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      Magnitude, demographics and dynamics of the effect of the first wave of the COVID-19 pandemic on all-cause mortality in 21 industrialized countries.

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          Abstract

          The Coronavirus Disease 2019 (COVID-19) pandemic has changed many social, economic, environmental and healthcare determinants of health. We applied an ensemble of 16 Bayesian models to vital statistics data to estimate the all-cause mortality effect of the pandemic for 21 industrialized countries. From mid-February through May 2020, 206,000 (95% credible interval, 178,100-231,000) more people died in these countries than would have had the pandemic not occurred. The number of excess deaths, excess deaths per 100,000 people and relative increase in deaths were similar between men and women in most countries. England and Wales and Spain experienced the largest effect: ~100 excess deaths per 100,000 people, equivalent to a 37% (30-44%) relative increase in England and Wales and 38% (31-45%) in Spain. Bulgaria, New Zealand, Slovakia, Australia, Czechia, Hungary, Poland, Norway, Denmark and Finland experienced mortality changes that ranged from possible small declines to increases of 5% or less in either sex. The heterogeneous mortality effects of the COVID-19 pandemic reflect differences in how well countries have managed the pandemic and the resilience and preparedness of the health and social care system.

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          Author and article information

          Journal
          Nat Med
          Nature medicine
          Springer Science and Business Media LLC
          1546-170X
          1078-8956
          Dec 2020
          : 26
          : 12
          Affiliations
          [1 ] MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
          [2 ] The Earth Institute, Columbia University, New York, NY, USA.
          [3 ] Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
          [4 ] French Institute for Demographic Studies (INED), Paris, France.
          [5 ] Population Studies Center, Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA.
          [6 ] Directorate for Social Statistics and Population Census, Italian National Institute of Statistics (Istat), Rome, Italy.
          [7 ] Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
          [8 ] Department of Natural Sciences, Middlesex University London, London, UK.
          [9 ] Independent Researcher, Geneva, Switzerland.
          [10 ] MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. majid.ezzati@imperial.ac.uk.
          [11 ] Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK. majid.ezzati@imperial.ac.uk.
          [12 ] Regional Institute for Population Studies, University of Ghana, Legon, Ghana. majid.ezzati@imperial.ac.uk.
          Article
          10.1038/s41591-020-1112-0
          10.1038/s41591-020-1112-0
          33057181
          7fb45090-601e-46c4-8e04-19f171a0a84b
          History

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