Direct and indirect effects of the COVID-19 pandemic on mortality in Switzerland.
Ontology highlight
ABSTRACT:
SUBMITTER: Riou J
PROVIDER: S-EPMC9817462 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
Publications
Direct and indirect effects of the COVID-19 pandemic on mortality in Switzerland.
Riou Julien J Hauser Anthony A Fesser Anna A Althaus Christian L CL Egger Matthias M Konstantinoudis Garyfallos G
Nature communications 20230106 1
The direct and indirect impact of the COVID-19 pandemic on population-level mortality is of concern to public health but challenging to quantify. Using data for 2011-2019, we applied Bayesian models to predict the expected number of deaths in Switzerland and compared them with laboratory-confirmed COVID-19 deaths from February 2020 to April 2022 (study period). We estimated that COVID-19-related mortality was underestimated by a factor of 0.72 (95% credible interval [CrI]: 0.46-0.78). After acco ...[more]
Similar Datasets
Project description:Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we used time series approaches to separate the direct contribution of SARS-CoV-2 infections on mortality from the indirect consequences of pandemic interventions and behavior changes in the United States. We estimated deaths occurring in excess of seasonal baselines stratified by state, age, week and cause (all causes, COVID-19 and respiratory diseases, Alzheimer's disease, cancer, cerebrovascular disease, diabetes, heart disease, and external causes, including suicides, opioids, accidents) from March 1, 2020 to April 30, 2021. Our estimates of COVID-19 excess deaths were highly correlated with SARS-CoV-2 serology, lending support to our approach. Over the study period, we estimate an excess of 666,000 (95% Confidence Interval (CI) 556000, 774000) all-cause deaths, of which 90% could be attributed to the direct impact of SARS-CoV-2 infection, and 78% were reflected in official COVID-19 statistics. Mortality from all disease conditions rose during the pandemic, except for cancer. The largest direct impacts of the pandemic were seen in mortality from diabetes, Alzheimer's, and heart diseases, and in age groups over 65 years. In contrast, the largest indirect consequences of the pandemic were seen in deaths from external causes, which increased by 45,300 (95% CI 30,800, 59,500) and were statistically linked to the intensity of non-pharmaceutical interventions. Within this category, increases were most pronounced in mortality from accidents and injuries, drug overdoses, and assaults and homicides, while the rate of death from suicides remained stable. Younger age groups suffered the brunt of these indirect effects. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups, in periods of stricter interventions, and in mortality from external causes. Further research on the drivers of indirect mortality is warranted to optimize interventions in future pandemics.
| S-EPMC8863161 | biostudies-literature
Project description:The COVID-19 pandemic has highlighted the importance of understanding environmental factors in disease transmission. This study aims to explore the spatial association between nighttime light (NTL) from satellite imagery and COVID-19 mortality. It particularly examines how NTL serves as a pragmatic proxy to estimate human interaction in illuminated nocturnal area, thereby impacting viral transmission dynamics to neighboring areas, which is defined as spillover effect. Analyzing 43,199 COVID-19 deaths from national mortality data during January 2020 and October 2022, satellite-derived NTL data, and various environmental and socio-demographic covariates, we employed the Spatial Durbin Error Model to estimate the direct and indirect effect of NTL on COVID-19 mortality. Higher NTL was initially directly linked to increased COVID-19 mortality but this association diminished over time. The spillover effect also changed: during the early 3rd wave (December 2020 - February 2021), a unit (nanoWatts/sr/cm2) increase in NTL led to a 7.9% increase in neighboring area mortality (p = 0.013). In contrast, in the later 7th wave (July - September 2022), dominated by Omicron, a unit increase in NTL resulted in an 8.9% decrease in mortality in neighboring areas (p = 0.029). The shift from a positive to a negative spillover effect indicates a change in infection dynamics during the pandemic. The study provided a novel approach to assess nighttime human activity and its influence on disease transmission, offering insights for public health strategies utilizing satellite imagery, particularly when direct data collection is impractical while the collection from space is readily available.
| S-EPMC11499862 | biostudies-literature
Project description:Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we use time series approaches to separate the direct contribution of SARS-CoV-2 infection on mortality from the indirect consequences of the pandemic in the United States. We estimate excess deaths occurring above a seasonal baseline from March 1, 2020 to January 1, 2022, stratified by week, state, age, and underlying mortality condition (including COVID-19 and respiratory diseases; Alzheimer's disease; cancer; cerebrovascular diseases; diabetes; heart diseases; and external causes, which include suicides, opioid overdoses, and accidents). Over the study period, we estimate an excess of 1,065,200 (95% Confidence Interval (CI) 909,800-1,218,000) all-cause deaths, of which 80% are reflected in official COVID-19 statistics. State-specific excess death estimates are highly correlated with SARS-CoV-2 serology, lending support to our approach. Mortality from 7 of the 8 studied conditions rose during the pandemic, with the exception of cancer. To separate the direct mortality consequences of SARS-CoV-2 infection from the indirect effects of the pandemic, we fit generalized additive models (GAM) to age- state- and cause-specific weekly excess mortality, using covariates representing direct (COVID-19 intensity) and indirect pandemic effects (hospital intensive care unit (ICU) occupancy and measures of interventions stringency). We find that 84% (95% CI 65-94%) of all-cause excess mortality can be statistically attributed to the direct impact of SARS-CoV-2 infection. We also estimate a large direct contribution of SARS-CoV-2 infection (≥67%) on mortality from diabetes, Alzheimer's, heart diseases, and in all-cause mortality among individuals over 65 years. In contrast, indirect effects predominate in mortality from external causes and all-cause mortality among individuals under 44 years, with periods of stricter interventions associated with greater rises in mortality. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups and in mortality from external causes. Further research on the drivers of indirect mortality is warranted as more detailed mortality data from this pandemic becomes available.
| S-EPMC9946455 | biostudies-literature
Project description:BackgroundExcess mortality quantifies the overall mortality impact of a pandemic. Mortality data have been accessible for many countries in recent decades, but few continuous data have been available for longer periods.ObjectiveTo assess the historical dimension of the COVID-19 pandemic in 2020 for 3 countries with reliable death count data over an uninterrupted span of more than 100 years.DesignObservational study.SettingSwitzerland, Sweden, and Spain, which were militarily neutral and not involved in combat during either world war and have not been affected by significant changes in their territory since the end of the 19th century.ParticipantsComplete populations of these 3 countries.MeasurementsContinuous series of recorded deaths (from all causes) by month from the earliest available year (1877 for Switzerland, 1851 for Sweden, and 1908 for Spain) were jointly modeled with annual age group-specific death and total population counts using negative binomial and multinomial models, which accounted for temporal trends and seasonal variability of prepandemic years. The aim was to estimate the expected number of deaths in a pandemic year for a nonpandemic scenario and the difference in observed and expected deaths aggregated over the year.ResultsIn 2020, the number of excess deaths recorded per 100 000 persons was 100 (95% credible interval [CrI], 60 to 135) for Switzerland, 75 (CrI, 40 to 105) for Sweden, and 155 (CrI, 110 to 195) for Spain. In 1918, excess mortality was 6 to 7 times higher. In all 3 countries, the peaks of monthly excess mortality in 2020 were greater than most monthly excess mortality since 1918, including many peaks due to seasonal influenza and heat waves during that period.LimitationHistorical vital statistics might be affected by minor completeness issues before the beginning of the 20th century.ConclusionIn 2020, the COVID-19 pandemic led to the second-largest infection-related mortality disaster in Switzerland, Sweden, and Spain since the beginning of the 20th century.Primary funding sourceFoundation for Research in Science and the Humanities at the University of Zurich, Swiss National Science Foundation, and National Institute of Allergy and Infectious Diseases.
| S-EPMC8803137 | biostudies-literature
Project description:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been identified as the cause of the Coronavirus disease 19 (COVID-19), which was initially reported in December 2019 in China and has since rapidly spread worldwide.
Since then, the COVID-19 pandemic has caused a detrimental effect of the national health care system, causing a drastic reduction of the screening programs for colorectal cancer and requiring the redistribution of the hospital resources from elective surgery to the care of patients with SARS-Cov_2 infection requiring admission.
| 2364120 | ecrin-mdr-crc
Project description:BackgroundThe COVID-19 pandemic resulted in increased mortality directly and indirectly associated with COVID-19.AimTo assess the impact of the COVID-19 pandemic on all-cause and disease-specific mortality and explore potential health inequalities associated with area-level deprivation in Wales.MethodsTwo population-based cohort studies were derived from multi-sourced, linked demographic, administrative and electronic health record data from 2016 to 2019 (n = 3,113,319) and 2020 to 2022 (n = 3,571,471). Data were analysed using generalised linear models adjusting for age, sex, area-level deprivation and time at risk.ResultsCOVID-19 deaths peaked in January 2021 (54.9/100,000 person-months, 95% confidence interval (CI): 52.4-57.5). The pandemic indirectly affected deaths, with higher than expected maximum relative mortality rates (RR) related to cancer (RR: 1.24, 95% CI: 1.13-1.36), infectious diseases (excluding respiratory infections) (RR: 2.09, 95% CI: 1.27- 3.43), circulatory system (RR: 1.41, 95% CI: 1.28-1.56), trauma (RR: 2.04, 95% CI: 1.57- 2.65), digestive system (RR: 1.54, 95% CI: 1.25-1.91), nervous system (RR: 1.63; 95% CI: 1.34-2.00) and mental and behavioural disorders (RR: 1.85, 95% CI: 1.58-2.16). Mortality associated with respiratory diseases (unrelated to COVID-19) were lower than expected (minimum RR: 0.52, 95% CI: 0.45-0.60). All-cause mortality was lower in least deprived communities compared with most deprived (RR: 0.61, 95% CI: 0.60-0.62), and the magnitude of this effect increased during the pandemic.ConclusionsAll-cause and disease-specific mortality directly and indirectly associated with COVID-19 increased during the COVID-19 pandemic. Socioeconomic disparities were exacerbated during this time.
| S-EPMC11650509 | biostudies-literature
Project description:BackgroundSubstantial progress has been made in reducing the burden of malaria in Africa since 2000, but those gains could be jeopardised if the COVID-19 pandemic affects the availability of key malaria control interventions. The aim of this study was to evaluate plausible effects on malaria incidence and mortality under different levels of disruption to malaria control.MethodsUsing an established set of spatiotemporal Bayesian geostatistical models, we generated geospatial estimates across malaria-endemic African countries of the clinical case incidence and mortality of malaria, incorporating an updated database of parasite rate surveys, insecticide-treated net (ITN) coverage, and effective treatment rates. We established a baseline estimate for the anticipated malaria burden in Africa in the absence of COVID-19-related disruptions, and repeated the analysis for nine hypothetical scenarios in which effective treatment with an antimalarial drug and distribution of ITNs (both through routine channels and mass campaigns) were reduced to varying extents.FindingsWe estimated 215·2 (95% uncertainty interval 143·7-311·6) million cases and 386·4 (307·8-497·8) thousand deaths across malaria-endemic African countries in 2020 in our baseline scenario of undisrupted intervention coverage. With greater reductions in access to effective antimalarial drug treatment, our model predicted increasing numbers of cases and deaths: 224·1 (148·7-326·8) million cases and 487·9 (385·3-634·6) thousand deaths with a 25% reduction in antimalarial drug coverage; 233·1 (153·7-342·5) million cases and 597·4 (468·0-784·4) thousand deaths with a 50% reduction; and 242·3 (158·7-358·8) million cases and 715·2 (556·4-947·9) thousand deaths with a 75% reduction. Halting planned 2020 ITN mass distribution campaigns and reducing routine ITN distributions by 25%-75% also increased malaria burden to a total of 230·5 (151·6-343·3) million cases and 411·7 (322·8-545·5) thousand deaths with a 25% reduction; 232·8 (152·3-345·9) million cases and 415·5 (324·3-549·4) thousand deaths with a 50% reduction; and 234·0 (152·9-348·4) million cases and 417·6 (325·5-553·1) thousand deaths with a 75% reduction. When ITN coverage and antimalarial drug coverage were synchronously reduced, malaria burden increased to 240·5 (156·5-358·2) million cases and 520·9 (404·1-691·9) thousand deaths with a 25% reduction; 251·0 (162·2-377·0) million cases and 640·2 (492·0-856·7) thousand deaths with a 50% reduction; and 261·6 (167·7-396·8) million cases and 768·6 (586·1-1038·7) thousand deaths with a 75% reduction.InterpretationUnder pessimistic scenarios, COVID-19-related disruption to malaria control in Africa could almost double malaria mortality in 2020, and potentially lead to even greater increases in subsequent years. To avoid a reversal of two decades of progress against malaria, averting this public health disaster must remain an integrated priority alongside the response to COVID-19.FundingBill and Melinda Gates Foundation; Channel 7 Telethon Trust, Western Australia.
| S-EPMC7505634 | biostudies-literature
Project description:The virus responsible for the current COVID-19 pandemic is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a new virus with high infectivity and moderate mortality. The major clinical manifestation of COVID-19 is interstitial pneumonia, which may progress to acute respiratory distress syndrome (ARDS). However, the disease causes a potent systemic hyperin-flammatory response, i.e., a cytokine storm or macrophage activation syndrome (MAS), which is associated with thrombotic complications. The complexity of the disease requires appropriate intensive treatment. One of promising treatment is statin administration, these being 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors that exert pleiotropic anti-inflammatory effects. Recent studies indicate that statin therapy is associated with decreased mortality in COVID-19, which may be caused by direct and indirect mechanisms. According to literature data, statins can limit SARS-CoV-2 cell entry and replication by inhibiting the main protease (Mpro) and RNA-dependent RNA polymerase (RdRp). The cytokine storm can be ameliorated by lowering serum IL-6 levels; this can be achieved by inhibiting Toll-like receptor 4 (TLR4) and modulating macrophage activity. Statins can also reduce the complications of COVID-19, such as thrombosis and pulmonary fibrosis, by reducing serum PAI-1 levels, attenuating TGF-β and VEGF in lung tissue, and improving endothelial function. Despite these benefits, statin therapy may have side effects that should be considered, such as elevated creatinine kinase (CK), liver enzyme and serum glucose levels, which are already elevated in severe COVID-19 infection. The present study analyzes the latest findings regarding the benefits and limitations of statin therapy in patients with COVID-19.
| S-EPMC8073792 | biostudies-literature
Project description:During the COVID-19 pandemic, various behavioral measures were imposed to curb the spread of the virus. In a preregistered study based on a quota-representative sample of adult Danish citizens (N = 1031), we compared the prevalence estimates of self-reported handwashing, physical distancing, and attitudes toward the behavioral measures between people surveyed with a direct and an indirect questioning approach (i.e., the crosswise model). Moreover, we investigated two possible predictors of sensitive behaviors and attitudes, namely empathy for people vulnerable to the virus and Honesty-Humility from the HEXACO Model of Personality. We also examined the interaction of both predictors with the questioning format. Survey participants reported more violation of guidelines regarding handwashing and physical distancing when asked indirectly rather than directly, whereas attitudes regarding the behavioral measures did not differ between the two questioning formats. Respondents with less empathy for people vulnerable to COVID-19 reported more violations of handwashing and physical-distancing, and those low on Honesty-Humility reported more violations of physical distancing.
| S-EPMC8789573 | biostudies-literature
Project description:The COVID-19 pandemic is a crisis which called for two crucial modes of social regulation: social control and social solidarity. In the present pre-registered study, we examine how the perceived non-compliance with health measures relates to attitudes towards these modes of social regulation, as well as to the role played by the perception of disintegrated and disregulated society (anomie). Using data from an online cross-sectional survey conducted in Belgium in April 2020 (N = 717), results show that the causal attribution of the crisis to insufficient compliance was differentially associated with support for social control and social solidarity behaviours. Specifically, greater attribution to insufficient compliance was associated with a perceived breakdown in the social fabric (disintegration), which explained stronger support for social control and fewer solidarity-based actions. Perceived disregulation, conversely, was associated with less support for social control and more support for social solidarity. Therefore, the perception of the pandemic and associated perceived anomie tend to polarize citizens' attitudes towards these two modes of social regulation. In this way, prosocial behaviours might be inhibited by communications that attribute the pandemic's causes to incivility. Other implications of our findings for the social psychological literature on communities' reactions to the pandemic are discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
| S-EPMC9015481 | biostudies-literature