Abstract
BackgroundDisability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The aim was to estimate the DALYs due to Covid-19 in Malta (March 2020–21) and investigate its impact in relation to other causes of disease at a population level.MethodsMortality and weekly hospital admission data were used to calculate DALYs, based on the European Burden of Disease Network consensus Covid-19 model. Covid-19 infection duration of 14 days was considered. Sensitivity analyses for different morbidity scenarios, including post-acute consequences were presented.ResultsAn estimated 70,421 people were infected (with and without symptoms) by Covid-19 in Malta (March 2020–1), out of which 1636 required hospitalisation and 331 deaths, contributing to 5478 DALYs. These DALYs positioned Covid-19 as the fourth leading cause of disease in Malta. Mortality contributed to 95% of DALYs, while post-acute consequences contributed to 60% of morbidity.ConclusionsCovid-19 over 1 year has impacted substantially the population health in Malta. Post-acute consequences are the leading morbidity factors that require urgent targeted action to ensure timely multidisciplinary care. It is recommended that DALY estimations in 2021 and beyond are calculated to assess the impact of vaccine roll-out and emergence of new variants.
Highlights
Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population
The Covid-19 positive cases were sub-divided according to the different health states, as shown in Table 1, based on the European Burden of Disease Network and the European Centre of Disease Prevention and Control (ECDC) Covid-19 consensus disease model [9]
Over the course of a year (March 2020 – March 2021), an estimated 70,421 people were infected by Covid-19 in Malta, both with and without symptoms
Summary
Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The second Covid-19 wave initiated in mid-Summer and this saw a high mortality and admission rates to Burden of disease assessments allow the estimation of a disease impact on a population by measuring the morbidity and mortality attribution and presenting it through a single metric called disability-adjusted life years (DALYs) [7]. Morbidity occurrence is translated through the estimation of years lived with disability (YLD) following the adjustment for the severity and the Cuschieri et al BMC Public Health (2021) 21:1827 disability suffered due to a disease or injury. DALYs are estimated by the combination of YLD and YLL [7] This metric is a popular way used to assess the health impact at a population level and translated as evidence to influence national policy makers
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