Abstract
The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015–2019, we applied Bayesian spatio-temporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. With around 30%, Madrid, Castile-La Mancha, Castile-Leon (Spain) and Lombardia (Italy) were the regions with the highest excess mortality. In England, Greece and Switzerland, the regions most affected were Outer London and the West Midlands (England), Eastern, Western and Central Macedonia (Greece), and Ticino (Switzerland), with 15–20% excess mortality in 2020. Our study highlights the importance of the large transportation hubs for establishing community transmission in the first stages of the pandemic. Here, we show that acting promptly to limit transmission around these hubs is essential to prevent spread to other regions and countries.
Highlights
The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries
Preliminary estimates suggest that the total number of global deaths attributable to the COVID-19 pandemic in 2020 is at least 3 million, with approximately 37% of these deaths occurring in the European region[1]
In this study of five European countries, we examined the impact of the COVID-19 pandemic on mortality in 2020 using weekly regional all-cause mortality data
Summary
The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015–2019, we applied Bayesian spatiotemporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. COVID-19 related deaths are key to monitoring the pandemic’s burden, vital statistics generally suffer from issues related to accuracy and completeness[2] They can be subject to changes in definition and different policies regarding testing and reporting[3,4]. 10% excess mortality, in contrast to the Aegean islands and Crete for which the excess was smaller than 3%10 Studying these variations may help our understanding of the transmission patterns and the effectiveness of policies and measures to contain the pandemic. Other factors that may have contributed to the varying impact on mortality across regions include differences in demographics[13], the prevalence of comorbidities[13] and environmental factors[12,14,15]
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