All-cause excess mortality across 90 municipalities in Gujarat, India, during the COVID-19 pandemic (March 2020-April 2021).

Autor:	Acosta RJ; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America., Patnaik B; National Foundation for India, New Delhi, India., Buckee C; Center for Communicable Disease Dynamics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America., Kiang MV; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, United States of America., Irizarry RA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.; Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America., Balsari S; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.; Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America., Mahmud A; Department of Demography, University of California, Berkeley, California, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2022 Aug 16; Vol. 2 (8), pp. e0000824. Date of Electronic Publication: 2022 Aug 16 (Print Publication: 2022).
DOI:	10.1371/journal.pgph.0000824
Abstrakt:	Official COVID-19 mortality statistics are strongly influenced by local diagnostic capacity, strength of the healthcare and vital registration systems, and death certification criteria and capacity, often resulting in significant undercounting of COVID-19 attributable deaths. Excess mortality, which is defined as the increase in observed death counts compared to a baseline expectation, provides an alternate measure of the mortality shock-both direct and indirect-of the COVID-19 pandemic. Here, we use data from civil death registers from a convenience sample of 90 (of 162) municipalities across the state of Gujarat, India, to estimate the impact of the COVID-19 pandemic on all-cause mortality. Using a model fit to weekly data from January 2019 to February 2020, we estimated excess mortality over the course of the pandemic from March 2020 to April 2021. During this period, the official government data reported 10,098 deaths attributable to COVID-19 for the entire state of Gujarat. We estimated 21,300 [95% CI: 20, 700, 22, 000] excess deaths across these 90 municipalities in this period, representing a 44% [95% CI: 43%, 45%] increase over the expected baseline. The sharpest increase in deaths in our sample was observed in late April 2021, with an estimated 678% [95% CI: 649%, 707%] increase in mortality from expected counts. The 40 to 65 age group experienced the highest increase in mortality relative to the other age groups. We found substantial increases in mortality for males and females. Our excess mortality estimate for these 90 municipalities, representing approximately at least 8% of the population, based on the 2011 census, exceeds the official COVID-19 death count for the entire state of Gujarat, even before the delta wave of the pandemic in India peaked in May 2021. Prior studies have concluded that true pandemic-related mortality in India greatly exceeds official counts. This study, using data directly from the first point of official death registration data recording, provides incontrovertible evidence of the high excess mortality in Gujarat from March 2020 to April 2021. Competing Interests: The authors have no competing interests to declare. (Copyright: © 2022 Acosta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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