1887
  1. Home
  2. Eurosurveillance
  3. Volume 26, Issue 8, 25/Feb/2021
  4. Article
Surveillance Open Access
Like 0
Download

Abstract

Background

Timely monitoring of COVID-19 impact on mortality is critical for rapid risk assessment and public health action.

Aim

Building upon well-established models to estimate influenza-related mortality, we propose a new statistical Attributable Mortality Model (AttMOMO), which estimates mortality attributable to one or more pathogens simultaneously (e.g. SARS-CoV-2 and seasonal influenza viruses), while adjusting for seasonality and excess temperatures.

Methods

Data from Nationwide Danish registers from 2014-week(W)W27 to 2020-W22 were used to exemplify utilities of the model, and to estimate COVID-19 and influenza attributable mortality from 2019-W40 to 2020-W20.

Results

SARS-CoV-2 was registered in Denmark from 2020-W09. Mortality attributable to COVID-19 in Denmark increased steeply, and peaked in 2020-W14. As preventive measures and national lockdown were implemented from 2020-W12, the attributable mortality started declining within a few weeks. Mortality attributable to COVID-19 from 2020-W09 to 2020-W20 was estimated to 16.2 (95% confidence interval (CI): 12.0 to 20.4) per 100,000 person-years. The 2019/20 influenza season was mild with few deaths attributable to influenza, 3.2 (95% CI: 1.1 to 5.4) per 100,000 person-years.

Conclusion

AttMOMO estimates mortality attributable to several pathogens simultaneously, providing a fuller picture of mortality by COVID-19 during the pandemic in the context of other seasonal diseases and mortality patterns. Using Danish data, we show that the model accurately estimates mortality attributable to COVID-19 and influenza, respectively. We propose using standardised indicators for pathogen circulation in the population, to make estimates comparable between countries and applicable for timely monitoring.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.8.2001646
2021-02-25
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.8.2001646
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/8/eurosurv-26-8-2.html?itemId=/content/10.2807/1560-7917.ES.2021.26.8.2001646&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) Dashboard. Geneva: WHO. [Accessed 1 Nov 2020]. Available from: https://covid19.who.int/
  2. Faust JS, Del Rio C. Assessment of deaths from COVID-19 and from seasonal influenza. JAMA Intern Med. 2020;180(8):1045-6.  https://doi.org/10.1001/jamainternmed.2020.2306  PMID: 32407441 
  3. Serfling RE. Methods for current statistical analysis of excess pneumonia-influenza deaths. Public Health Rep. 1963;78(6):494-506.  https://doi.org/10.2307/4591848  PMID: 19316455 
  4. Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braeye T, et al. . Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. Euro Surveill. 2020;25(26):2001214.  https://doi.org/10.2807/1560-7917.ES.2020.25.26.2001214  PMID: 32643601 
  5. Nielsen J, Mazick A, Andrews N, Detsis M, Fenech TM, Flores VM, et al. Pooling European all-cause mortality: methodology and findings for the seasons 2008/2009 to 2010/2011. Epidemiol Infect. 2013;141(9):1996-2010.  https://doi.org/10.1017/S0950268812002580  PMID: 23182146 
  6. Nielsen J, Krause TG, Mølbak K. Influenza-associated mortality determined from all-cause mortality, Denmark 2010/11-2016/17: The FluMOMO model. Influenza Other Respir Viruses. 2018;12(5):591-604.  https://doi.org/10.1111/irv.12564  PMID: 29660769 
  7. Goldstein E, Cobey S, Takahashi S, Miller JC, Lipsitch M. Predicting the epidemic sizes of influenza A/H1N1, A/H3N2, and B: a statistical method. PLoS Med. 2011;8(7):e1001051.  https://doi.org/10.1371/journal.pmed.1001051  PMID: 21750666 
  8. International Organization for Standardization (ISO). ISO 8601. Geneva: ISO. Available from: https://www.iso.org/iso-8601-date-and-time-format.html
  9. European monitoring of excess mortality for public health action (EuroMOMO). Copenhagen: Statens Serum Institut. [Accessed 01 Sep 2020]. Available from: https://euromomo.eu/how-it-works/methods/
  10. Voldstedlund M, Haarh M, Mølbak K, the MiBa Board of Representatives. The Danish Microbiology Database (MiBa) 2010 to 2013. Euro Surveill. 2014;19(1):20667.  https://doi.org/10.2807/1560-7917.ES2014.19.1.20667  PMID: 24434175 
  11. National Oceanic and Atmospheric Administration (NOAA). Washington DC: NOAA. Available from: https://www.noaa.gov/
  12. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna: R Core Team; 2020. Available from: https://www.R-project.org/
  13. Dødsfald i Danmark, undtaget Grønland og Færøerne. [Surveillance of mortality in Denmark, with the exception of Greenland and the Faroe Islands]. [Accessed 1 Sep 2020]. Danish. Available from: https://www.ssi.dk/-/media/arkiv/dk/sygdomme-beredskab-og-forskning/sygdomsovervaagning/momo/dk_momo.pdf?la=en
  14. Emborg HD, Carnahan A, Bragstad K, Trebbien R, Brytting M, Hungnes O, et al. Abrupt termination of the influenza season following preventive measures against COVID-19 in Denmark, Norway and Sweden. Euro Surveill. Forthcoming.
  15. Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, et al. , Global Seasonal Influenza-associated Mortality Collaborator Network. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018;391(10127):1285-300.  https://doi.org/10.1016/S0140-6736(17)33293-2  PMID: 29248255 
  16. Nielsen J, Vestergaard LS, Richter L, Schmid D, Bustos N, Asikainen T, et al. European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered? Clin Microbiol Infect. 2019;25(10):1266-76.  https://doi.org/10.1016/j.cmi.2019.02.011  PMID: 30790685 
  17. Statens Serum Institut (SSI). INFLUENZA-NYT - 2019-2020. [Influenza News – 2019-2020]. Copenhagen: SSI. Danish. [Accessed 14 Jun 2020]. Available from: https://www.ssi.dk/aktuelt/nyhedsbreve/influenza-nyt/2019-2020
  18. Rose A, Kissling E, Emborg H-D, Larrauri A, McMenamin J, Pozo F, et al. , European IVE group. Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020. Euro Surveill. 2020;25(10):2000153.  https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000153  PMID: 32183932 
Estimates of mortality attributable to COVID-19: a statistical model for monitoring COVID-19 and seasonal influenza, Denmark, spring 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jens+Nielsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nielsen Jens</a>, <a href="/search?value1=Naja+Hulvej+Rod&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rod Naja Hulvej</a>, <a href="/search?value1=Lasse+S+Vestergaard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vestergaard Lasse S</a>, <a href="/search?value1=Theis+Lange&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lange Theis</a></span>. Estimates of mortality attributable to COVID-19: a statistical model for monitoring COVID-19 and seasonal influenza, Denmark, spring 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(8):pii=2001646. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.8.2001646" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.8.2001646</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 10 Sept 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 10 Nov 2020 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.8.2001646
/content/10.2807/1560-7917.ES.2021.26.8.2001646
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error