Regional excess mortality during the 2020 COVID-19 pandemic in five European countries

Abstract

The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015–2019, we applied Bayesian spatio-temporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. With around 30%, Madrid, Castile-La Mancha, Castile-Leon (Spain) and Lombardia (Italy) were the regions with the highest excess mortality. In England, Greece and Switzerland, the regions most affected were Outer London and the West Midlands (England), Eastern, Western and Central Macedonia (Greece), and Ticino (Switzerland), with 15–20% excess mortality in 2020. Our study highlights the importance of the large transportation hubs for establishing community transmission in the first stages of the pandemic. Here, we show that acting promptly to limit transmission around these hubs is essential to prevent spread to other regions and countries.

Survival among people hospitalized with COVID-19 in Switzerland: a nationwide population-based analysis

“…In many countries, strict lockdown measures controlled the first wave of SARS-CoV-2 infection in the first half of 2020, but a second larger wave followed the delayed re-introduction of control measures in autumn 2020. Switzerland, a high-income country, experienced the highest levels of excess mortality since the 1918 influenza pandemic, with a larger death toll during the second compared to the first epidemic wave [ 19 , 20 ]. As in many other countries, the number of available intensive care unit (ICU) beds has become an indicator of the need to introduce or intensify public health measures to control SARS-CoV-2 transmission.…”

Underestimation in Reporting Excess COVID-19 Death Data in Poland during the First Three Pandemic Waves

“…However, it required assuming that after normalization through log transformation, the excess deaths during the pandemic should be compensated by dips in other periods, while the more deadly the pandemic, the more reality should diverge from this assumption. This problem is not unsolvable on its own, as those models are refined further to include variables correcting for suspected causes of excess deaths, such as weather conditions [ 21 ] or both heat waves and the influenza season [ 22 ] ( Supplementary Figures S1 and S2 ).…”

COVID-19 excess death rate in Eastern European countries associated with weaker regulation implementation and lower vaccination coverage

“…Excess death rate is a more complex indicator but it may show the true impact of the pandemic across a population, especially in the long term (3). It may also serve as a better comparative measure across countries with differences in health system and surveillance resources (4). In the countries of Eastern Europe, where intensive circulation of COVID 19 started later than in the West, public health measures were very effective in first half of 2020.…”

“…Excess death rate is a more complex indicator but it may show the true impact of the pandemic across a population, especially in the long term (3). It may also serve as a better comparative measure across countries with differences in health system and surveillance resources (4).…”