COVID-19 is not an Independent Cause of Death

The COVID-19 pandemic has had overwhelming global impacts with deleterious social, economic, and health consequences. To assess the COVID-19 death toll researchers have estimated declines in 2020 life expectancy at birth. Because data are often available only for COVID-19 deaths, the risks of dying from COVID-19 are assumed to be independent of those from other causes. We explore the soundness of this assumption based on data from the US and Brazil, the countries with the largest number of reported COVID-19 deaths. We use three methods. One estimates the difference between 2019 and 2020 life tables and therefore does not require the assumption of independence. The other two assume independence to simulate scenarios in which COVID-19 mortality is added to 2019 death rates or is eliminated from 2020 rates. Our results reveal that COVID-19 is not independent of other causes of death. The assumption of independence can lead to either an overestimate (Brazil) or an underestimate (US) of the decline in e0, depending on how the number of other reported causes of death changed in 2020.

Age reporting in the Brazilian COVID-19 vaccination database: What can we learn from it?

Age is a key variable for sciences and public planning. The demographic consequences of not measuring age correctly are manifold, including errors in mortality rates and population estimates, particularly at older ages. It also affects public programs because target populations depend on reliable population age distributions. In Brazil, the start of the vaccination campaign against COVID-19 marked the collection of new administrative data. Every citizen must be registered and need to show an identity document to get vaccinated. The requirement of proof-of-age documentation provides a unique opportunity for measuring the elderly population using a different database. This article examines the reliability of age distributions of men and women 80 years and older. We calculate various demographic indicators using data from the vaccination registration system and compare them to those from the target population estimates of the National Vaccination Plan, censuses, and population projections for Brazil and countries with high-quality population data. We show that requiring proof-of-age, such as in the vaccination records, increases data quality, mainly through the reduction of age heaping and age exaggeration. However, I.D. cards cannot fully solve wrong birth dates that result from weak historical registration systems. Thus, one should be careful when using estimates of the old age population living in some of the Brazilian regions, particularly the North, Northeast, and Center-West. Also, our analysis reveals a mismatch between the projected population by age, sex, and region, which guided the vaccination plan, and the number of vaccinated at ages 80 and older. The methodology developed to adjust the mortality rates used in the demographic projections is probably the main factor behind the disparities found.

Reduction in the 2020 Life Expectancy in Brazil after COVID-19

Brazil has the second-largest number of COVID-19 deaths worldwide. We use data on reported deaths to measure and compare the death toll across states from a demographic perspective. We estimate a decline in 2020 life expectancy at birth of 1.94 years, resulting in a mortality level not seen since 2013. The reduction in life expectancy at age 65 was 1.58 years, setting Brazil back to 2009 levels. The decline was larger for males, widening by 2.3% and 5.4% the female-male gap in life expectancy at birth and at age 65, respectively. Among states, Amazonas lost 59.6% of the improvements in life expectancy at birth since 2000. With 2021 COVID-19 deaths at about 43% of the total 2020 figures (as of mid-March) the demographic effect is likely to be even higher this year.