Weekend deaths lagging behind weekday deaths: Mere coincidence or an actual miss?

ABSTRACT

INTRODUCTION: 17 million cases & 0.6 million deaths are attributed to the novel Coronavirus disease (COVID 19). After decades of reluctance to implement pathogenreporting systems, the current pandemic has resulted in the formulation of comprehensive national reporting systems. We hypothesized that despite all efforts to improve reporting, fewer number of deaths are reported on weekends when compared to weekdays due to closure of health offices or lack of staffing on weekends, as reporting being highly dynamic. METHODS: Worldometer, a reliable database that reports real-time statistics on COVID-19 was used to retrieve the number of COVID-19 related deaths. We selected 9 worsthit countries from across the globe where reporting systems assumed to be robust. We observed the number of daily deaths over the course of 9 weeks, 4 weeks prior to their peak week, and 4 weeks afterwards. The average number of deaths/day on weekdays (WDs) and weekends (WEs) were recorded and compared. RESULTS: The WDs/WEs deaths/day for the USA, Sweden, Canada, Germany Spain, Italy, UK, Belgium and Netherlands were 1748/1142, 84/27, 150/113, 149/76, 445/386, 452/387, 594/441, 150/127 and 87/70. All countries showed data leaning towards fewer deaths on weekends. Data was first confirmed with the Kolmogorov-Smirnov Test of Normality. The test statistic (D) for Both Weekdays (WDs) and Weekends (WDs) was 0.27 & 0.26 with p values of 0.46 & 0.48 respectively, confirming that our data does not differ significantly from that which is normally distributed. T-value was calculated using the formula t = (M - μ)/SM. T-Test for two dependent means while comparing WDs and WEs deaths were significant at p < .05 (Two-tailed) for all countries except Canada and Spain. Our study was limited by data collection from a single-site though reliable, continuous updating of death counts by some countries, and limited number of countries though supposed to have proper reporting. CONCLUSIONS: Our review showed a statistically significant less number of deaths being reported on Weekends in all countries other than Spain and Canada, which may be due to the closure of administrative offices and the continuous mounting of high death counts. More research is warranted to quantify the extent of under-reporting of weekend deaths to effectively rectify the problem.