gender, and geographic region from 2015 to 2020. We also compiled surveillance data on COVID-19 cases and deaths to assess the timing and intensity of the pandemic and assembled weekly series of the proportion of tweets about ‘death’ from Mexico to assess the correlation between people’s media interaction about ‘death’ and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models and forecasted the total excess deaths for Mexico for the first 4 weeks of 2021 using the generalized logistic growth model. Results We estimated the all-cause excess mortality rate associated with the COVID-19 pandemic in Mexico in 2020 at 26.10 per 10,000 population, which corresponds to 333,538 excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). Mexico City reported the highest excess death rate (63.54) and RR (2.09) compared to rest of the country (excess rate = 23.25, RR = 1.62). While COVID-19 deaths accounted for only 38.64% of total excess deaths in Mexico, our forecast estimate that Mexico has accumulated a total of ~ 61,610 [95% PI: 60,003, 63,216] excess deaths in the first 4 weeks of 2021. Proportion of tweets was significantly correlated with the excess mortality (ρ = 0.508 [95% CI: 0.245, 0.701], p-value = 0.0004). Conclusion The COVID-19 pandemic has heavily affected Mexico. The lab-confirmed COVID-19 deaths accounted for only 38.64% of total all cause excess deaths (333,538) in Mexico in 2020. This reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes during the pandemic. A model-based forecast indicates that an average of 61,610 excess deaths have occurred in January 2021.

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Section: Discussionmentioning

confidence: 99%

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

et al. 2021

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“…It is worth noting that, Mexico has the highest number of health worker deaths due to the COVID-19 pandemic (∼1400 deaths) in the world [36, 37]. Another factor contributing to the low proportion of COVID-19 deaths out of total excess deaths could be the low COVID-19 testing rates in the country [4], and delay in reporting the COVID-19 deaths [38].…”

Section: Discussionmentioning

confidence: 99%

“…Estimates of all-cause excess mortality rate per 10,000 population and RR during COVID-14% of the total estimated excess deaths in Mexico City, compared to 40.83% in the rest of Mexico.Excess mortality rate among males nearly doubled the rate among females (proportion test, pvalue <0.0001, and the proportion of COVID-19 deaths out of total excess deaths was similar,38.321% among males and 39.22% among females (proportion test, p-value <0.0001).…”

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confidence: 95%

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

Dahal

Banda

Bento

et al. 2021

Preprint

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Background: The low testing rates, compounded by reporting delays, hinders the estimation of the mortality burden associated with the COVID-19 pandemic based on surveillance data alone. A more reliable picture of the effect of COVID-19 pandemic on mortality can be derived by estimating excess deaths above an expected level of death. In this study we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico in 2020 by gender and two geographic regions: Mexico City and the rest of the country. Methods: We obtained mortality time series due to all causes for Mexico, and by gender, and geographic region using epidemiological weeks from January to December 2020 and for preceding 5 years. We also compiled data on COVID-19 related morbidity and mortality to assess the timing and intensity of the pandemic in Mexico. We assembled weekly series of the number of tweets about death from Mexico to assess the correlation between media interaction of people about death and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models. Results: The COVID-19 pandemic excess mortality rates per 10,000 population in Mexico between March 1, 2020 and January 2, 2021 was estimated at 26.10. The observed total number of deaths due to COVID-19 was 128,886 which is 38.64% of the total estimated excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). The excess mortality rate for Mexico City (63.54) was about 2.7-fold higher than the rest of the country (23.25). Similarly, the mortality rate ratio relative to baseline was highest for Mexico City (RR: 2.09). There was no significant correlation between weekly number of tweets on death and the weekly all-cause excess mortality rates (ρ=0.309 (95% CI: 0.010, 0.558, p-value=0.043). Conclusion: The excess mortality rate of 26.10 per 10,000 population corresponds to a total of 333,538 excess deaths in Mexico between March 1, 2020 to January 2, 2021. COVID-19 accounted for only 38.21% of the total excess deaths, which reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes.

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“…Moreover, there is likely to have been substantial variation in terms of delay in notification of confirmed cases and deaths throughout the pandemic, further complicating the interpretation of CFRs in the early phase, partially due to changes in surveillance and reporting practices. In the United Kingdom, the reporting delay is reported to have decreased over time [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Delay-Adjusted Age-Specific COVID-19 Case Fatality Rates in a High Testing Setting: South Korea, February 2020 to February 2021

Shim

2021

IJERPH

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In South Korea, a country with a high coronavirus disease 19 (COVID-19) testing rate, a total of 87,324 COVID-19 cases, including 1562 deaths, have been recorded as of 23 February 2021. This study assessed the delay-adjusted COVID-19 case fatality risk (CFR), including data from the second and third waves. A statistical method was applied to the data from 20 February 2021 through 23 February 2021 to minimize bias in the crude CFR, accounting for the survival interval as the lag time between disease onset and death. The resulting overall delay-adjusted CFR was 1.97% (95% credible interval: 1.94–2.00%). The delay-adjusted CFR was highest among adults aged ≥80 years and 70–79 years (22.88% and 7.09%, respectively). The cumulative incidence rate was highest among individuals aged ≥80 years and 60–69 years. The cumulative mortality rate was highest among individuals aged ≥80 years and 70–79 years (47 and 12 per million, respectively). In South Korea, older adults are being disproportionately affected by COVID-19 with a high death rate, although the incidence rate among younger individuals is relatively high. Interventions to prevent COVID-19 should target older adults to minimize the number of deaths.

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Delays in Death Reports and their Implications for Tracking the Evolution of COVID-19

Cited by 18 publications

References 0 publications

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

Delay-Adjusted Age-Specific COVID-19 Case Fatality Rates in a High Testing Setting: South Korea, February 2020 to February 2021

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