Researchers have identified the main reasons why deaths are currently increasing

Analysts from the Evidence-Based Medical Team working on the Hold on to Doctors project calculated the excess deaths observed during this period, showing how many more people died than expected over a period of time, and identified the main reasons why that we are currently seeing an increase in deaths.

Analysts compared the first 48 weeks of 2020 (both public data are currently provided by Statistics Lithuania) with the same weeks in the previous 20 years. The last week, the 48th, begins on November 23. and ends on November 29. Analysts found that the demographic composition of the population varied from year to year and that annual mortality unrelated to demographic composition also differed. As a result of these adapted methods, all data from the previous 20 years has become comparable to data from 2020, according to the press release.

Figure 1. Comparison of the total number of deaths in Lithuania in 2020 (regardless of cause of death) with previous years. From the previous 20 years (2000 to 2019), the number of deaths most likely to be calculated in each calendar week was calculated.

As of October 2020. For at least seven weeks, there has been a growing surplus of deaths, coinciding with the recent wave of the COVID-19 pandemic in Lithuania.

Figure 2. Statistics on confirmed Covid-19 cases and deaths are officially published (source: Lithuania Statistics). Weekly fluctuations were mitigated using a moving average.

According to the evidence-based medical team, 6,100 deaths were observed in Lithuania at 42-48 weeks, or even 1,200 more than at the usual time, when 4,900 deaths were expected during the same period. This phenomenon is especially pronounced in the older group (80+ years), but it is already noticeable in the group older than 50 years. According to official figures, around 350 people have died from Covid-19 during this period, leaving the remaining 850 people invisible victims of this pandemic.

Figure 3. The excess deaths is divided into two parts: the official excess deaths from Covid-19 marked darker; other excess deaths during the COVID-19 pandemic stand out more clearly.

Analysts have cited the reasons why we are witnessing such a pronounced surplus of deaths.

1. Direct victims of Covid-19. Deaths of people not diagnosed with Covid-19 without seeking or receiving help.

2. Deferred planned assistance. COVID-19 patients receive emergency care in hospitals for respiratory failure. To this end, all hospital emergency departments are being closed and reorganized. Reorganization of the intensive care and resuscitation unit to provide care for COVID-19 patients delaying postoperative surgery and other scheduled treatments (for example, cancer chemotherapy), which may require treatment in intensive care units.

3. Insufficient number of medical staff to provide planned services. Doctors are transferred to the COVID-19 ward and fall ill with COVID-19 and must isolate themselves. As a result, the availability of scheduled services to patients is further hampered.

4. Patients delay or avoid seeking emergency care. Outbreaks of COVID-19 infection are seen in many institutions. Fearing infection, patients may seek emergency care late, increasing the risk of complications and death.

5. COVID-19 complicates other chronic diseases. Even recovery from COVID-19 can have consequences: problems with breathing, heart, kidney or other systems. The total deterioration of comorbidities increases the probability of death.

6. Patients avoid participating in prevention programs. Patients may delay participation in cardiovascular cancer prevention programs because of fear of infection or because access to doctors has become more difficult, increasing the risk that these chronic diseases will be diagnosed at a later stage.

7. Possibly stress, anxiety-related deaths caused by loneliness, isolation

8. A possible partial explanation could also be suicide (for example, due to the loss of a job or a loved one).

9. However, there may be a reduction in deaths from certain causes during the COVID-19 pandemic. With the introduction of quarantine measures by states and restrictions on the movement of people, the number of deaths from certain causes, such as traffic accidents and the spread of some other infections (such as influenza), is likely to decrease.

In order to promote a responsible advertising culture for openness of data and research, the authors provide a link to material errors, corrections, or changes of opinion or interpretation found in this text. Public link to the GoogleDoc errata for this post: Click HERE. There you will also find a list of used scientific sources.