2 research outputs found
Magnitude and time-course of excess mortality during COVID-19 outbreak: population-based empirical evidence from highly impacted provinces in northern Italy
Background: The real impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on overall
mortality remains uncertain as surveillance reports have attributed a limited number of deaths to novel
coronavirus disease 2019 (COVID-19) during the outbreak. The aim of this study was to assess the excess
mortality during the COVID-19 outbreak in highly impacted areas of northern Italy.
Methods: We analysed data on deaths that occurred in the first 4 months of 2020 provided by the health
protection agencies (HPAs) of Bergamo and Brescia (Lombardy), building a time-series of daily number of
deaths and predicting the daily standardised mortality ratio (SMR) and cumulative number of excess
deaths through a Poisson generalised additive model of the observed counts in 2020, using 2019 data as a
reference.
Results: We estimated that there were 5740 (95% credible set (CS) 5552–5936) excess deaths in the HPA of
Bergamo and 3703 (95% CS 3535–3877) in Brescia, corresponding to a 2.55-fold (95% CS 2.50–2.61) and
1.93 (95% CS 1.89–1.98) increase in the number of deaths. The excess death wave started a few days later in
Brescia, but the daily estimated SMR peaked at the end of March in both HPAs, roughly 2 weeks after the
introduction of lockdown measures, with significantly higher estimates in Bergamo (9.4, 95% CI 9.1–9.7).
Conclusion: Excess mortality was significantly higher than that officially attributed to COVID-19, disclosing
its hidden burden likely due to indirect effects on the health system. Time-series analyses highlighted the
impact of lockdown restrictions, with a lower excess mortality in the HPA where there was a smaller delay
between the epidemic outbreak and their enforcement