Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths

Authors

André Vieira^{1, *,} , Vasco Ricoca Peixoto^{1, 2,} , Pedro Aguiar^1, , Alexandre Abrantes^1,

¹Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal

²Public Health Unit, North Lisbon Health Centers, Lisbon, Portugal

^*Corresponding author. Email: aam.vieira@ensp.unl.pt

DOI

10.2991/jegh.k.200628.001How to use a DOI?

Keywords

Coronavirus; disease outbreaks; mortality; pandemics; Portugal

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.

Copyright

© 2020 The Authors. Published by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - André Vieira
AU  - Vasco Ricoca Peixoto
AU  - Pedro Aguiar
AU  - Alexandre Abrantes
PY  - 2020
DA  - 2020/07/07
TI  - Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths
JO  - Journal of Epidemiology and Global Health
SP  - 209
EP  - 213
VL  - 10
IS  - 3
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200628.001
DO  - 10.2991/jegh.k.200628.001
ID  - Vieira2020
ER  -