Historically High Excess Mortality During the COVID-19 Pandemic in Switzerland, Sweden, and Spain.

Staub, Kaspar; Panczak, Radoslaw; Matthes, Katarina L; Floris, Joël; Berlin, Claudia; Junker, Christoph; Weitkunat, Rolf; Mamelund, Svenn-Erik; Zwahlen, Marcel; Riou, Julien (2022). Historically High Excess Mortality During the COVID-19 Pandemic in Switzerland, Sweden, and Spain. Annals of internal medicine, 175(4), pp. 523-532. American College of Physicians 10.7326/M21-3824

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BACKGROUND

Excess 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.

OBJECTIVE

To 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.

DESIGN

Observational study.

SETTING

Switzerland, 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.

PARTICIPANTS

Complete populations of these 3 countries.

MEASUREMENTS

Continuous 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.

RESULTS

In 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.

LIMITATION

Historical vital statistics might be affected by minor completeness issues before the beginning of the 20th century.

CONCLUSION

In 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 SOURCE

Foundation for Research in Science and the Humanities at the University of Zurich, Swiss National Science Foundation, and National Institute of Allergy and Infectious Diseases.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Panczak, Radoslaw, Berlin, Claudia, Zwahlen, Marcel, Riou, Julien Yannis

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0003-4819

Publisher:

American College of Physicians

Funders:

[210] Foundation for Research in Science and the Humanities at the University of Zurich = Stiftung für wissenschaftliche Forschung an der Universität Zürich ; [211] NIH National Institute of Allergy and Infectious Diseases ; [4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

14 Feb 2022 19:05

Last Modified:

05 Dec 2022 16:08

Publisher DOI:

10.7326/M21-3824

PubMed ID:

35099995

Additional Information:

Staub and Panczak contributed equally to this work and share first authorship. Zwahlen and Riou contributed equally to this work and share senior authorship.

BORIS DOI:

10.48350/165509

URI:

https://boris.unibe.ch/id/eprint/165509

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