Abstract
We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.
Highlights
IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
The debate about the necessity of non-pharmaceutical intervention, and the extent of such measures, is still raging, and in Scandinavia one of the hottest issues in this debate is how to measure the real mortality and the years of life lost that can be attributed to COVID-19
The purpose of this paper is to scrutinize claims that all-cause excess mortality deviates substantially from the official COVID-19 mortality reported in Norway and Sweden, and that an explanation for such a claimed difference could be explained as a mortality displacement from one season to the
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. There is an ongoing scientific and public debate worldwide about the optimal strategy for mitigating the negative impacts of the COVID-19 pandemic [1,2,3,4,5,6]. In Europe, most countries executed strong non-pharmaceutical interventions in March 2020 to combat the disease’s explosive spread and, by early summer, the epidemic was reasonably controlled. Among the western European countries, Sweden was an exception, adopting a strategy of implementing mainly voluntary measures [7]. The rate of confirmed cases entered a second and more substantial wave in June and a third and even stronger one throughout the autumn, coinciding with the widespread second wave in Europe.
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