Local Factors and COVID-19 Severity: Typological Analysis of Urban Districts in Russia

The COVID-19 pandemic has demonstrated that the lack of consideration of the local specifics of territories, such as the specifics of socio-economic interactions, labor market characteristics, leads to serious social or economic consequences when developing response measures to epidemiological threats. The creation of a typology of territories (urban districts / okrugs) makes it possible to more accurately select measures to regulate socio-economic interactions in the event of future complications of the epidemiological situation. Clustering of municipalities according to a set of local factors that significantly explain the severity of the pandemic in the first year made it possible to identify three types of urban districts that differ in population size and intensity of socio-economic interactions (SEI): these are key service centers with a high intensity of SEI, local centers with medium SEI intensity, small towns with low SEI intensity. © 2023 Spatial Economics. All rights reserved.

Excess Mortality from Diabetes Mellitus in the First Year of the Pandemic in Colombia

Objectives: To describe the mortality from diabetes mellitus before and after the first year of the COVID 19 pandemic in Colombia. Method(s): We conducted an ecological study to describe mortality from DM in Colombia by sex and age groups, before and in the first year of the pandemic in Colombia. We obtained DM mortality data from the national agency for population statistics (known as DANE for its initials in Spanish) which collects vital statistics in Colombia. We analyzed anonymized mortality records coded as DM (code 601 from causes of mortality grouped according to the list 6/67 of the PAHO for ICD, 10th revision) for 2019-2020 considering only the underlying cause of death. The variables considered were year of registration of death, number of deaths per year, sex, age, and underlying cause of death. Result(s): In 2019 and 2020 there were 244,355 and 300,853 deaths by all causes respectively. Out of 56,498 (23.1%) excess deaths, 46,019 were due to COVID-19 (code U071). Deaths from DM for were 7,967 (3.26% out of total;2.71% men - 3.94% women) in 2019 and 10,198 (3.39% out of total;2.82% men - 4.15% women) in 2020. The increase for deaths from DM was 28% (n=2,231) 32.7% for men(n=1,193) and 24% for women (n=1,038). Conclusion(s): The COVID-19 pandemic increased deaths from DM in Colombia with a greater impact on men. Priority should be given to rebuild health care services for chronic diseases.Copyright © 2023

Impact of the COVID-19 pandemic on total, sex- and age-specific all-cause mortality in 20 countries worldwide during 2020: results from the C-MOR project.

BACKGROUND: To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020. METHODS: Total, sex- and age-specific weekly all-cause mortality for 2015-2020 was collected from national vital statistics databases. Excess mortality for 2020 was calculated by comparing weekly 2020 observed mortality against expected mortality, estimated from historical data (2015-2019) accounting for seasonality, long- and short-term trends. Crude and age-standardized rates were analysed for total and sex-specific mortality. RESULTS: Austria, Brazil, Cyprus, England and Wales, France, Georgia, Israel, Italy, Northern Ireland, Peru, Scotland, Slovenia, Sweden, and the USA displayed substantial excess age-standardized mortality of varying duration during 2020, while Australia, Denmark, Estonia, Mauritius, Norway, and Ukraine did not. In sex-specific analyses, excess mortality was higher in males than females, except for Slovenia (higher in females) and Cyprus (similar in both sexes). Lastly, for most countries substantial excess mortality was only detectable (Austria, Cyprus, Israel, and Slovenia) or was higher (Brazil, England and Wales, France, Georgia, Italy, Northern Ireland, Sweden, Peru and the USA) in the oldest age group investigated. Peru demonstrated substantial excess mortality even in the <45 age group. CONCLUSIONS: This study highlights that excess all-cause mortality during 2020 is context dependent, with specific countries, sex- and age-groups being most affected. As the pandemic continues, tracking excess mortality is important to accurately estimate the true toll of COVID-19, while at the same time investigating the effects of changing contexts, different variants, testing, quarantine, and vaccination strategies.

Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared.

During the COVID-19 pandemic, excess mortality has been reported worldwide, but its magnitude has varied depending on methodological differences that hinder between-study comparability. Our aim was to estimate variability attributable to different methods, focusing on specific causes of death with different pre-pandemic trends. Monthly mortality figures observed in 2020 in the Veneto Region (Italy) were compared with those forecasted using: (1) 2018-2019 monthly average number of deaths; (2) 2015-2019 monthly average age-standardized mortality rates; (3) Seasonal Autoregressive Integrated Moving Average (SARIMA) models; (4) Generalized Estimating Equations (GEE) models. We analyzed deaths due to all-causes, circulatory diseases, cancer, and neurologic/mental disorders. Excess all-cause mortality estimates in 2020 across the four approaches were: +17.2% (2018-2019 average number of deaths), +9.5% (five-year average age-standardized rates), +15.2% (SARIMA), and +15.7% (GEE). For circulatory diseases (strong pre-pandemic decreasing trend), estimates were +7.1%, -4.4%, +8.4%, and +7.2%, respectively. Cancer mortality showed no relevant variations (ranging from -1.6% to -0.1%), except for the simple comparison of age-standardized mortality rates (-5.5%). The neurologic/mental disorders (with a pre-pandemic growing trend) estimated excess corresponded to +4.0%/+5.1% based on the first two approaches, while no major change could be detected based on the SARIMA and GEE models (-1.3%/+0.3%). The magnitude of excess mortality varied largely based on the methods applied to forecast mortality figures. The comparison with average age-standardized mortality rates in the previous five years diverged from the other approaches due to the lack of control over pre-existing trends. Differences across other methods were more limited, with GEE models probably representing the most versatile option.

Selection Effects and COVID-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records.

Prior research generally finds that the Pfizer-BioNTech (BNT162b2) and Moderna (mRNA1273) COVID-19 vaccines provide similar protection against mortality, sometimes with a Moderna advantage due to slower waning. However, most comparisons do not address selection effects for those who are vaccinated and with which vaccine. We report evidence on large selection effects, and use a novel method to control for these effects. Instead of directly studying COVID-19 mortality, we study the COVID-19 excess mortality percentage (CEMP), defined as the COVID-19 deaths divided by non-COVID-19 natural deaths for the same population, converted to a percentage. The CEMP measure uses non-COVID-19 natural deaths to proxy for population health and control for selection effects. We report the relative mortality risk (RMR) for each vaccine relative to the unvaccinated population and to the other vaccine, using linked mortality and vaccination records for all adults in Milwaukee County, Wisconsin, from 1 April 2021 through 30 June 2022. For two-dose vaccinees aged 60+, RMRs for Pfizer vaccinees were consistently over twice those for Moderna, and averaged 248% of Moderna (95% CI = 175%,353%). In the Omicron period, Pfizer RMR was 57% versus 23% for Moderna. Both vaccines demonstrated waning of two-dose effectiveness over time, especially for ages 60+. For booster recipients, the Pfizer-Moderna gap is much smaller and statistically insignificant. A possible explanation for the Moderna advantage for older persons is the higher Moderna dose of 100 µg, versus 30 µg for Pfizer. Younger persons (aged 18-59) were well-protected against death by two doses of either vaccine, and highly protected by three doses (no deaths among over 100,000 vaccinees). These results support the importance of a booster dose for ages 60+, especially for Pfizer recipients. They suggest, but do not prove, that a larger vaccine dose may be appropriate for older persons than for younger persons.

Impact of Influenza in South-East Asia

Influenza infection is asymptomatic in up to 75% of cases, but outbreaks result in significant morbidity. Reports found that severe influenza complications tend to occur among the very young (<5 years) and very old (>65 years), especially those with underlying co-morbidities like diabetes mellitus and heart disease. Even with no co-morbidity, some older persons with severe influenza may require hospitalisation or intensive care, with increased risk of myocardial infarction and stroke. In South-East Asia, influenza was often seen as a mild problem and was not deemed notifiable until the appearance of the Influenza A(H1N1) pandemic in 2009. For decades the data made available were based on extrapolated estimates collected mainly from paediatric populations, resulting in inconsistent findings. Following expanded surveillance across the region using national surveillance systems for influenza-like illness (ILI) and severe acute respiratory illness (SARI), and better diagnostic methods, improved estimates of disease burden was achieved in South-East Asia. However, two studies conducted in 2008-2010 reported findings ranging from 2-3% to 11%. With regards to increased risk of complications, the estimated global annual attack rates for influenza were 5-10% in adults and 20-30% in children, resulting in 3-5 million cases of severe illness and 290,000-650,000 deaths. A study In Singapore reported that influenza is associated with annual excess mortality rates (EMR) of 11-14.8 per 100 000 person-years, especially affecting the elderly;these rates are comparable to that of the USA. As for hospitalisation rates of children under 5 years with seasonal influenza, the USA estimated a rate of 1.4 per 100,000. Comparable rates were reported in Singapore (0.7-0.9), Thailand (2.4), Viet Nam (3.9-4.7), and the Philippines (4.7). In 2018, an updated study reported a mean annual influenza-associated respiratory EMR of 4.0-8.8 per 100 000 individuals, with South-East Asia showing a high mortality rate of 3.5-9.2 per 100,000 individuals. It was already estimated in Thailand in 2004 that influenza resulted in USD23-63 million in economic costs, with the main contribution from lost productivity due to missed workdays. Thus, comparable to countries in temperate climate, the clinical and socioeconomic impact of influenza in South-East Asia appear to be just as substantial. With the emergence of the COVID-19 pandemic in 2020, global influenza incidence dropped dramatically. In South-East Asia, the trend in influenza detections was similar to the rest of the world, with numbers slightly higher than average in early 2020, followed by a quick drop-off by the end of April 2020. After April 2020, the detection rate remained low until late July 2020, when Influenza A(H3N2) predominated in Cambodia, Malaysia, the Philippines, Singapore, Thailand and Timor-Leste;influenza B in Lao People's Democratic Republic but with an upsurge in A(H3N2) activity. Following a two-year hiatus, influenza outbreaks began to re-emerge significantly since early 2022. From February through August 2022, influenza activity in the southern hemisphere remained lower than in pre-COVID-19 pandemic years, but was at the highest level compared to similar periods since the start of the COVID-19 pandemic. Reasons for the reduction during the COVID-19 pandemic include non-pharmaceutical interventions (NPIs), reduced population mixing and reduced travel, and possibly viral interference between SARS-CoV-2 and influenza virus in the same host. In general, the reduction in influenza detections however does not appear to be associated with lack of testing. The World Health Organisation (WHO) continues to recommend that vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses. Although influenza vaccine is not commonly used in most countries in South-East Asia, its burden is similar in other parts of the world where influenza vaccine is now routinely used. Currently, the countries in South-East Asia that are providing free influenza vacc na ion for those at high risk include Thailand, Singapore, the Philippines and Lao People's Democratic Republic.Copyright © 2023

Excess Mortality during the First Ten Months of Covid-19 Epidemic at Jakarta, Indonesia

Excess mortality during the COVID-19 epidemic is a crucial indicator of the health effects. We examined mortality records from government sources in Jakarta, Indonesia, from January 2015 to October 2020: 1) burials in public cemeteries;2) civil registration of deaths;and 3) registration of deaths by health authorities. During 2015-2019, there were an average of 26,342 burials per year between January and October. During the same time frame in 2020, there were 42,460 burials, a 61% increase. Two months before the first official laboratory confirmation of SARS-CoV-2 infection in Indonesia in March 2020, a surge in burials began in early January 2020. In 2020, an examination of civil death registrations or health authority death registrations revealed insensitive trends. Both the characterization and management of the health crisis in Jakarta are clouded by insufficient laboratory diagnostic and death surveillance capabilities. The public burials data described may serve as a useful indicator of mortality impacts and the efficacy of epidemic interventions.Copyright © 2023

Fading Voices: COVID-19, Language Death and the Case of Bergamasco in Italy

The chapter explores the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on language endangerment in Italy. Despite their misleading name, Italian Dialects (IDs) are sister languages of Italian and independently developed from Latin. Since the introduction of compulsory education in the 1960s and concurrent Italy's sharp industrialisation, IDs are in decline, and a clear language shift is detectable towards the dominant national language: Italian. IDs are hence only discretely vital among the aging population with the younger generations having broken their intergenerational transmission. Given the higher mortality rates among the elderly and the strict intermittent national and regional lockdowns enforced by the Italian Government, the COVID-19 pandemic has accelerated the process of language death across Italy. This is particularly noticeable in Bergamo, one of the Italian provinces most affected by COVID-19, where the disease caused a five-fold increase in excess mortality in March 2020. In the same period, COVID-19 was the attributable cause of death in half of those older than 50 and the mean age of those dying for COVID-19 was 80. The death toll of COVID-19 on the elderly population has left Bergamasco, the ancestral language of Bergamo, a step closer to extinction. By taking Bergamasco as a case study, the chapter denounces the vulnerability of IDs and the negative impact of the COVID-19 pandemic on their level of vitality. To this aim, the chapter presents a quantitative sociolinguistic study of the vitality of Bergamasco in relation to COVID-19 incidence and lethality rates in the province of Bergamo. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Geography, Factors and Consequences of COVID-19 Diffusion in Russia

The chapter describes the spread of the COVID-19 in the Russian regions and its consequences. Two COVID-19 waves could be distinguished, the beginning of the third was recorded. Each wave began in the largest metropolitan areas, where there is a high density of population and interaction, then spread to the periphery. The epidemic affected Russia more than the world average but less than most East-European countries;Moscow was among the most affected areas worldwide. However, the current (real-time) statistics of confirmed cases and deaths may underestimate their real extent due to a number of discussed distortions. Excess mortality in Russia in 2020 corresponded to Latin American countries. It was higher in the least developed Russian regions with high poverty and insufficient health care infrastructure, in the largest agglomerations with an elderly population and in mining regions with a large number of temporary labor migrants. As a result of the epidemic, a special healthcare infrastructure was created and numerous electronic services were developed. However, it also sharpened the debate about restrictive measures. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Conditional on the Environment? The Contextual Embeddedness of Age, Health, and Socioeconomic Status as Predictors of Remote Work among Older Europeans through the COVID-19 Pandemic

COVID-19 era lockdown measures resulted in many workers performing their employment tasks remotely. While identifying individual-level predictors of COVID-19 era remote work, scholarship has neglected heterogeneity based on contextual characteristics. Using the first COVID-19 module (2020) of the Survey of Health, Ageing and Retirement in Europe (N = 8,121) and multinomial logistic regression analyses, this study examined how country-level digitalization, stringency of government COVID-19 containment measures, and COVID-19 era excess mortality moderated how individual-level age, health, education, and income affected working partly or fully remotely among older Europeans (50-89 years) continuing to work through the pandemic. The central findings are that higher societal digitalization reduced the positive association between education and fully remote work, and greater country-level excess mortality accentuated how more education and poorer health increased the probability of fully remote work. These findings are interpreted through the fundamental cause theory of health and the health belief model. They further lead to recommendations that during future epidemics, policies and programs should address the remote working capabilities of older persons with fewer years of education, with fewer skills with modern digital technologies, and in worse health, especially within nations that are less digitally developed and harder hit by the epidemic in question. [ FROM AUTHOR] Copyright of Sociological Perspectives is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The coronavirus conundrum - From pandemic to endemic COVID-19 - Should we continue taking care of ourselves?

It seems that things are calming down with SARS-Cov-2, as there are no longer daily reports and notes of findings of new variants and subvariants of the virus, as well as clinical changes in symptomatology, hospitalizations, severity, and deaths due to COVID-19. We do not know how we should guard against viral infection during the impending endemic phase of the disease, knowing the complex health problems of prolonged COVID if we contract the virus. In this article we describe the latest known coronavirus mutations, how they affect certain organs and systems, the advantage of a better response to infection in people with healthy lifestyle, the rebound of symptomatology, reinfections at the time of the vaccine, prolonged COVID, excess mortality of physicians who attended the first waves without vaccine, and some news and knowledge about COVID in the pregnant woman and her fetus and newborn;the future of the newborn born to a mother with COVID remains unknown. In the COVID endemic, should we continue to protect ourselves? How?Copyright © Peruvian Society of Obstetrics and Gynecology. All Rights Reserved.

Local and regional factors of spatial differentiation of the excess mortality related to the COVID-19 pandemic in Romania.

COVID-19 revealed some major weaknesses and threats that are related to the level of territorial development. In Romania, the manifestation and the impact of the pandemic were not homogenous, which was influenced, to a large extent, by a diversity of sociodemographic, economic, and environmental/geographic factors. The paper is an exploratory analysis focused on selecting and integrating multiple indicators that could explain the spatial differentiation of COVID-19-related excess mortality (EXCMORT) in 2020 and 2021. These indicators include, among others, health infrastructure, population density and mobility, health services, education, the ageing population and distance to the closest urban center. We analyzed the data from local (LAU2) and county level (NUTS3) by applying multiple linear regression and geographically weighted regression models. The results show that mobility and lower social distancing were far more critical factors for higher mortality than the intrinsic vulnerability of the population, at least in the first two years of COVID-19. However, the highly differentiated patterns and specificities of different areas of Romania resulting from the modelling of EXCMORT factors drive to the conclusion that the decision-making approaches should be place-specific in order to have more efficiency in case of pandemics.

Assessment of COVID-19 pandemic-related detrimental impact on the population of nuclear city: two-year results

Background - Since the announcement of the global coronavirus infection disease (COVID-19) pandemic, the attempts to assess the pandemic-related detrimental impact are of particular interest. The methodology of assessing the overall mortality attributed to COVID-19 pandemic, unlike the use of specific indicators that are sensitive to different methods of accounting the number of infected and deaths, provides more clear understanding of the pandemic-related impact. Objective - Quantitative assessment of the pandemic-related detrimental impact caused by the novel coronavirus infection in a small nuclear city, which is relevant for evaluating the effectiveness of anti-epidemic measures. Methods and Results - The population changes in a small urban district located in the South Ural Region of the Russian Federation were retrospectively analyzed for the decade, based on the open-source demographic data. The pandemic-related detrimental impact was calculated as overall excess mortality rate, compared with the previous non-pandemic years by using the additive model of excess absolute risk. The number of absolute excess deaths, adjusted for gender, age, population size, and number of diseased, was modeled using multivariate linear regression. The pandemic-related detriment was calculated based on the number of predicted excess deaths attributed to COVID-19. The relationship between the total number of deaths and the number of COVID-19 cases was analyzed. The total predicted two-year excess of pandemic-related deaths was 557.9. The pandemic-related total excess mortality per 1, 000 patients infected with SARSCov-2 was 50.2 (95% CI 38.4;62.0). Conclusion - The analyses revealed significant impact of the COVID-19 pandemic on the overall excess mortality in the nuclear city population in 2020 and 2021 implemented in both direct and indirect way. The population size was a major significant risk factor confounding the overall mortality. In order to develop an effective strategy to control and prevent the consequences of a pandemic, further monitoring of the epidemic situation in a nuclear city is required.Copyright © 2022, Russian Open Medical Journal.

Excess of Mortality in Older People during the Covid-19 Pandemic in Mozambique

Background: The impact of COVID-19 pandemic was apparently less severe in African continents, probably underestimated due to the limited testing capacities and access to health facilities, particularly in rural areas. Hospital and community surveillance of COVID-19 was established in Manhica District, rural Mozambique to understand the epidemic curve and natural history of SARSCoV- 2 including age-specific incidence of severe COVID-19 and reproduction number and effects of interventions through mathematical modelling Methods: Suspected cases visiting the Manhica District Hospital were screened for SARS-CoV-2 by qRT-PCR. Four age-stratified (0-19, 20-39, 40-59 and >=60 years, n=300 each) community-based serosurveys were conducted (Apr 2021-Feb 2022) to estimate the prevalence of antibodies (Abs) against SARS-CoV-2. We fitted a statistical model within a Bayesian framework, to estimate the extent to which older people were over-represented in mortality data throughout the pandemic. This involved training the model on data from the pre-pandemic period and then using this model to generate estimates of the expected levels of mortality in the absence of COVID-19 in adults aged 40+ using data from our reference category (15-39 year olds). Result(s): Between Dec 2020 and Aug 2022, 31.2% of 1332 swabs tested positive for SARS-CoV-2, with high proportion among people aged 50-59 years (62.1%, 36/58). Abs against SARS-CoV-2 were detected in 28% (180/666) of subjects enrolled in survey one, which increased two and tri-fold, in surveys 2 (64%, 595/936) and 3 (91%, 700/768);remaining stable (91.3%, 1023/1121) in 4. Age-specific analysis showed consistency on Abs detection over the surveys, including people non-eligible for vaccination (0-17 years) where >80% (165/188) had Abs detected. 93% (359/384) of subjected with Abs in survey 3, remained positive 3 months later. Shifting age-patterns throughout the pandemic are consistent with a high impact of the disease particularly in older ages. Depending on assumptions made in our modelling, we estimate a cumulative excess mortality rates in adults aged 80+ of between 8 and 17% with the largest peak coinciding with the peak in the delta variant wave. Conclusion(s): Our data reveal that people in rural areas were widely exposed across including unvaccinated ones;and there was a signature COVID-19-like shift in mortality patterns towards older ages, suggesting substantial impact, of the pandemic that is largely not reflected in patterns of confirmed COVID-19 deaths. Quantitative estimates of shift in age-patterns throughout the pandemic. (A) Shows the fit of the model to age-patterns of mortality in the pre-pandemic period 2018-2020. This model is then used to generate the expected numbers of deaths in individuals aged 40+ throughout the pandemic (2020-2022). (B) excess deaths in the pandemic relative to the model, shown in (A), black lines and grey shaded regions show estimates assuming that declines in reported mortality in under 40s are due to declines in mortality (assumption 1), coloured show equivalent estimates assuming that declines in mortality in under 40s are due to declines in ascertainment (assumption 2). (C) Shows estimates from (A) as mortality per 1000 individuals within the age strata, (D) shows each excess mortality estimate as a proportion of the population within the age strata, with seroprevalence estimated from the first two cross-sectional surveys highlighted for reference.

THE SPREAD OF THE COVID-19 INFECTION IN RUSSIA'S BALTIC MACRO-REGION: INTERNAL DIFFERENCES

This article explores the spread of the COVID-19 infection in Russia's Baltic macro-region. The monthly excess mortality rate in the Baltic region is analysed along with regional and municipal COVID-19 response acts to identify regional features affecting the spread of the disease. The spatial characteristics of Russia's Baltic regions, germane to the propagation of COVID-19, were distinguished by examining selected social and economic statistical indicators. Based on the space of places/space of flows dichotomy, Russia's Baltic regions can be divided into three spaces: 1) St. Petersburg, the Leningrad and Kaliningrad regions (dominated by spaces of flows;highly permeable space);2) the Republic of Karelia and the Murmansk region (the key factors are rotational employment and the introduction of the virus from without);3) the Novgorod and Pskov regions (lowly permeable spaces of places;the central role of local foci of the disease). The principal risk factor for the space of flows is the rapid spread of COVID-19 along transport arteries, whilst, within the space of places, the coronavirus spreads through spatial diffusion from isolated foci along short radii. In the former case, local authorities counteracted spatial diffusion by restricting movement in the local labour market;in the latter, by limiting travel between the centre and the periphery. The traditional ideas about positive (openness, centrality) and negative (closedness, peripherality) characteristics of space are reversed in the context of the pandemic: periphery gains the benefit of natural protection from the pandemic, whilst centres become acutely vulnerable © Alov, I. N., Pilyasov, A. N., 2023

Excess deaths by cause and place of death in England and Wales during the first year of COVID-19.

Using officially registered weekly mortality data, we estimate a counterfactual death count in the absence of the pandemic and we calculate the number of excess deaths in England and Wales during 2020 after the pandemic onset. We also break down those figures by region, age, gender, place of death, and cause of death. Our results suggest that there were 82,428 (95% Confidence interval [CI]: 78,402 to 86,415) excess deaths, and 88.9% (95% CI: 84.8%-93.5%) of them was due to COVID-19, suggesting that non-COVID-19 excess mortality may have been slightly higher that what has been previously estimated. Regarding deaths not due to COVID-19, persons older than 45 years old who died at their homes, mainly from heart diseases and cancer, were the most affected group. Across all causes of death, there was increased excess mortality from dementia and Alzheimer's disease, diabetes, Parkinson's disease and heart-related disease, while at the same period there was a reduction in deaths from pneumonia and influenza, stroke as well as infectious diseases and accidents. Supported by regional panel event estimates, our results highlight how measures to mitigate the pandemic spread and ease the pressure on healthcare service systems may adversely affect out-of-hospital mortality from other causes.

The Casualties of War: An Excess Mortality Estimate of Lives Lost in the 2020 Nagorno-Karabakh Conflict.

Who and how many died in the 2020 Karabakh War? With limited evidence provided by authorities, media outlets, and human rights organizations, still little is known about the death toll caused by the 44-day conflict in and around Nagorno-Karabakh. This paper provides a first assessment of the human cost of the war. Using age-sex vital registration data from Armenia, Azerbaijan, and the de facto Republic of Artsakh/Nagorno-Karabakh, we difference the 2020 observed mortality values from expected deaths based on trends in mortality between 2015 and 2019 to offer sensible estimates of excess mortality resulting from the conflict. We compare and contrast our findings with neighboring peaceful countries with similar mortality patterns and socio-cultural background and discuss them against the backdrop of the concurrent first wave of Covid-19. We estimate that the war led to almost 6,500 excess deaths among people aged 15-49. Nearly 2,800 excess losses occurred in Armenia, 3,400 in Azerbaijan, and 310 in de facto Artsakh. Deaths were highly concentrated among late adolescent and young adult males, suggesting that most excess mortality was directly related to combat. Beyond the human tragedy, for small countries like Armenia and Azerbaijan, such loss of young men represents a considerable long-term cost for future demographic, economic, and social development. Supplementary Information: The online version contains supplementary material available at 10.1007/s11113-023-09790-2.

How have we got through the COVID-19 pandemic so far? A comparative look at Europe

Coping with the COVID-19 pandemic has required far-reaching containment measures. In order to classify the effects of German pandemic policy, a European view can be helpful. We take up the concept of excess mortality to gain an impression of the pandemic course so far and, implicitly, of pandemic management in the EU-27 countries and primarily Germany. Overall, Germany has come through the pandemic comparatively well so far. This is probably also due to the measures taken, the effectiveness of which, however, cannot be determined in detail. In order to be prepared for future pandemics, clear responsibilities and decision-making structures must be defined and an accompanying pandemic monitoring system established.

Excess Mortality and COVID-19 Deaths: Preliminary Data from Serbia and Comparison with European Experience

Mortality statistics is underlay for public health measures and action and consequently it is one of the major indicator in measures of Covid-19 impact on population. This study aim to explore excess mor-tality during the Covid-19 pandemic in Serbia. Excess mortality compares expected and observed num-ber of deaths during the given period. Analysis in this paper was based on excess deaths and excess mortality rate. Data was downloaded from the national COVID-19 database and obtained from a rele-vant source from the Statistical Office of the Republic of Serbia. In order to provide better understand-ing of excess death, the excess mortality rate was calculated for the period January 2015-June 2022. For the period January 2015-February 2020, 38 months were observed without excess deaths, while in months with excess deaths, almost in all months excess mortality rate was below 12%. Since March 2020, the excess mortality rate has increased significantly, with highest values in December 2020 (91.4%), October (84.3) and November (67.8) 2021.