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Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city

Author

Listed:
  • Joseph A. Lewnard

    (University of California, Berkeley
    University of California, Berkeley
    College of Engineering, University of California, Berkeley)

  • Chandra Mohan B

    (Indian Administrative Service)

  • Gagandeep Kang

    (Christian Medical College)

  • Ramanan Laxminarayan

    (One Health Trust
    Princeton University)

Abstract

Globally, excess deaths during 2020–21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality related to pandemic control measures using medically-certified death registrations from Madurai, India—an urban center with well-functioning vital surveillance. Between March, 2020 and July, 2021, all-cause deaths in Madurai exceeded expected levels by 30% (95% confidence interval: 27–33%). Although driven by deaths attributed to cardiovascular or cerebrovascular conditions, diabetes, senility, and other uncategorized causes, increases in these attributions were restricted to medically-unsupervised deaths, and aligned with surges in confirmed or attributed COVID-19 mortality, likely reflecting mortality among unconfirmed COVID-19 cases. Implementation of lockdown measures was associated with a 7% (0–13%) reduction in all-cause mortality, driven by reductions in deaths attributed to injuries, infectious diseases and maternal conditions, and cirrhosis and other liver conditions, respectively, but offset by a doubling in cancer deaths. Our findings help to account for gaps between documented COVID-19 mortality and excess all-cause mortality during the pandemic in an LMIC setting.

Suggested Citation

  • Joseph A. Lewnard & Chandra Mohan B & Gagandeep Kang & Ramanan Laxminarayan, 2023. "Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-39322-7
    DOI: 10.1038/s41467-023-39322-7
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    References listed on IDEAS

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    1. William Msemburi & Ariel Karlinsky & Victoria Knutson & Serge Aleshin-Guendel & Somnath Chatterji & Jon Wakefield, 2023. "The WHO estimates of excess mortality associated with the COVID-19 pandemic," Nature, Nature, vol. 613(7942), pages 130-137, January.
    2. Shakil Ahmed & M Omar Khaium & Fabeha Tazmeem, 2020. "COVID-19 lockdown in India triggers a rapid rise in suicides due to the alcohol withdrawal symptoms: Evidence from media reports," International Journal of Social Psychiatry, , vol. 66(8), pages 827-829, December.
    3. , Aman & N, Thejesh G & Ranaware, Krushna & Sharma, Kanika, 2021. "Of denial and data: Deaths due to India’s COVID-19 national lockdown," SocArXiv h9knu, Center for Open Science.
    4. John-Sebastian Eden & Chisha Sikazwe & Ruopeng Xie & Yi-Mo Deng & Sheena G. Sullivan & Alice Michie & Avram Levy & Elena Cutmore & Christopher C. Blyth & Philip N. Britton & Nigel Crawford & Xiaomin D, 2022. "Off-season RSV epidemics in Australia after easing of COVID-19 restrictions," Nature Communications, Nature, vol. 13(1), pages 1-9, December.
    5. Andrew C Stokes & Dielle J Lundberg & Irma T Elo & Katherine Hempstead & Jacob Bor & Samuel H Preston, 2021. "COVID-19 and excess mortality in the United States: A county-level analysis," PLOS Medicine, Public Library of Science, vol. 18(5), pages 1-18, May.
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