Rangachev Antoni, Marinov Georgi K, Mladenov Mladen
Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria.
International Center for Mathematical Sciences-Sofia, 1113 Sofia, Bulgaria.
Vaccines (Basel). 2022 Nov 10;10(11):1901. doi: 10.3390/vaccines10111901.
After initially having low levels of SARS-CoV-2 infections for much of the year, Bulgaria experienced a major epidemic surge at the end of 2020, which caused the highest recorded excess mortality in Europe, among the highest in the word (Excess Mortality Rate, or EMR ∼0.25%). Two more major waves followed in 2021, followed by another one in early 2022. In this study, we analyze the temporal and spatial patterns of excess mortality at the national and local levels and across different demographic groups in Bulgaria and compare those to the European levels. Bulgaria has continued to exhibit the previous pattern of extremely high excess mortality, as measured both by crude mortality metrics (an EMR of ∼1.05%, up to the end of March 2022) and by standardized ones-Potential Years of Life Lost (PYLL) and Aged-Standardized Years of life lost Rate (ASYR). Unlike Western Europe, the bulk of excess mortality in Bulgaria, as well as in several other countries in Eastern Europe, occurred in the second year of the pandemic, likely related to the differences in the levels of vaccination coverage between these regions. We also observe even more extreme levels of excess mortality at the regional level and in some subpopulations (e.g., total EMR values for males ≥ 2% and EMR values for males aged 40-64 ≥ 1% in certain areas). We discuss these observations in light of the estimates of infection fatality rate (IFR) and eventual population fatality rate (PFR) made early in the course of the pandemic.
在一年中的大部分时间里，保加利亚的新冠病毒感染水平最初较低，但在2020年底经历了一次重大疫情激增，导致欧洲有记录以来最高的超额死亡率，在全球范围内也位居前列（超额死亡率，即EMR约为0.25%）。2021年又出现了两次重大疫情浪潮，随后在2022年初出现了另一次。在本研究中，我们分析了保加利亚全国和地方层面以及不同人口群体中超额死亡率的时间和空间模式，并将其与欧洲水平进行比较。保加利亚继续呈现出此前极高的超额死亡率模式，无论是通过粗略死亡率指标（截至2022年3月底，EMR约为1.05%）还是标准化指标——潜在寿命损失年数（PYLL）和年龄标准化寿命损失率（ASYR）来衡量。与西欧不同，保加利亚以及东欧其他几个国家的大部分超额死亡率发生在疫情的第二年，这可能与这些地区疫苗接种覆盖率的差异有关。我们还观察到在地区层面和一些亚人群中存在更为极端的超额死亡率水平（例如，某些地区男性的总EMR值≥2%，40 - 64岁男性的EMR值≥1%）。我们根据疫情早期对感染致死率（IFR）和最终人群致死率（PFR）的估计来讨论这些观察结果。
