Galmiche Simon, Coustaury Camille, Charniga Kelly, Grant Rebecca, Cauchemez Simon, Fontanet Arnaud
Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France.
Mathematical Modelling of Infectious Diseases Unit, UMR2000, Institut Pasteur, Université Paris Cité, CNRS, Paris, France.
BMC Glob Public Health. 2024 Dec 9;2(1):78. doi: 10.1186/s44263-024-00103-z.
Important differences in excess mortality between European countries during the COVID-19 pandemic have been reported. Understanding the drivers of these differences is essential to pandemic preparedness.
We examined patterns in age- and sex-standardized cumulative excess mortality in 13 Western European countries during the first 30 months of the COVID-19 pandemic and the correlation of country-level characteristics of interest with excess mortality.
In a timeline analysis, we identified notable differences in seeding events, particularly in early 2020 and when the Alpha variant emerged, likely contributing to notable differences in excess mortality between countries (lowest in Denmark during that period). These differences were more limited from July 2021 onwards. Lower excess mortality was associated with implementing stringent non-pharmaceutical interventions (NPIs) when hospital admissions were still low in 2020 (correlation coefficient rho = 0.65, p = 0.03) and rapid rollout of vaccines in the elderly in early 2021 (rho = - 0.76, p = 0.002). Countries which implemented NPIs while hospital admissions were low tended to experience lower gross domestic product (GDP) losses in 2020 (rho = - 0.55, p = 0.08). Structural factors, such as high trust in the national government (rho = - 0.77, p = 0.002) and low ratio of population at risk of poverty (rho = 0.55, p = 0.05), were also associated with lower excess mortality.
These results suggest the benefit of early implementation of NPIs and swift rollout of vaccines to the most vulnerable. Further analyses are required at a more granular level to better understand how these factors impacted excess mortality and help guide pandemic preparedness plans.
据报道，在新冠疫情期间，欧洲国家之间的超额死亡率存在重要差异。了解这些差异的驱动因素对于疫情防范至关重要。
我们研究了13个西欧国家在新冠疫情的前30个月中按年龄和性别标准化的累积超额死亡率模式，以及相关国家层面特征与超额死亡率的相关性。
在时间线分析中，我们发现疫情传播事件存在显著差异，特别是在2020年初和阿尔法变异毒株出现时，这可能导致各国超额死亡率出现显著差异（在此期间丹麦的超额死亡率最低）。从2021年7月起，这些差异变得更为有限。较低的超额死亡率与在2020年医院收治率仍较低时实施严格的非药物干预措施（NPIs）（相关系数rho = 0.65，p = 0.03）以及在2021年初迅速为老年人接种疫苗（rho = -0.76，p = 0.002）有关。在医院收治率较低时实施NPIs的国家在2020年往往经历较低的国内生产总值（GDP）损失（rho = -0.55，p = 0.08）。结构因素，如对国家政府的高度信任（rho = -0.77，p = 0.002）和低贫困风险人口比例（rho = 0.55，p = 0.05），也与较低的超额死亡率相关。
这些结果表明早期实施NPIs以及迅速为最脆弱人群接种疫苗的益处。需要在更细化的层面进行进一步分析，以更好地理解这些因素如何影响超额死亡率，并帮助指导疫情防范计划。
