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Fernandez-Naranjo RP, Vasconez-Gonzalez J, Izquierdo-Condoy JS, Landazuri S, Castillo D, Ortiz-Prado E. A proposed analytical approach to estimate excess daily mortality rates in Ecuador. Front Public Health 2024; 12:1250343. [PMID: 38525341 PMCID: PMC10957652 DOI: 10.3389/fpubh.2024.1250343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Background The COVID-19 pandemic has proved deadly all over the globe; however, one of the most lethal outbreaks occurred in Ecuador. Aims This study aims to highlight the pandemic's impact on the most affected countries worldwide in terms of excess deaths per capita and per day. Methods An ecological study of all-cause mortality recorded in Ecuador was performed. To calculate the excess deaths relative to the historical average for the same dates in 2017, 2018, and 2019, we developed a bootstrap method based on the central tendency measure of mean. A Poisson fitting analysis was used to identify trends on officially recorded all-cause deaths and COVID-19 deaths. A bootstrapping technique was used to emulate the sampling distribution of our expected deaths estimator μ ⌢ d e a t h s by simulating the data generation and model fitting processes daily since the first confirmed case. Results In Ecuador, during 2020, 115,070 deaths were reported and 42,453 were cataloged as excess mortality when compared to 2017-2019 period. Ecuador is the country with the highest recorded excess mortality in the world within the shortest timespan. In one single day, Ecuador recorded 1,120 deaths (6/100,000), which represents an additional 408% of the expected fatalities. Conclusion Adjusting for population size and time, the hardest-hit country due to the COVID-19 pandemic was Ecuador. The mortality excess rate shows that the SARS-CoV-2 virus spread rapidly in Ecuador, especially in the coastal region. Our results and the proposed new methodology could help to address the real situation of the number of deaths during the initial phase of pandemics.
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Affiliation(s)
| | | | | | | | | | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
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Pulido J, Barrio G, Donat M, Politi J, Moreno A, Cea-Soriano L, Guerras JM, Huertas L, Mateo-Urdiales A, Ronda E, Martínez D, Lostao L, Belza MJ, Regidor E. Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic. Disaster Med Public Health Prep 2024; 18:e27. [PMID: 38372080 DOI: 10.1017/dmp.2024.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education. METHODS An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison. RESULTS All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people. CONCLUSION Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.
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Affiliation(s)
- José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Huertas
- Instituto Valenciano de Estadística, Valencia, Spain
- National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Ronda
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
| | - David Martínez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Yang Z, Li J, Li Y, Huang X, Zhang A, Lu Y, Zhao X, Yang X. The impact of urban spatial environment on COVID-19: a case study in Beijing. Front Public Health 2024; 11:1287999. [PMID: 38259769 PMCID: PMC10800729 DOI: 10.3389/fpubh.2023.1287999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Epidemics are dangerous and difficult to prevent and control, especially in urban areas. Clarifying the correlation between the COVID-19 Outbreak Frequency and the urban spatial environment may help improve cities' ability to respond to such public health emergencies. In this study, we firstly analyzed the spatial distribution characteristics of COVID-19 Outbreak Frequency by correlating the geographic locations of COVID-19 epidemic-affected neighborhoods in the city of Beijing with the time point of onset. Secondly, we created a geographically weighted regression model combining the COVID-19 Outbreak Frequency with the external spatial environmental elements of the city. Thirdly, different grades of epidemic-affected neighborhoods in the study area were classified according to the clustering analysis results. Finally, the correlation between the COVID-19 Outbreak Frequency and the internal spatial environmental elements of different grades of neighborhoods was investigated using a binomial logistic regression model. The study yielded the following results. (i) Epidemic outbreak frequency was evidently correlated with the urban external spatial environment, among building density, volume ratio, density of commercial facilities, density of service facilities, and density of transportation facilities were positively correlated with COVID-19 Outbreak Frequency, while water and greenery coverage was negatively correlated with it. (ii) The correlation between COVID-19 Outbreak Frequency and the internal spatial environmental elements of neighborhoods of different grades differed. House price and the number of households were positively correlated with the COVID-19 Outbreak Frequency in low-end neighborhoods, while the number of households was positively correlated with the COVID-19 Outbreak Frequency in mid-end neighborhoods. In order to achieve spatial justice, society should strive to address the inequality phenomena of income gaps and residential differentiation, and promote fair distribution of spatial environments.
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Affiliation(s)
| | | | - Yu Li
- School of Architecture and Urban Planning, Beijing University of Civil Engineering and Architecture, Beijing, China
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Ayala A, Vargas C, Elorrieta F, Villalobos Dintrans P, Maddaleno M. Inequity in mortality rates and potential years of life lost caused by COVID-19 in the Greater Santiago, Chile. Sci Rep 2023; 13:16293. [PMID: 37770515 PMCID: PMC10539509 DOI: 10.1038/s41598-023-43531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/25/2023] [Indexed: 09/30/2023] Open
Abstract
Several studies have shown that, in Chile, income inequality is relevant in explaining health inequities. The COVID-19 pandemic has also had a negative impact, with higher mortality rates in those municipalities of Greater Santiago with lower socioeconomic status. We study inequity in mortality based on Potential Years of Life Lost (PYLL) in 34 urban municipalities of the Metropolitan Region (Greater Santiago) and analyze its evolution between 2018 and 2021 and by COVID-19 waves. To compare the results obtained for PYLL, we also computed the mortality rates adjusted by direct standardization. In addition, we used the concentration index (CI) to measure the health inequalities between municipalities. In the first year of the pandemic, the absolute PYLL and the standardized mortality rate for all causes of death showed an increase of 13.6% and 18.9%, respectively. Moreover, 409,086 years of life were prematurely lost in 2020, one-fifth of them due to COVID-19. The concentration indices confirm inequality in both mortality rates and PYLL, where it is more pronounced when calculating the latter measure. Results show that the deaths due to the COVID-19 pandemic affected the most economically disadvantaged municipalities, and particularly young people in those places.
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Affiliation(s)
- Andrés Ayala
- Departamento de Matemática y Ciencia de la Computación, Facultad de Ciencias, Universidad de Santiago de Chile, Santiago, Chile
| | - Claudio Vargas
- Departamento de Matemática y Ciencia de la Computación, Facultad de Ciencias, Universidad de Santiago de Chile, Santiago, Chile
| | - Felipe Elorrieta
- Departamento de Matemática y Ciencia de la Computación, Facultad de Ciencias, Universidad de Santiago de Chile, Santiago, Chile.
| | - Pablo Villalobos Dintrans
- Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Matilde Maddaleno
- Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
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Barceló MA, Saez M. Impact of the COVID-19 Pandemic on the Socioeconomic Inequalities in Mortality in Spanish Provinces. J Epidemiol Glob Health 2023; 13:453-475. [PMID: 37294460 PMCID: PMC10250865 DOI: 10.1007/s44197-023-00125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Although many studies have assessed the socioeconomic inequalities caused by COVID-19 in several health outcomes, there are numerous issues that have been poorly addressed. For instance, have socioeconomic inequalities in mortality from COVID-19 increased? What impact has the pandemic had on inequalities in specific causes of mortality other than COVID-19? Are the inequalities in COVID-19 mortality different from other causes? In this paper we have attempted to answer these questions for the case of Spain. METHODS We used a mixed longitudinal ecological design in which we observed mortality from 2005 to 2020 in the 54 provinces into which Spain is divided. We considered mortality from all causes, not excluding, and excluding mortality from COVID-19; and cause-specific mortality. We were interested in analysing the trend of the outcome variables according to inequality, controlling for both observed and unobserved confounders. RESULTS Our main finding was that the increased risk of dying in 2020 was greater in the Spanish provinces with greater inequality. In addition, we have found that: (i) the pandemic has exacerbated socioeconomic inequalities in mortality, (ii) COVID-19 has led to gender differences in the variations in risk of dying (higher in the case of women) and (iii) only in cardiovascular diseases and Alzheimer did the increased risk of dying differ between the most and least unequal provinces. The increase in the risk of dying was different by gender (greater in women) for cardiovascular diseases and cancer. CONCLUSION Our results can be used to help health authorities know where and in which population groups future pandemics will have the greatest impact and, therefore, be able to take appropriate measures to prevent such effects.
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Affiliation(s)
- Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, Girona, Spain.
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.
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Richter E, Liebl D, Schulte B, Lehmann N, Fuhrmann C, Jöckel KH, Ioannidis JPA, Streeck H. Analysis of fatality impact and seroprevalence surveys in a community sustaining a SARS-CoV-2 superspreading event. Sci Rep 2023; 13:5440. [PMID: 37012282 PMCID: PMC10069345 DOI: 10.1038/s41598-023-32441-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
There is an ongoing debate on the COVID-19 infection fatality rate (IFR) and the impact of COVID-19 on overall population mortality. Here, we addressed these issues in a community in Germany with a major superspreader event analyzing deaths over time and auditing death certificates in the community.18 deaths that occurred within the first six months of the pandemic had a positive test for SARS-CoV-2. Six out of 18 deaths had non-COVID-19 related causes of death (COD). Individuals with COVID-19 COD typically died of respiratory failure (75%) and tended to have fewer reported comorbidities (p = 0.029). Duration between first confirmed infection and death was negatively associated with COVID-19 being COD (p = 0.04). Repeated seroprevalence essays in a cross-sectional epidemiological study showed modest increases in seroprevalence over time, and substantial seroreversion (30%). IFR estimates accordingly varied depending on COVID-19 death attribution. Careful ascertainment of COVID-19 deaths is important in understanding the impact of the pandemic.
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Affiliation(s)
- Enrico Richter
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Dominik Liebl
- Institute of Finance and Statistics and Hausdorff Center for Mathematics, University of Bonn, Bonn, Germany
| | - Bianca Schulte
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Nils Lehmann
- Institute of Medical Informatics, Biometry und Epidemiology (IMIBE), University Hospital Essen, Essen, Germany
| | - Christine Fuhrmann
- Clinical Study Core Unit, Study Center Bonn (SZB), Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry und Epidemiology (IMIBE), University Hospital Essen, Essen, Germany
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, Stanford University, Stanford, USA
| | - Hendrik Streeck
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany.
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany.
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Wolff M, Mykhnenko V. COVID-19 as a game-changer? The impact of the pandemic on urban trajectories. CITIES (LONDON, ENGLAND) 2023; 134:104162. [PMID: 36593903 PMCID: PMC9797415 DOI: 10.1016/j.cities.2022.104162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/08/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Will the COVID-19 pandemic interrupt the recent European urbanization trends - and if so - what is the magnitude of this sudden shock, and how deaths, births, and net migration contribute to this disruption? Until now, most discussions on the topic have circled either around the anecdotal evidence of city center decline, or contrarian speculations about residential inertia and the forthcoming business-as-usual. Bringing clarity to the uncertainty and confusion surrounding COVID-19, this paper seeks to detect overarching patterns in and the magnitude of its sudden shock to long-term urban trajectories, understood as a reversal of the pre-pandemic population development trend, across European cities in the early 2020s. It reveals that during the first year of COVID-19, population growth in European cities significantly slowed down to -0.3 % per annum, with 28 % of all European cities having experienced a U-turn from population growth to loss. Out-migration was the main driver of such rapid urban shrinkage, while excess mortality associated with COVID-19 has also contributed to population loss in several European city-regions; some, especially, smaller cities suffered from a significant drop in birth rates. Based on the factorial, hierarchical, and temporal dimensions of the COVID-19 crisis, the paper provides a plausible forecast about the future of Europe's post-coronavirus city.
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Affiliation(s)
- Manuel Wolff
- Department of Geography, Lab for Landscape Ecology, Humboldt Universität zu Berlin, Berlin, Germany
- Department of Urban and Environmental Sociology, Helmholtz Centre for Environmental Research UFZ, Leipzig, Germany
| | - Vlad Mykhnenko
- St. Peter's College, University of Oxford, New Inn Hall Street, Oxford OX1 2DL, United Kingdom
- Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, OX1 2JA, Oxford, United Kingdom
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Nikitin B, Zakharova M, Pilyasov A, Zamyatina N. The burden of big spaces: Russian regions and cities in the COVID-19 pandemic. LETTERS IN SPATIAL AND RESOURCE SCIENCES 2023; 16:16. [PMID: 37073269 PMCID: PMC10092935 DOI: 10.1007/s12076-023-00341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Boris Nikitin
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Maria Zakharova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Alexander Pilyasov
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Nadezhda Zamyatina
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
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