Kontis Vasilis, Bennett James E, Parks Robbie M, Rashid Theo, Pearson-Stuttard Jonathan, Asaria Perviz, Zhou Bin, Guillot Michel, Mathers Colin D, Khang Young-Ho, McKee Martin, Ezzati Majid
MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
The Earth Institute, Columbia University, New York, NY, USA.
Wellcome Open Res. 2022 Feb 15;6:279. doi: 10.12688/wellcomeopenres.17253.2. eCollection 2021.
Industrialised countries had varied responses to the COVID-19 pandemic, which may lead to different death tolls from COVID-19 and other diseases. We applied an ensemble of 16 Bayesian probabilistic models to vital statistics data to estimate the number of weekly deaths if the pandemic had not occurred for 40 industrialised countries and US states from mid-February 2020 through mid-February 2021. We subtracted these estimates from the actual number of deaths to calculate the impacts of the pandemic on all-cause mortality. Over this year, there were 1,410,300 (95% credible interval 1,267,600-1,579,200) excess deaths in these countries, equivalent to a 15% (14-17) increase, and 141 (127-158) additional deaths per 100,000 people. In Iceland, Australia and New Zealand, mortality was lower than would be expected in the absence of the pandemic, while South Korea and Norway experienced no detectable change. The USA, Czechia, Slovakia and Poland experienced >20% higher mortality. Within the USA, Hawaii experienced no detectable change in mortality and Maine a 5% increase, contrasting with New Jersey, Arizona, Mississippi, Texas, California, Louisiana and New York which experienced >25% higher mortality. Mid-February to the end of May 2020 accounted for over half of excess deaths in Scotland, Spain, England and Wales, Canada, Sweden, Belgium, the Netherlands and Cyprus, whereas mid-September 2020 to mid-February 2021 accounted for >90% of excess deaths in Bulgaria, Croatia, Czechia, Hungary, Latvia, Montenegro, Poland, Slovakia and Slovenia. In USA, excess deaths in the northeast were driven mainly by the first wave, in southern and southwestern states by the summer wave, and in the northern plains by the post-September period. Prior to widespread vaccine-acquired immunity, minimising the overall death toll of the pandemic requires policies and non-pharmaceutical interventions that delay and reduce infections, effective treatments for infected patients, and mechanisms to continue routine health care.
工业化国家对新冠疫情的应对措施各不相同，这可能导致因新冠疫情和其他疾病造成的死亡人数有所差异。我们运用了16个贝叶斯概率模型的集合，对生命统计数据进行分析，以估算在2020年2月中旬至2021年2月中旬期间，如果疫情没有发生，40个工业化国家和美国各州每周的死亡人数。我们从实际死亡人数中减去这些估算值，以计算疫情对全因死亡率的影响。在这一年里，这些国家有1410300例（95%可信区间为1267600 - 1579200）超额死亡，相当于增加了15%（14 - 17），每10万人中有141例（127 - 158）额外死亡。在冰岛、澳大利亚和新西兰，死亡率低于若无疫情时的预期，而韩国和挪威的死亡率没有明显变化。美国、捷克、斯洛伐克和波兰的死亡率上升超过20%。在美国国内，夏威夷的死亡率没有明显变化，缅因州上升了5%，这与新泽西州、亚利桑那州、密西西比州、得克萨斯州、加利福尼亚州、路易斯安那州和纽约州形成对比，这些州的死亡率上升超过25%。2020年2月中旬至5月底占苏格兰、西班牙、英格兰和威尔士、加拿大、瑞典、比利时、荷兰和塞浦路斯超额死亡人数的一半以上，而2020年9月中旬至2021年2月中旬占保加利亚、克罗地亚、捷克、匈牙利、拉脱维亚、黑山、波兰、斯洛伐克和斯洛文尼亚超额死亡人数的90%以上。在美国，东北部的超额死亡主要由第一波疫情驱动，南部和西南部各州由夏季疫情驱动，北部平原由9月之后的疫情驱动。在广泛获得疫苗免疫力之前，要将疫情的总体死亡人数降至最低，需要采取政策和非药物干预措施来延缓和减少感染，为感染患者提供有效的治疗，以及维持常规医疗保健的机制。
