Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
Department of Computer Science, College of Arts and Sciences, Georgia State University, Atlanta, GA, USA.
BMC Infect Dis. 2021 May 7;21(1):432. doi: 10.1186/s12879-021-06122-7.
Low testing rates and delays in reporting hinder the estimation of the mortality burden associated with the COVID-19 pandemic. During a public health emergency, estimating all cause excess deaths above an expected level of death can provide a more reliable picture of the mortality burden. Here, we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico.
We obtained weekly mortality time series due to all causes for Mexico, and by gender, and geographic region from 2015 to 2020. We also compiled surveillance data on COVID-19 cases and deaths to assess the timing and intensity of the pandemic and assembled weekly series of the proportion of tweets about 'death' from Mexico to assess the correlation between people's media interaction about 'death' and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models and forecasted the total excess deaths for Mexico for the first 4 weeks of 2021 using the generalized logistic growth model.
We estimated the all-cause excess mortality rate associated with the COVID-19 pandemic in Mexico in 2020 at 26.10 per 10,000 population, which corresponds to 333,538 excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). Mexico City reported the highest excess death rate (63.54) and RR (2.09) compared to rest of the country (excess rate = 23.25, RR = 1.62). While COVID-19 deaths accounted for only 38.64% of total excess deaths in Mexico, our forecast estimate that Mexico has accumulated a total of ~ 61,610 [95% PI: 60,003, 63,216] excess deaths in the first 4 weeks of 2021. Proportion of tweets was significantly correlated with the excess mortality (ρ = 0.508 [95% CI: 0.245, 0.701], p-value = 0.0004).
The COVID-19 pandemic has heavily affected Mexico. The lab-confirmed COVID-19 deaths accounted for only 38.64% of total all cause excess deaths (333,538) in Mexico in 2020. This reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes during the pandemic. A model-based forecast indicates that an average of 61,610 excess deaths have occurred in January 2021.
低检测率和报告延迟阻碍了对与 COVID-19 大流行相关的死亡率负担的估计。在公共卫生紧急情况下，估计高于预期死亡水平的所有原因超额死亡人数可以更可靠地了解死亡率负担。在这里，我们旨在估计 COVID-19 大流行在墨西哥的绝对和相对死亡率影响。
我们获得了墨西哥 2015 年至 2020 年所有原因每周死亡率时间序列，以及按性别和地理区域划分的死亡率时间序列。我们还汇编了 COVID-19 病例和死亡的监测数据，以评估大流行的时间和强度，并汇编了每周来自墨西哥的关于“死亡”的推文比例的系列，以评估人们对“死亡”的媒体互动与大流行死亡人数的增加之间的相关性。我们通过拟合 Serfling 回归模型来估计所有原因的超额死亡率和死亡率比基线增加，并使用广义逻辑增长模型预测 2021 年第一季度的墨西哥总超额死亡人数。
我们估计 2020 年墨西哥与 COVID-19 大流行相关的所有原因超额死亡率为每 10,000 人 26.10 人，这对应于 333,538 人超额死亡。男性的超额死亡率（33.99）是女性（18.53）的两倍多。墨西哥城的超额死亡率（63.54）和 RR（2.09）报告高于该国其他地区（超额死亡率=23.25，RR=1.62）。虽然 COVID-19 死亡人数仅占墨西哥总超额死亡人数的 38.64%，但我们的预测估计，2021 年第一季度，墨西哥累计共发生约 61,610 例（95%PI：60,003，63,216）超额死亡。推文比例与超额死亡率呈显著相关（ρ=0.508 [95%CI：0.245, 0.701]，p 值=0.0004）。
COVID-19 大流行对墨西哥造成了严重影响。在 2020 年，墨西哥实验室确诊的 COVID-19 死亡人数仅占总所有原因超额死亡人数（333,538 人）的 38.64%。这反映了墨西哥低检测率的影响，或者大流行期间其他原因导致的死亡人数激增。基于模型的预测表明，2021 年 1 月平均发生了 61,610 例超额死亡。
