Abstract
Background
One month after the first COVID-19 infection was recorded, Portugal counted 18,051 cases and 599 deaths from COVID-19. To understand the overall impact on mortality of the pandemic of COVID-19, we estimated the excess mortality registered in Portugal during the first month of the epidemic, from March 16 until April 14 using two different methods.
Methods
We compared the observed and expected daily deaths (historical average number from daily death registrations in the past 10 years) and used 2 standard deviations confidence limit for all-cause mortality by age and specific mortality cause, considering the last 6 years. An adapted Auto Regressive Integrated Moving Average (ARIMA) model was also tested to validate the estimated number of all-cause deaths during the study period.
Results
Between March 16 and April 14, there was an excess of 1255 all-cause deaths, 14% more than expected. The number of daily deaths often surpassed the 2 standard deviations confidence limit. The excess mortality occurred mostly in people aged 75+. Forty-nine percent (49%) of the estimated excess deaths were registered as due to COVID-19, the other 51% registered as other natural causes.
Conclusion
Even though Portugal took early containment measures against COVID-19, and the population complied massively with those measures, there was significant excess mortality during the first month of the pandemic, mostly among people aged 75+. Only half of the excess mortality was registered as directly due do COVID-19.
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Data availability statement: The datasets generated and/or analysed during the current study are available in the SICO-eVm repository (https://evm.min-saude.pt/#shiny-tab-q_total) and Directorate-General of Health) daily Situation Reports (https://www.dgs.pt/informacao-e-comunicacao/historico-de-destaques.aspx).
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Vieira, A., Ricoca Peixoto, V., Aguiar, P. et al. Rapid Estimation of Excess Mortality during the COVID-19 Pandemic in Portugal -Beyond Reported Deaths. J Epidemiol Glob Health 10, 209–213 (2020). https://doi.org/10.2991/jegh.k.200628.001
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DOI: https://doi.org/10.2991/jegh.k.200628.001