Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset

  1. Ariel Karlinsky  Is a corresponding author
  2. Dmitry Kobak  Is a corresponding author
  1. Hebrew University, Israel
  2. University of Tübingen, Germany

Abstract

Comparing the impact of the COVID-19 pandemic between countries or across time is difficult because the reported numbers of cases and deaths can be strongly affected by testing capacity and reporting policy. Excess mortality, defined as the increase in all-cause mortality relative to the expected mortality, is widely considered as a more objective indicator of the COVID-19 death toll. However, there has been no global, frequently-updated repository of the all-cause mortality data across countries. To fill this gap, we have collected weekly, monthly, or quarterly all-cause mortality data from 94 countries and territories, openly available as the regularly-updated World Mortality Dataset. We used this dataset to compute the excess mortality in each country during the COVID-19 pandemic. We found that in several worst-affected countries (Peru, Ecuador, Bolivia, Mexico) the excess mortality was above 50% of the expected annual mortality. At the same time, in several other countries (Australia, New Zealand) mortality during the pandemic was below the usual level, presumably due to social distancing measures decreasing the non-COVID infectious mortality. Furthermore, we found that while many countries have been reporting the COVID-19 deaths very accurately, some countries have been substantially underreporting their COVID-19 deaths (e.g. Nicaragua, Russia, Uzbekistan), sometimes by two orders of magnitude (Tajikistan). Our results highlight the importance of open and rapid all-cause mortality reporting for pandemic monitoring.

Data availability

Full data is publicly available at: https://github.com/akarlinsky/world_mortality

The following data sets were generated

Article and author information

Author details

  1. Ariel Karlinsky

    Economics, Hebrew University, Jerusalem, Israel
    For correspondence
    ariel.karlinsky@mail.huji.ac.il
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-0966-5837
  2. Dmitry Kobak

    Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
    For correspondence
    dmitry.kobak@uni-tuebingen.de
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-5639-7209

Funding

DK was supported by the Deutsche Forschungsgemeinschaft (BE5601/4-1 and the Cluster of Excellence ``Machine Learning --- New Perspectives for Science', EXC 2064, project number 390727645), the Federal Ministry of Education and Research (FKZ 01GQ1601 and 01IS18039A) and the National Institute of Mental Health of the National Institutes of Health under Award Number U19MH114830. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Reviewing Editor

  1. Marc Lipsitch, Harvard TH Chan School of Public Health, United States

Publication history

  1. Received: April 13, 2021
  2. Accepted: June 29, 2021
  3. Accepted Manuscript published: June 30, 2021 (version 1)
  4. Accepted Manuscript updated: July 7, 2021 (version 2)
  5. Version of Record published: August 3, 2021 (version 3)

Copyright

© 2021, Karlinsky & Kobak

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Ariel Karlinsky
  2. Dmitry Kobak
(2021)
Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset
eLife 10:e69336.
https://doi.org/10.7554/eLife.69336

Further reading

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    Background: Worldwide, most colorectal cancer screening programmes were paused at the start of the COVID-19 pandemic, whilst the Danish faecal immunochemical test (FIT)-based programme continued without pausing. We examined colorectal cancer screening participation and compliance with subsequent colonoscopy in Denmark throughout the pandemic.

    Methods: We used data from the Danish Colorectal Cancer Screening Database among individuals aged 50-74 years old invited to participate in colorectal cancer screening from 2018-2021 combined with population-wide registries. Using a generalised linear model, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) of colorectal cancer screening participation within 90 days since invitation and compliance with colonoscopy within 60 days since a positive FIT test during the pandemic in comparison with the previous years adjusting for age, month and year of invitation.

    Results: Altogether, 3,133,947 invitations were sent out to 1,928,725 individuals and there were 94,373 positive FIT tests (in 92,848 individuals) during the study period. Before the pandemic, 60.7% participated in screening within 90 days. A minor reduction in participation was observed at the start of the pandemic (PR=0.95; 95% CI: 0.94-0.96 in pre-lockdown and PR=0.85; 95% CI: 0.85-0.86 in 1st lockdown) corresponding to a participation rate of 54.9% during pre-lockdown and 53.0% during 1st lockdown. This was followed by a 5-10% increased participation in screening corresponding to a participation rate of up to 64.9%. The largest increase in participation was observed among 55-59 year olds and among immigrants. The compliance with colonoscopy within 60 days was 89.9% before the pandemic. A slight reduction was observed during 1st lockdown (PR=0.96; 95% CI: 0.93-0.98), where after it resumed to normal levels.

    Conclusions: Participation in the Danish FIT-based colorectal cancer screening programme and subsequent compliance to colonoscopy after a positive FIT result was only slightly affected by the COVID-19 pandemic.

    Funding: The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.