Header

UZH-Logo

Maintenance Infos

Historically High Excess Mortality During the COVID-19 Pandemic in Switzerland, Sweden, and Spain


Staub, Kaspar; Panczak, Radoslaw; Matthes, Katarina L; Floris, Joël; Berlin, Claudia; Junker, Christoph; Weitkunat, Rolf; Mamelund, Svenn-Erik; Zwahlen, Marcel; Riou, Julien (2022). Historically High Excess Mortality During the COVID-19 Pandemic in Switzerland, Sweden, and Spain. Annals of Internal Medicine, 175(4):523-532.

Abstract

Background:

Excess mortality quantifies the overall mortality impact of a pandemic. Mortality data have been accessible for many countries in recent decades, but few continuous data have been available for longer periods.
Objective:

To assess the historical dimension of the COVID-19 pandemic in 2020 for 3 countries with reliable death count data over an uninterrupted span of more than 100 years.
Design:

Observational study.
Setting:

Switzerland, Sweden, and Spain, which were militarily neutral and not involved in combat during either world war and have not been affected by significant changes in their territory since the end of the 19th century.
Participants:

Complete populations of these 3 countries.
Measurements:

Continuous series of recorded deaths (from all causes) by month from the earliest available year (1877 for Switzerland, 1851 for Sweden, and 1908 for Spain) were jointly modeled with annual age group–specific death and total population counts using negative binomial and multinomial models, which accounted for temporal trends and seasonal variability of prepandemic years. The aim was to estimate the expected number of deaths in a pandemic year for a nonpandemic scenario and the difference in observed and expected deaths aggregated over the year.
Results:

In 2020, the number of excess deaths recorded per 100 000 persons was 100 (95% credible interval [CrI], 60 to 135) for Switzerland, 75 (CrI, 40 to 105) for Sweden, and 155 (CrI, 110 to 195) for Spain. In 1918, excess mortality was 6 to 7 times higher. In all 3 countries, the peaks of monthly excess mortality in 2020 were greater than most monthly excess mortality since 1918, including many peaks due to seasonal influenza and heat waves during that period.
Limitation:

Historical vital statistics might be affected by minor completeness issues before the beginning of the 20th century.
Conclusion:

In 2020, the COVID-19 pandemic led to the second-largest infection-related mortality disaster in Switzerland, Sweden, and Spain since the beginning of the 20th century.
Primary Funding Source:

Foundation for Research in Science and the Humanities at the University of Zurich, Swiss National Science Foundation, and National Institute of Allergy and Infectious Diseases.

Abstract

Background:

Excess mortality quantifies the overall mortality impact of a pandemic. Mortality data have been accessible for many countries in recent decades, but few continuous data have been available for longer periods.
Objective:

To assess the historical dimension of the COVID-19 pandemic in 2020 for 3 countries with reliable death count data over an uninterrupted span of more than 100 years.
Design:

Observational study.
Setting:

Switzerland, Sweden, and Spain, which were militarily neutral and not involved in combat during either world war and have not been affected by significant changes in their territory since the end of the 19th century.
Participants:

Complete populations of these 3 countries.
Measurements:

Continuous series of recorded deaths (from all causes) by month from the earliest available year (1877 for Switzerland, 1851 for Sweden, and 1908 for Spain) were jointly modeled with annual age group–specific death and total population counts using negative binomial and multinomial models, which accounted for temporal trends and seasonal variability of prepandemic years. The aim was to estimate the expected number of deaths in a pandemic year for a nonpandemic scenario and the difference in observed and expected deaths aggregated over the year.
Results:

In 2020, the number of excess deaths recorded per 100 000 persons was 100 (95% credible interval [CrI], 60 to 135) for Switzerland, 75 (CrI, 40 to 105) for Sweden, and 155 (CrI, 110 to 195) for Spain. In 1918, excess mortality was 6 to 7 times higher. In all 3 countries, the peaks of monthly excess mortality in 2020 were greater than most monthly excess mortality since 1918, including many peaks due to seasonal influenza and heat waves during that period.
Limitation:

Historical vital statistics might be affected by minor completeness issues before the beginning of the 20th century.
Conclusion:

In 2020, the COVID-19 pandemic led to the second-largest infection-related mortality disaster in Switzerland, Sweden, and Spain since the beginning of the 20th century.
Primary Funding Source:

Foundation for Research in Science and the Humanities at the University of Zurich, Swiss National Science Foundation, and National Institute of Allergy and Infectious Diseases.

Statistics

Citations

Dimensions.ai Metrics
15 citations in Web of Science®
15 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Evolutionary Medicine
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:General Medicine, Internal Medicine
Language:English
Date:1 April 2022
Deposited On:01 Feb 2022 16:08
Last Modified:18 Jun 2024 03:35
Publisher:American College of Physicians
ISSN:0003-4819
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.7326/m21-3824
PubMed ID:35099995
Full text not available from this repository.