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Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths.
J Epidemiol Glob Health. 2020 Sep; 10(3):209-213.JE

Abstract

BACKGROUND

One month after the first COVID-19 infection was recorded, Portugal counted 18,051 cases and 599 deaths from COVID-19. To understand the overall impact on mortality of the pandemic of COVID-19, we estimated the excess mortality registered in Portugal during the first month of the epidemic, from March 16 until April 14 using two different methods.

METHODS

We compared the observed and expected daily deaths (historical average number from daily death registrations in the past 10 years) and used 2 standard deviations confidence limit for all-cause mortality by age and specific mortality cause, considering the last 6 years. An adapted Auto Regressive Integrated Moving Average (ARIMA) model was also tested to validate the estimated number of all-cause deaths during the study period.

RESULTS

Between March 16 and April 14, there was an excess of 1255 all-cause deaths, 14% more than expected. The number of daily deaths often surpassed the 2 standard deviations confidence limit. The excess mortality occurred mostly in people aged 75+. Forty-nine percent (49%) of the estimated excess deaths were registered as due to COVID-19, the other 51% registered as other natural causes.

CONCLUSION

Even though Portugal took early containment measures against COVID-19, and the population complied massively with those measures, there was significant excess mortality during the first month of the pandemic, mostly among people aged 75+. Only half of the excess mortality was registered as directly due do COVID-19.

KEY POINTS

An Excess Mortality (EM) of 1255 deaths were estimated 1 month after the first death classified by COVID-19, and it would probably be more if the government had not taken early action.

The age group where a significant increase in mortality was noted was above 75 years.

51% of the EM was due to natural causes other than COVID-19.

Authors+Show Affiliations

Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal.Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal. Public Health Unit, North Lisbon Health Centers, Lisbon, Portugal.Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal.Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32954711

Citation

Vieira, André, et al. "Rapid Estimation of Excess Mortality During the COVID-19 Pandemic in Portugal -Beyond Reported Deaths." Journal of Epidemiology and Global Health, vol. 10, no. 3, 2020, pp. 209-213.
Vieira A, Peixoto VR, Aguiar P, et al. Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths. J Epidemiol Glob Health. 2020;10(3):209-213.
Vieira, A., Peixoto, V. R., Aguiar, P., & Abrantes, A. (2020). Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths. Journal of Epidemiology and Global Health, 10(3), 209-213. https://doi.org/10.2991/jegh.k.200628.001
Vieira A, et al. Rapid Estimation of Excess Mortality During the COVID-19 Pandemic in Portugal -Beyond Reported Deaths. J Epidemiol Glob Health. 2020;10(3):209-213. PubMed PMID: 32954711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths. AU - Vieira,André, AU - Peixoto,Vasco Ricoca, AU - Aguiar,Pedro, AU - Abrantes,Alexandre, PY - 2020/05/14/received PY - 2020/06/20/accepted PY - 2020/9/21/entrez PY - 2020/9/22/pubmed PY - 2020/10/2/medline KW - Coronavirus KW - Portugal KW - disease outbreaks KW - mortality KW - pandemics SP - 209 EP - 213 JF - Journal of epidemiology and global health JO - J Epidemiol Glob Health VL - 10 IS - 3 N2 - BACKGROUND: One month after the first COVID-19 infection was recorded, Portugal counted 18,051 cases and 599 deaths from COVID-19. To understand the overall impact on mortality of the pandemic of COVID-19, we estimated the excess mortality registered in Portugal during the first month of the epidemic, from March 16 until April 14 using two different methods. METHODS: We compared the observed and expected daily deaths (historical average number from daily death registrations in the past 10 years) and used 2 standard deviations confidence limit for all-cause mortality by age and specific mortality cause, considering the last 6 years. An adapted Auto Regressive Integrated Moving Average (ARIMA) model was also tested to validate the estimated number of all-cause deaths during the study period. RESULTS: Between March 16 and April 14, there was an excess of 1255 all-cause deaths, 14% more than expected. The number of daily deaths often surpassed the 2 standard deviations confidence limit. The excess mortality occurred mostly in people aged 75+. Forty-nine percent (49%) of the estimated excess deaths were registered as due to COVID-19, the other 51% registered as other natural causes. CONCLUSION: Even though Portugal took early containment measures against COVID-19, and the population complied massively with those measures, there was significant excess mortality during the first month of the pandemic, mostly among people aged 75+. Only half of the excess mortality was registered as directly due do COVID-19. KEY POINTS: : An Excess Mortality (EM) of 1255 deaths were estimated 1 month after the first death classified by COVID-19, and it would probably be more if the government had not taken early action. : The age group where a significant increase in mortality was noted was above 75 years. : 51% of the EM was due to natural causes other than COVID-19. SN - 2210-6014 UR - https://www.unboundmedicine.com/medline/citation/32954711/Rapid_Estimation_of_Excess_Mortality_during_the_COVID_19_Pandemic_in_Portugal__Beyond_Reported_Deaths_ DB - PRIME DP - Unbound Medicine ER -