Data and COVID-19: Comparing Excess Mortality Data

By Luca Di Gennaro Splendore and Alessio Crisafulli Carpani

In a follow-up to an earlier post about the lack of quality data on COVID-19, the authors built a data dashboard to surface 2020 excess mortality data. In this post, they contrast two countries (Ecuador and Australia) and conclude that more analysis of the heterogeneity of results between countries is needed.

Introduction

This post analyses the excess mortality data for 23 countries in 2020, the starting year of COVID-19. Excess mortality is a term used in epidemiology and public health that refers to the number of deaths from all causes during a crisis above and beyond what we would have expected to see under ‘normal’ conditions.

The World Health Organization (WHO) published the 2020 data of mortality for 23 countries from all over the world. Among these countries, Ecuador and Australia experienced vastly contrasting results. Ecuador, in 2020, registered more than 50% excess mortality in comparison to 2019. In contrast, Australia’s mortality decreased by 5% in 2020, compared to 2019. Among those 23 countries, Mauritius alone did not experience an excess of mortality in 2020.

The data dashboard is publicly available at: https://alecrsf.shinyapps.io/ExcessMortality2020/

Within this dashboard, it is possible to consult more graphs on the data provided and see our more in-depth analysis, like those below for Ecuador and Australia.

Quality Data

The WHO data mostly are directly taken from the national civil registration. We focus on 23 available countries that already have the mortality rate by 2020. We then focused on the raw number of deaths and death rates. The cause of deaths, especially during COVID-19, are not always trustable and comparable data among the countries. For many reasons, governments under the pressure of the COVID-19 had reported COVID-19 mortality in different ways. The data is not comparable over time and over countries, as explored in our previous blog.

COVID-19 data mostly are produced and disseminated directly by governments, not by National Statistics Offices, as noted in Andreas V Georgiou 2020 and Di Gennaro 2020.

There is a lot of data on mortality, projections and other forecasts. However, at the moment, the WHO’s data is the most trustable and conclusive. Other sources of data, for now, are partial data or based on forecasts.

Mortality 2020 and Dashboard

Most of the countries registered an excess of mortality. Our dashboard aims to highlight these worldwide trends until 2020. The importance of this visualization tool is to help readers to quickly explore and learn from this data, in particular the comparison between 2019 and 2020 for these 23 countries. Moreover, it allows to compare through maps and line chart the time series of the mortality (number of deaths and death rates) for every country until 2019, which was until then without the effect of COVID-19.

Except for Australia (-4%) and Mauritius (-1%), the only data in Africa, the other countries registered a positive excess mortality in the year 2020 in comparison to the 2019. In Europe by 2020, most of the countries registered an increase of deaths at around 10% to 20% (Spain +18%, Netherlands +11%, Austria +10%, Lithuania +14%, Slovenia +17%, Czechia +15, Serbia +15%, Bosnia and Herzegovina +14). Northern European countries experienced a lower excess of mortality: Germany +5%, Latvia +4%, Estonia +3%, Iceland +1%. North Macedonia registered an important excess of mortality in 2020 which is +26%.

In the Americas, the WHO published the mortality data for 5 countries. Ecuador (+57%) and Mexico (+47%) registered a great increase of deaths in 2020. Elsewhere, Guatemala (+12%), USA (+18%) and Costa Rica (+7%) registered a significant increase.

In Asia, we have 3 countries with 2020 data mortality with heterogeneous increases: Kazakhstan (+21%), Georgia (+8%) and Singapore (+3%).

We can split the 23 countries into three different groups:

• First group: the countries with a small or negative excess of mortality in 2020, less than 10%.
• Second group: the countries with excess mortality between 10% and 20%.
• Third group: the countries with a mortality greater than 20%.

The 4 countries of the third group, with a relevant excess of mortality over 20% (Ecuador 57%, Mexico 47%, North Macedonia 26% and Kazakhstan 21%), are marked in red in the figure below. The second group, the one marked in blue, is composed by the 9 countries that registered an increase between 10% and 20%, which are: USA, Spain, Slovenia, Serbia, Czechia, Lithuania, Bosnia and Herzegovina, Guatemala, and the Netherlands. Finally, the green group, again of 9 countries (Austria, Georgia, Costa Rica, Germany, Latvia, Estonia, Singapore, Iceland, Mauritius and Australia) that experienced a normal or a decrease of mortality for 2020.

Policy conclusions

Further analysis, with more variables which deal with the heterogeneity between countries, are needed in order to investigate COVID-19 policies more deeply. Obviously, every country is an isolated case that needs to be fully understood in detail. By the mortality rates in 2020/2021 we can point out where the policy was appropriate and where it would have been necessary to take a different approach. We can start to focus on the specific COVID-19 restriction policies implemented and the result should reach out to every country.

Can the excess of mortality justify the restriction policies implemented in the different countries? Which restriction policy was successful? Can we apply different restriction policies in different countries?

About the Authors

Dr. Luca Di Gennaro Splendore is a Statistical Consultant, Data Analyst and Electoral and Humanitarian Data Expert. Alessio Crisafulli Carpani is an MSc Student of Statistical Sciences, European Master of Statistical Sciences (EMOS), at the University of Bologna.

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