Research press release


Nature Medicine

Epidemiology: Calculating excess deaths as a result of the COVID-19 pandemic

イングランド、ウェールズ、スペインでは、2020年2月中旬から3月にかけて、COVID-19のパンデミック(世界的大流行)の結果として、これまでで最も多数の超過死亡がの見られたことが、ヨーロッパの19か国とオーストラリア、ニュージーランドでのモデル化研究によって明らかになった。Nature Medicine に寄せられたこの研究結果は、は、パンデミックが起こらなかった場合の予測に比べて、これらの各国で死者が約20万6000人が余分に死亡したことを示している。


Majid Ezzatiたちは、21か国から得た2010年~2020年2月中旬の毎週の死亡数データを用いて、COVID-19パンデミックが起こらなかった場合に2020年5月までに生じたであろう死亡数を予測するモデルを作成した。そしてこの数字を、各国で実際に報告された死亡数と比較して、原因がCOVID-19であるかそれ以外であるかに関わらず、パンデミックに由来する超過死亡を算出した。そして、これら21か国で20万6000もの超過死亡が、パンデミックの結果として生じたと推定した。10万人当たりの全死因死亡数が最も高かったのは、スペイン、イングランド、ウェールズ、イタリア、スコットランド、ベルギーだった。また、超過死亡数は男性と女性でほとんど違いはなく、男性10万5800人、女性10万人であることが分かった。死亡率の上昇が最も大きかったのはイングランド、ウェールズ、スペインで、10万人当たりの超過死亡は100人近くに上り、パンデミックがなかった場合に比べて、イングランドとウェールズは37%の増加、スペインは38%の増加という結果であった。


England and Wales and Spain experienced the highest numbers of excess deaths as a result of the COVID-19 pandemic from mid-February to May 2020, suggests a modelling study of 19 European countries, and Australia and New Zealand, published in Nature Medicine. The results indicate that around 206,000 additional deaths occurred across these countries than were expected had the pandemic not occurred.

The current COVID-19 pandemic has caused over 1 million deaths directly from SARS-CoV-2 infections globally. However, the indirect effects of the pandemic and responses to it through social, economic, environmental and healthcare pathways can also be substantial. Understanding the total impact of the pandemic on mortality is important for assessing its full impact on public health and policy responses.

Majid Ezzati and colleagues used weekly data on deaths from 2010 to mid-February 2020, from 21 countries, to create a model that could predict how many deaths would have occurred by May 2020 had there not been a COVID-19 pandemic. They compared this figure with the actual reported deaths in the countries studied to calculate the excess deaths that resulted from the pandemic whether it was from COVID-19 or other causes. The authors estimate that an additional 206,000 deaths had occurred as a result of the pandemic in these 21 countries, with the highest figures for all-cause mortality per 100,000 people in Spain, England and Wales, Italy, Scotland and Belgium. The authors found that the numbers of excess deaths for men and women were similar, with 105,800 deaths in men and 100,000 deaths in women. They indicated that England and Wales and Spain experienced the largest increase in mortality, with nearly 100 excess deaths per 100,000 people, which was an increase of 37% for England and Wales and 38% for Spain, relative to levels without a pandemic.

The authors conclude that the differences in mortality among the 21 countries reflect the variability in characteristics of the populations, policy responses to the pandemic, the preparedness of public health systems, and extent of community-based and facility-based care systems. They argue that in addition to suppressing transmission, building integrated care pathways to allow appropriate triage and care for those with long-term health conditions will be important for minimizing deaths resulting both directly and indirectly from the ongoing pandemic. To achieve this, countries may need to reallocate and expand healthcare resources, particularly in settings in which there has been underinvestment in health and social care systems, they suggest.

doi: 10.1038/s41591-020-1112-0


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