COVID-19 and drivers of excess death rate in Peru: A longitudinal ecological study

Cajachagua-Torres, Kim N.; Quezada-Pinedo, Hugo G.; Huayanay-Espinoza, Carlos A.; Obeso-Manrique, Jordan A.; Rodríguez, Veloz; Vidal, Elisa; Huicho, Luis

doi:10.1016/j.heliyon.2022.e11948

Cited by 17 publications

(17 citation statements)

References 61 publications

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“…Chronic and acute dysfunctions in health systems 46 can be exacerbated by pandemic responses resulting in extra fatalities. Unemployment, bankruptcies, poverty and lack of health insurance and health access may promote fatal outcomes from diverse causes in countries as diverse as United States and Peru 47,48 …”

Section: Causal (Mis)interpretation Of Excess Deathsmentioning

confidence: 99%

“…Unemployment, bankruptcies, poverty and lack of health insurance and health access may promote fatal outcomes from diverse causes in countries as diverse as United States and Peru. 47,48 When excess deaths far outnumber recorded COVID-19 deaths, the excess is probably mostly not by missed lethal SARS-CoV-2 infections. Illustratively, India has the largest absolute difference between reported COVID-19 deaths in 2020-2021 (n = 481,080 per JHU) and excess death calculations (e.g.…”

Section: Interpretation Of Excess Deathsmentioning

confidence: 99%

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Flaws and uncertainties in pandemic global excess death calculations

Ioannidis

Zonta

Levitt

2023

Eur J Clin Investigation

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Several teams have been publishing global estimates of excess deaths during the COVID‐19 pandemic. Here, we examine potential flaws and underappreciated sources of uncertainty in global excess death calculations. Adjusting for changing population age structure is essential. Otherwise, excess deaths are markedly overestimated in countries with increasingly aging populations. Adjusting for changes in other high‐risk indicators, such as residence in long‐term facilities, may also make a difference. Death registration is highly incomplete in most countries; completeness corrections should allow for substantial uncertainty and consider that completeness may have changed during pandemic years. Excess death estimates have high sensitivity to modelling choice. Therefore different options should be considered and the full range of results should be shown for different choices of pre‐pandemic reference periods and imposed models. Any post‐modelling corrections in specific countries should be guided by pre‐specified rules. Modelling of all‐cause mortality (ACM) in countries that have ACM data and extrapolating these models to other countries is precarious; models may lack transportability. Existing global excess death estimates underestimate the overall uncertainty that is multiplicative across diverse sources of uncertainty. Informative excess death estimates require risk stratification, including age groups and ethnic/racial strata. Data to‐date suggest a death deficit among children during the pandemic and marked socioeconomic differences in deaths, widening inequalities. Finally, causal explanations require great caution in disentangling SARS‐CoV‐2 deaths, indirect pandemic effects and effects from measures taken. We conclude that excess deaths have many uncertainties, but globally deaths from SARS‐CoV‐2 may be the minority of calculated excess deaths.

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Section: Causal (Mis)interpretation Of Excess Deathsmentioning

confidence: 99%

Section: Interpretation Of Excess Deathsmentioning

confidence: 99%

Flaws and uncertainties in pandemic global excess death calculations

Ioannidis

Zonta

Levitt

2023

Eur J Clin Investigation

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“…32 Socioeconomic factors are likely to have had a major impact on mortality during 2020-2023 also in other countries, perhaps even to a larger extent than in the 34 countries that we analyzed. [33][34][35] Their impact might have been even larger for non-COVID-19 deaths. 33 Conversely, most countries not analyzed here have much younger populations and few frail elderly in long-term care facilities than the 34 analyzed countries, and thus deaths directly due to SARS-CoV-2 are expected to have been fewer.…”

Section: Covid-19 Was a Crisis Of Inequalities And Many Measures Take...mentioning

confidence: 99%

Variability in excess deaths across countries with different vulnerability during 2020-2023

Ioannidis

Zonta

Levitt

2023

Preprint

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Importance: Excess deaths provide estimates of total impact of major crises, such as the COVID-19 pandemic. Objective: To evaluate excess deaths trajectories during 2020-2023 across countries with accurate death registration and population age structure data; and to assess how excess death patterns and trajectories correlate with economic indicators of vulnerability overall and in different age strata. Methods: Data were used from the Human Mortality Database on 34 countries. Excess deaths were calculated for 2020-2023 (to 2/26/2023) using 2017-2019 as baseline reference, with weekly expected death calculations and adjustment for 5 age strata. Countries were divided into less and more vulnerable; the latter had per capita nominal GDT<$30,000, Gini>0.35 for income inequality and/or at least 2.5% of their population living in poverty. Results: Excess deaths (as proportion of expected deaths, p% ) were strongly inversely correlated with per capita GDP (r=-0.61), strongly correlated with proportion living in poverty (r=0.65) and modestly correlated with income inequality (r=0.42). The 17 less vulnerable countries had 201,471 excess deaths versus 2,005,380 among the 17 more vulnerable countries. The USA would have had 1.50 million fewer deaths if it had the performance of Sweden, 1.13 million fewer deaths if it had the performance of Finland, and 0.93 million fewer deaths if it had the performance of France. Excess deaths started deviating in the two groups after the first wave when correlational patterns with the 3 economic indicators also started to emerge. Between-country heterogeneity diminished over time within each of the two groups. Less vulnerable countries had mean p%=-0.4% and 0.9% in 0-64 and >65 year-old strata while more vulnerable countries had mean p%=8.3% and 9.0%, respectively. Certain countries performed substantially worse (USA, Canada, Chile, UK) or better (France, Poland, Slovenia) in the non-elderly than in the elderly. Usually lower death rates were seen in children 0-14 years old during 2020-2023 versus pre-pandemic years. Conclusion: While the pandemic hit some countries earlier than others, country vulnerability dominated eventually the cumulative impact. Half of the analyzed countries witnessed no substantial excess deaths versus pre-pandemic levels, while the other half suffered major death tolls.

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“…Los empresarios peruanos son ingeniosos y creativos, siempre dispuestos a encontrar una salida a las situaciones económicas adversas (Rodríguez Zapata y Ruiz Agudelo, 2021). Casi la mitad de las empresas del país son de carácter económico (Cajachagua Torres et al, 2022). En estas situaciones, es importante tener ideas claras y un plan para convertirla en una oportunidad de negocio.…”

Section: Introductionunclassified

Emprendimiento rural como estrategia de innovación inclusiva

Copaja

2023

eyn

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El presente artículo presenta el análisis de indicadores de la innovación inclusiva, sobre emprendedores rurales del altiplano andino de la región de Tacna. El objetivo fue describir percepciones y condiciones de la innovación inclusiva de los emprendedores rurales. Hubo limitaciones como la dispersión de la población en los anexos de las zonas altoandinas, los usuarios no estaban en un solo lugar, sino que por las mañanas paraban en el campo y por las tardes en sus casas, lo que ha hecho que el tiempo de recolección de datos sea de 6 meses. La muestra estuvo conformada por 253 personas, determinada por la saturación lingüística, la muestra consistía en perfiles de personas por función o sector de actividad apoyado con el programa atlas ti. A cada una de las personas se les realizó entrevistas semiestructuradas en profundidad, estas se llevaron a cabo en la casa o en el lugar de trabajo. Se solicitó el permiso para grabar la conversación en forma íntegra, se incorporaron las reacciones, actitudes o gestos del emprendedor observados durante la entrevista. Las percepciones y condiciones de la innovación inclusiva de los emprendedores rurales han dado como resultado que la innovación inclusiva lleva a profundizar en los beneficios para los habitantes y el ecosistema local, y a la creación de un valor añadido que no descuida la naturaleza, no daña el medioambiente y respeta las costumbres de los pueblos andinos.

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COVID-19 and drivers of excess death rate in Peru: A longitudinal ecological study

Cited by 17 publications

References 61 publications

Flaws and uncertainties in pandemic global excess death calculations

Flaws and uncertainties in pandemic global excess death calculations

Variability in excess deaths across countries with different vulnerability during 2020-2023

Emprendimiento rural como estrategia de innovación inclusiva

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