Volume 50 - Article 1 | Pages 1–40
Lives saved, lives lost, and under-reported COVID-19 deaths: Excess and non-excess mortality in relation to cause-specific mortality during the first year of the COVID-19 pandemic in Sweden
By Eleonora Mussino, Sven Drefahl, Matthew Wallace, Sunnee Billingsley, Siddartha Aradhya, Gunnar Andersson
References
Alicandro, G., Remuzzi, G., and La Vecchia, C. (2020). Italy’s first wave of the COVID-19 pandemic has ended: No excess mortality in May, 2020. The Lancet 396(10253): 27–28.
Andersson, G., Drefahl, S., Mussino, E., Modig, K., and Meyer, A. (2021). Dödlighet och sjuklighet i Covid-19 i Sverige under mars 2020 – februari 2021. Stockholm: Corona Kommissionen.
Aradhya, S., Brandén, M., Drefahl, S., Obućina, O., Andersson, G., Rostila, M., Mussino, E., and Juárez, S.P. (2021). Intermarriage and COVID-19 mortality among immigrants. A population-based cohort study from Sweden. BMJ Open 11(9): 048952.
Beaney, T., Clarke, J.M., Jain, V., Golestaneh, A.K., Lyons, G., Salman, D., and Majeed, A. (2020). Excess mortality: The gold standard in measuring the impact of COVID-19 worldwide? Journal of the Royal Society of Medicine 113(9): 329–334.
Biswas, R.K., Afiaz, A., and Huq, S. (2020). Underreporting COVID-19: The curious case of the Indian subcontinent. Epidemiology and Infection 148: e207.
Blangiardo, M., Cameletti, M., Pirani, M., Corsetti, G., Battaglini, M., and Baio, G. (2020). Estimating weekly excess mortality at sub-national level in Italy during the COVID-19 pandemic. PLOS ONE 15(10): e0240286.
Boka, D.M. and Wainer, H. (2020). How can we estimate the death toll from COVID-19? CHANCE 33(3): 67–72.
Bradshaw, D., Dorrington, R.E., Laubscher, R., Moultrie, T.A., and Groenewald, P. (2021). Tracking mortality in near to real time provides essential information about the impact of the COVID-19 pandemic in South Africa in 2020. South African Medical Journal 111(8): 732.
Brandén, M., Aradhya, S., Kolk, M., Härkönen, J., Drefahl, S., Malmberg, B., Rostila, M., Cederström, A., Andersson, G., and Mussino, E. (2020). Residential context and COVID-19 mortality among adults aged 70 years and older in Stockholm: A population-based, observational study using individual-level data. The Lancet Healthy Longevity 1(2): 80–88.
Calderón-Larrañaga, A., Dekhtyar, S., Vetrano, D.L., Bellander, T., and Fratiglioni, L. (2020). COVID-19: Risk accumulation among biologically and socially vulnerable older populations. Ageing Research Reviews 63.
Castro, M.C., Gurzenda, S., Turra, C.M., Kim, S., Andrasfay, T., and Goldman, N. (2023). Research Note: COVID-19 is not an independent cause of death. Demography 60(2): 343–349.
Davies, B., Parkes, B.L., Bennett, J., Fecht, D., Blangiardo, M., Ezzati, M., and Elliott, P. (2021). Community factors and excess mortality in first wave of the COVID-19 pandemic in England. Nature Communications 12(1): 3755.
Dinmohamed, A.G., Visser, O., Verhoeven, R.H.A., Louwman, M.W.J., Nederveen, F.H., Willems, S.M., Merkx, M.A.W., Lemmens, V.E.P.P., Nagtegaal, I.D., and Siesling, S. (2020). Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. The Lancet Oncology 21(6): 750–751.
Dong, E., Du, H., and Gardner, L. (2020). An interactive web-based dashboard to track COVID-19 in real time. The Lancet Infectious Diseases 20(5): 533–534.
Drefahl, S. (2010). How does the age gap between partners affect their survival? Demography 47(2): 313–326.
Drefahl, S., Wallace, M., Mussino, E., Aradhya, S., Kolk, M., Brandén, M., Malmberg, B., and Andersson, G. (2020). A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden. Nature Communications 11(1): 5097.
Folino, A.F., Zorzi, A., Cernetti, C., Marchese, D., Pasquetto, G., Roncon, L., Saccà, S., Themistoclakis, S., Turiano, G., Verlato, R., Perazzolo Marra, M., Gregori, D., and Iliceto, S. (2020). Impact of COVID-19 epidemic on coronary care unit accesses for acute coronary syndrome in Veneto region, Italy. American Heart Journal 226: 26–28.
Ghafari, M., Kadivar, A., and Katzourakis, A. (2021). Excess deaths associated with the Iranian COVID-19 epidemic: A province-level analysis. International Journal of Infectious Diseases 107: 101–115.
Ghislandi, S., Muttarak, R., Sauerberg, M., and Scotti, B. (2020). News from the front: Estimation of excess mortality and life expectancy in the major epicenters of the COVID-19 pandemic in Italy. (preprint. Health Policy.).
Herby, J. (2020). Mortality displacement: Exceptionally many vulnerable – ‘dry tinder' – in Sweden prior to COVID-19. SSRN.
Hollinghurst, J., Lyons, J., Fry, R., Akbari, A., Gravenor, M., Watkins, A., Verity, F., and Lyons, R.A. (2021). The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: A retrospective population-based cohort study for mortality in 2016–2020. Age and Ageing 50(1): 25–31.
Islam, N., Khunti, K., Dambha-Miller, H., Kawachi, I., and Marmot, M. (2020). COVID-19 mortality: A complex interplay of sex, gender, and ethnicity. European Journal of Public Health 30(5): 847–848.
Islam, N., Shkolnikov, V.M., Acosta, R.J., Klimkin, I., Kawachi, I., Irizarry, R.A., Alicandro, G., Khunti, K., Yates, T., Jdanov, D.A., White, M., Lewington, S., and Lacey, B. (2021). Excess deaths associated with Covid-19 pandemic in 2020: Age and sex disaggregated time series analysis in 29 high income countries. BMJ 373(8295): n1137.
Kaczorowski, J. and Del Grande, C. (2021). Beyond the tip of the iceberg: Direct and indirect effects of COVID-19. The Lancet Digital Health 3(4): 205–206.
Karanikolos, M. and McKee, M. (2020). How comparable is COVID-19 mortality across countries? Cross-country analysis. COVID-19 Health System Response Monitor.
Karlinsky, A. and Kobak, D. (2021). Tracking excess mortality across countries during the COVID-19 pandemic with the world mortality dataset. eLife 10: 69336.
Kepp, K.P., Björk, J., Kontis, V., Parks, R.M., Bæk, K.T., Emilsson, L., and Lallukka, T. (2022). Estimates of excess mortality for the five Nordic countries during the COVID-19 pandemic 2020−2021. International Journal of Epidemiology 51(6): 1722–1732.
Kobak, D. (2021). Excess mortality reveals COVID’s true toll in Russia. Significance 18(1): 16–19.
Kolk, M., Drefahl, S., Wallace, M., and Andersson, G. (2022). Excess mortality and COVID-19 in Sweden in 2020: A demographic account. Vienna Yearbook of Population Research 2022: 317–348.
Konstantinoudis, G., Cameletti, M., Gómez-Rubio, V., León Gómez, I., Pirani, M., Baio, G., Larrauri, A., Riou, J., Egger, M., Vineis, P., and Blangiardo, M. (2022). Regional excess mortality during the 2020 COVID-19 pandemic in five European countries. Nature Communications 13(1): 482.
Kontis, V., Bennett, J.E., Rashid, T., Parks, R.M., Pearson-Stuttard, J., Guillot, M., Asaria, P., Zhou, B., Battaglini, M., Corsetti, G., McKee, M., Di Cesare, M., Mathers, C.D., and Ezzati, M. (2020). Magnitude, demographics and dynamics of the effect of the first wave of the COVID-19 pandemic on all-cause mortality in 21 industrialized countries. Nature Medicine 26(12): 1919–1928.
Kung, S., Doppen, M., Black, M., Hills, T., and Kearns, N. (2021). Reduced mortality in New Zealand during the COVID-19 pandemic. The Lancet 397(10268): 25.
Kupek, E. (2021). How many more? Under‐reporting of the COVID‐19 deaths in Brazil in 2020. Tropical Medicine and International Health 26(9): 1019–1028.
Lau, H., Khosrawipour, T., Kocbach, P., Ichii, H., Bania, J., and Khosrawipour, V. (2021). Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters. Pulmonology 27(2): 110–115.
Li, X., Xu, S., Yu, M., Wang, K., Tao, Y., Zhou, Y., Shi, J., Zhou, M., Wu, B., Yang, Z., Zhang, C., Yue, J., Zhang, Z., Renz, H., Liu, X., Xie, J., Xie, M., and Zhao, J. (2020). Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. Journal of Allergy and Clinical Immunology 146(1): 110–118.
Li, Y., Fang, F., and He, M. (2020). RESEARCHFactors associated with nursing homesʼ late participation in COVID‐19 reporting. Journal of the American Geriatrics Society 68(11): 2468–2469.
Modi, C., Böhm, V., Ferraro, S., Stein, G., and Seljak, U. (2021). Estimating COVID-19 mortality in Italy early in the COVID-19 pandemic. Nature Communications 12(1): 2729.
Modig, K., Lambe, M., Ahlbom, A., and Ebeling, M. (2021). Excess mortality for men and women above age 70 according to level of care during the first wave of COVID-19 pandemic in Sweden: A population-based study. The Lancet Regional Health – Europe 4(100072).
Msemburi, W., Karlinsky, A., Knutson, V., Aleshin-Guendel, S., Chatterji, S., and Wakefield, J. (2023). The WHO estimates of excess mortality associated with the COVID-19 pandemic. Nature 613(7942): 130–137.
Mungmunpuntipantip, R. and Wiwanitkit, V. (2021). The COVID-19 pandemic and traffic accidents. South African Medical Journal 111(3): 192.
Murray, C.J.L., Lopez, A.D., Chin, B., Feehan, D., and Hill, K.H. (2006). Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918–20 pandemic: A quantitative analysis. The Lancet 368(9554): 2211–2218.
Nepomuceno, M.R., Klimkin, I., Jdanov, D.A., Alustiza‐Galarza, A., and Shkolnikov, V.M. (2022). Sensitivity analysis of excess mortality due to the COVID‐19 pandemic. Population and Development Review 48(2): 279–302.
Remund, A., Camarda, C.G., and Riffe, T. (2018). A cause-of-death decomposition of young adult excess mortality. Demography 55(3): 957–978.
Riffe, T., Acosta, E., and COVerAGE-DB team (2021). Data resource profile: COVerAGE-DB: A global demographic database of COVID-19 cases and deaths. International Journal of Epidemiology 50(2): 390–390.
Rizzi, S., Søgaard, J., and Vaupel, J.W. (2022). High excess deaths in Sweden during the first wave of COVID-19: Policy deficiencies or ‘dry tinder’? Scandinavian Journal of Public Health 50(1): 33–37.
Rizzi, S., Strozza, C., and Zarulli, V. (2022). Sex-differences in excess death risk during the COVID-19 pandemic: An analysis of the first wave across Italian regions. What have we learned? Genus 78(1): 24.
Rostila, M., Cederström, A., Wallace, M., Brandén, M., Malmberg, B., and Andersson, G. (2021). Disparities in COVID-19 deaths by country of birth in Stockholm, Sweden: A total population based cohort study. American Journal of Epidemiology 190(8): 1510–1518.
Rozenfeld, M., Peleg, K., Givon, A., Bala, M., Shaked, G., Bahouth, H., and Bodas, M. (2021). COVID-19 changed the injury patterns of hospitalized patients. Prehospital and Disaster Medicine 36(3): 251–259.
Salottolo, K., Caiafa, R., Mueller, J., Tanner, A., Carrick, M.M.Lieser, M, Berg, Bar-Or, D., and G (2021). Multicenter study of US trauma centers examining the effect of the COVID-19 pandemic on injury causes, diagnoses and procedures. Trauma Surgery and Acute Care Open 6(1): e000655.
Sanmarchi, F., Golinelli, D., Lenzi, J., Esposito, F., Capodici, A., Reno, C., and Gibertoni, D. (2021). Exploring the gap between excess mortality and COVID-19 deaths in 67 countries. JAMA Network Open 4(7): e2117359.
SCB (2020). Excess mortality in Sweden is followed by mortality deficit [electronic resource]. Stockholm: Statistics Sweden.
SCB (2020). The future population of Sweden 2020–2070. Stockholm: Statistics Sweden (BE 18 SM 2001).
Schwarz, V., Mahfoud, F., Lauder, L., Reith, W., Behnke, S., Smola, S., Rissland, J., Pfuhl, T., Scheller, B., Böhm, M., and Ewen, S. (2020). Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19. Clinical Research in Cardiology 109(12): 1500–1506.
Scortichini, M., Santos, R., De’ Donato, F., De Sario, M., Michelozzi, P., Davoli, M., Masselot, P., Sera, F., and Gasparrini, A. (2021). Excess mortality during the COVID-19 outbreak in Italy: A two-stage interrupted time-series analysis. International Journal of Epidemiology 49(6): 1909–1917.
Shilling, F. and Waetjen, D. (2020). Special Report(Update): Impact of COVID19 mitigation on numbers and costs of California traffic crashes. UC Davis: Road Ecology Center.
Simonsen, L., Spreeuwenberg, P., Lustig, R., Taylor, R.J., Fleming, D.M., Kroneman, M., Van Kerkhove, M.D., Mounts, A.W., Paget, W.J., and GLaMOR Collaborating Teams (2013). Global mortality estimates for the 2009 influenza pandemic from the GLaMOR project: A modeling study. PLoS Medicine 10(11): e1001558.
Spiegelhalter, D. (2020). Coronavirus deaths: How does Britain compare with other countries?
Stang, A., Standl, F., Kowall, B., Brune, B., Böttcher, J., Brinkmann, M., Dittmer, U., and Jöckel, K.H. (2020). Excess mortality due to COVID-19 in Germany. Journal of Infection 81(5): 797–801.
Stokes, A.C., Lundberg, D.J., Elo, I.T., Hempstead, K., Bor, J., and Preston, S.H. (2021). COVID-19 and excess mortality in the United States: A county-level analysis. PLOS Medicine 18(5): e1003571.
The Lancet (2020). Editorial – The gendered dimensions of COVID-19. The Lancet 395(10231): 1168.
Vestergaard, L.S., Nielsen, J., Richter, L., Schmid, D., Bustos, N., Braeye, T., Denissov, G., Veideman, T., Luomala, O., Möttönen, T., Fouillet, A., Caserio-Schönemann, C., Heiden, M., Uphoff, H., Lytras, T., Gkolfinopoulou, K., Paldy, A., Domegan, L., O’Donnell, J., Donato, F., Noccioli, F., Hoffmann, P., Velez, T., England, K., Asten, L., White, R.A., Tønnessen, R., Silva, S.P., Rodrigues, A.P., Larrauri, A., Delgado-Sanz, C., Farah, A., Galanis, I., Junker, C., Perisa, D., Sinnathamby, M., Andrews, N., O’Doherty, M., Marquess, D.F.P., Kennedy, S., Olsen, S.J., Pebody, R., Krause, T.G., and Mølbak, K. (2020). ECDC Public Health Emergency Team for COVID-19. Eurosurveillance 25(26) (Excess all-cause mortality during the COVID-19 pandemic in Europe – Preliminary pooled estimates from the EuroMOMO Network).
Viboud, C., Grais, R.F., Lafont, B.A.P., Miller, M.A., Simonsen, L., and Multinational Influenza Seasonal Mortality Study Group (2005). Multinational impact of the 1968 Hong Kong influenza pandemic: Evidence for a smoldering pandemic. The Journal of Infectious Diseases 192(2): 233–248.
Viboud, C., Simonsen, L., Fuentes, R., Flores, J., Miller, M.A., and Chowell, G. (2016). Global mortality impact of the 1957–1959 influenza pandemic. Journal of Infectious Diseases 213(5): 738–745.
Vos, T., Lim, S.S., Abbafati, C., Abbas, K.M., Abbasi, M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abolhassani, H., Aboyans, V., Abrams, E.M., Guimarães Abreu, L., Abrigo, M.R.M., Abu-Raddad, L.J., Abushouk, A.I., Acebedo, A., Ackerman, I.N., Adabi, M., Adamu, A.A., Adebayo, O.M., Adekanmbi, V., Adelson, J.D., Adetokunboh, DavoOO, Adham, D., Afshari, M., Afshin, A., Agardh, E.E., Agarwal, G., Agesa, K.M., Aghaali, M., Aghamir, S.M.K., Agrawal, A., Ahmad, T., Ahmadi, A., Ahmadi, M., Ahmadieh, H., Ahmadpour, E., Akalu, T.Y., Akinyemi, R.O., Akinyemiju, T., Akombi, B., Al-Aly, Z., Alam, K., Alam, N., Alam, S., Alam, T., Alanzi, T.M., Albertson, S.B., Alcalde-Rabanal, J.E., Alema, N.M., Ali, M., and Ali, S. (2020). Global burden of 369 diseases and injuries in 204 countries and territories. The Lancet 396(10258): 1204–1222.
Wallace, M. and Kulu, H. (2014). Low immigrant mortality in England and Wales: A data artefact? Social Science and Medicine 120: 100–109.
Wallace, M. and Wilson, B. (2019). Migrant mortality advantage versus origin and the selection hypothesis. Population and Development Review 45(4): 767–794.
Wang, H., Paulson, K.R., Pease, S.A., Watson, S., Comfort, H., Zheng, P., Aravkin, A.Y., Bisignano, C., Barber, R.M., Alam, T., Fuller, J.E., May, E.A., Phan Jones, D., Frisch, M.E., Abbafati, C., Adolph, C., Allorant, A., Amlag, J.O., Bang-Jensen, B., Bertolacci, G.J., Bloom, S.S., Carter, A., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R.M., Collins, J.K., Cooperrider, K., Dai, X., Dangel, W.J., Daoud, F., Dapper, C., Deen, A., Duncan, B.B., Erickson, M., Ewald, S.B., Fedosseeva, T., Ferrari, A.J., Frostad, J.J., Fullman, N., Gallagher, J., Gamkrelidze, A., Guo, G., He, J., Helak, M., Henry, N.J., Hulland, E.N., Huntley, B.M., Kereselidze, M., Lazzar-Atwood, A., LeGrand, K.E., Lindstrom, A., Linebarger, E., Lotufo, P.A., Lozano, R., Magistro, B., Carvalho Malta, D., Månsson, J., Mantilla Herrera, A.M., Marinho, F., Mirkuzie, A.H., Misganaw, A.T., Monasta, L., Naik, P., Nomura, S., O’Brien, E.G., O’Halloran, J.K., Olana, L.T., Ostroff, S.M., Penberthy, L., Reiner Jr, R.C., Reinke, G., Ribeiro, A.L.P., Santomauro, D.F., Schmidt, M.I., Shaw, D.H., Sheena, B.S., Sholokhov, A., Skhvitaridze, N., Sorensen, R.J.D., Spurlock, E.E., Syailendrawati, R., Topor-Madry, R., Troeger, C.E., Walcott, R., Walker, A., Wiysonge, C.S., Worku, N.A., Zigler, B., Pigott, D.M., Naghavi, M., Mokdad, A.H., Lim, S.S., Hay, S.I., Gakidou, E., and Murray, C.J.L. (2022). Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020–21. The Lancet 399(10334): 1513–1536.
Weinberger, D.M., Chen, J., Cohen, T., Crawford, F.W., Mostashari, F., Olson, D., Pitzer, V.E., Reich, N.G., Russi, M., Simonsen, L., Watkins, A., and Viboud, C. (2020). Estimation of excess deaths associated with the COVID-19 pandemic in the United States. JAMA Internal Medicine 180(10): 1336.
WHO (2020). The true death toll of COVID-19: Estimating global excess mortality.
WHO (2023). WHO Coronavirus (COVID-19) Dashboard.
Williamson, E.J., Walker, A.J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C.E., Curtis, H.J., Mehrkar, A., Evans, D., Inglesby, P., Cockburn, J., McDonald, H.I., MacKenna, B., Tomlinson, L., Douglas, I.J., Rentsch, C.T., Mathur, R., Wong, A.Y.S., Grieve, R., Harrison, D., Forbes, H., Schultze, A., Croker, R., Parry, J., Hester, F., Harper, S., Perera, R., Evans, S.J.W., Smeeth, L., and Goldacre, B. (2020). Factors associated with COVID-19-related death using OpenSAFELY. Nature 584(7821): 430–436.
Woolf, S.H., Chapman, D.A., Sabo, R.T., Weinberger, D.M., and Hill, L. (2020). Excess deaths from COVID-19 and other causes, March–April 2020. JAMA 324(5): 510.
Woolf, S.H., Chapman, D.A., Sabo, R.T., Weinberger, D.M., Hill, L., and Taylor, D.D.H. (2020). Excess deaths from COVID-19 and other causes, March–July 2020. JAMA 324(15): 1562.
Yasin, Y.J., Grivna, M., and Abu-Zidan, F.M. (2021). Global impact of COVID-19 pandemic on road traffic collisions. World Journal of Emergency Surgery 16(1): 51.
Zubiri, L., Rosovsky, R.P., Mooradian, M.J., Piper-Vallillo, A.J., Gainor, J.F., Sullivan, R.J., Marte, D., Boland, G.M., Gao, X., Hochberg, E.P., Ryan, D.P., McEwen, C., Mai, M., Sharova, T., Soumerai, T.E., Bardia, A., and Reynolds, K.L. (2021). Temporal trends in inpatient oncology census before and during the COVID-19 pandemic and rates of nosocomial COVID-19 among patients with cancer at a large academic center. The Oncologist 26(8): 1427–1433.