Lockdown and non-COVID-19 deaths: Cause-specific mortality during the first wave of the 2020 pandemic in Norway. A population-based register study

Abstract

Objective To explore the potential impact of the first wave of COVID-19 pandemic on all cause and cause-specific mortality in Norway. Design Population based register study. Setting The Norwegian cause of Death Registry and the National Population Register of Norway. Participants All recorded deaths in Norway during March to May from 2010 to 2020. Main outcome measures Rate (per 100 000) of all-cause mortality and causes of death in the EU Shortlist for Causes of Death March to May 2020. The rates were age-standardised and adjusted to a 100% register coverage and compared with a 95% prediction interval (PI) based on corresponding rates for 2010-2019. Results 113 710 deaths were included, of which 10 226 from 2020. We did not observe any deviation from predicted total mortality. There were fewer than predicted deaths from chronic lower respiratory diseases excluding asthma (11.4, 95% PI 11.8 to 15.2) and from other non-ischemic, non-rheumatic heart diseases (13.9, 95% PI 14.5 to 20.2). The death rates were higher than predicted for Alzheimer's disease (7.3, 95% PI 5.5 to 7.3) and diabetes mellitus (4.1, 95% PI 2.1 to 3.4). Conclusions There was no significant difference in the frequency of the major causes of death in the first wave of the 2020 COVID-19 pandemic in Norway. An increase in diabetes mellitus deaths and reduced mortality due to some heart and lung conditions may be linked to infection control measures.

Self-reported Mental and Physical Health Among Norwegian Adolescents Before and During the COVID-19 Pandemic

“…First, at the time of our study, Norway had experienced no excess mortality and only a relatively moderate economic hardship owing to a set of well-funded governmental policies. 2 , 3 , 13 Second, our 2020 data collection took place approximately 8 to 10 months into the pandemic, during the peak of the second wave but after the school summer vacations and before the winter season. How the examined outcomes developed after the prolonged and more sustained pandemic exposure (ie, until spring 2021 or later) is not known from these relatively short-term data.…”

“…The MyLife study aimed to recruit entire cohorts of 8th, 9th, and 10th grade students from 33 middle schools throughout Norway. All eligible students were invited to complete annual electronic surveys during class time while in middle school (ie, grades 8-10) and individually once in high school (ie, grades [11][12][13]. Baseline data collection took place during the 2017 fall semester.…”

“…Another set of stricter national policies was implemented on October 26, 2020, after the spike in hospitalizations following summer holidays. 6 Ultimately, Norway did not register elevated mortality during the first pandemic year, 3,13 yet all aspects of society were deeply affected. [3][4][5]7 There is an overarching agreement that these extraordinary circumstances may contribute to a global public mental health crisis.…”

Associations between reductions in routine care delivery and non-COVID-19-related mortality in people with diabetes in England during the COVID-19 pandemic: a population-based parallel cohort study

“…Although overall mortality was not increased in Norway, in which the COVID-19-related mortality was low (only 216 COVID-19 deaths as of May 31, 2020; the time of reporting), the observed death rate from diabetes was 50% higher than predicted. 14 In the first pandemic wave in England, we showed that 30–35% of the excess mortality in those with diabetes was not associated with recording of COVID-19 on death certificates. 12 However, the access to testing outside hospital environments at that point was poor.…”

Learning from the pandemic: mortality trends and seasonality of deaths in Australia in 2020

“…There were increased total deaths from diabetes in Australia as were observed in Italy, 7 and Norway during the first wave. 40 In the latter report, which focuses on the effects of lockdown (there were 216 COVID-19 deaths during the study period), the authors speculated that the observed 45% increase in diabetes deaths may have been due to some patients with diabetes inappropriately avoiding health care. This explanation that may also apply to the Australian findings, a hypothesis supported by data showing increases in diabetes deaths coincident with the two periods of stay-at-home orders (lockdowns) in the state of Victoria in 2020.…”