Direct and indirect effects of the COVID-19 pandemic on mortality in Switzerland: A population-based study

Abstract

The direct and indirect impact of the COVID-19 pandemic on population-level mortality is of concern to public health but challenging to quantify. We modelled excess mortality and the direct and indirect effects of the pandemic on mortality in Switzerland. We analyzed yearly population data and weekly all-cause deaths by age, sex, and canton 2010-2019 and all-cause and laboratory-confirmed COVID-19 deaths from February 2020 to April 2022 (study period). Bayesian models predicted the expected number of deaths. A total of 13,130 laboratory-confirmed COVID-19 deaths were reported. The model estimated that COVID-19-related mortality was underestimated by a factor of 0.72 [95% Credible Interval: 0.46-0.78] resulting in 18,140 [15,962-20,174] excess deaths. After accounting for COVID-19 deaths, the observed mortality was 3% [-1-7] lower than expected, corresponding to a deficit of 4,406 deaths, with a wide credibility interval [-1,776-10,700]. Underestimation of COVID-19 deaths was greatest for ages 70 years and older; the mortality deficit was most pronounced in age groups 40 to 69 years. We conclude that shortcomings in testing caused underestimation of COVID-19-related deaths in Switzerland, particularly in older people. Although COVID-19 control measures may have negative effects (e.g., delays in seeking care or mental health impairments), after subtracting COVID-19 deaths, there were fewer deaths in Switzerland during the pandemic than expected, suggesting that any negative effects of control measures on mortality were offset by the positive effects. These results have important implications for the ongoing debate about the appropriateness of COVID-19 control measures.

Explanations for higher-than-expected mortality from April 2021: a scoping review

“…Two estimated unascertained Covid-19 mortality but both presented estimates for cumulative mortality from 2020 to early 2022, so may be less relevant in later time periods. 65 49 Two Italian time series studies using different mortality metrics reached opposing conclusions about the association between Covid-19 and all-cause mortality in 2022. 54 66 Two ecological studies correlated excess mortality and vaccination rates.…”

The footprint of human-induced climate change on heat-related deaths in the summer of 2022 in Switzerland

“…The actual burden due to COVID-19 cannot be estimated due to the large underreporting of the cases in Switzerland. 47 The exceptional heat in the summer of 2022 resulted in a substantial mortality burden in Switzerland, despite the adaptation measures implemented during the last decade. More importantly, our ndings indicate that anthropogenic climate change is responsible for more than half of the observed burden.…”