Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. Research Support, Non-U.S. Gov't Epublish 22 citations
PubMed: 37322091 DOI: 10.1038/s41467-023-39322-7
Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city.
Nat Commun 14(1):3563
Authors: Joseph A Lewnard, Chandra Mohan B, Gagandeep Kang, Ramanan Laxminarayan
Affiliations
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Center for Computational Biology, College of Engineering, University of California, Berkeley, Berkeley, CA, USA.
- Indian Administrative Service, Chennai, India.
- Christian Medical College, Vellore, India.
- One Health Trust, Bangalore, India.
- Princeton University, Princeton, NJ, USA.
Abstract
Globally, excess deaths during 2020-21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality related to pandemic control measures using medically-certified death registrations from Madurai, India-an urban center with well-functioning vital surveillance. Between March, 2020 and July, 2021, all-cause deaths in Madurai exceeded expected levels by 30% (95% confidence interval: 27-33%). Although driven by deaths attributed to cardiovascular or cerebrovascular conditions, diabetes, senility, and other uncategorized causes, increases in these attributions were restricted to medically-unsupervised deaths, and aligned with surges in confirmed or attributed COVID-19 mortality, likely reflecting mortality among unconfirmed COVID-19 cases. Implementation of lockdown measures was associated with a 7% (0-13%) reduction in all-cause mortality, driven by reductions in deaths attributed to injuries, infectious diseases and maternal conditions, and cirrhosis and other liver conditions, respectively, but offset by a doubling in cancer deaths. Our findings help to account for gaps between documented COVID-19 mortality and excess all-cause mortality during the pandemic in an LMIC setting.
MeSH
Mortality, Biological Science Disciplines, Covid-19, Pandemics
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