Mortality in Norway and Sweden during the COVID-19 pandemic 2020-22 : A comparative study
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved..
BACKGROUND: Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV-2 virus. Norway introduced the strictest lockdown in Europe with strict border controls and intense virus tracking of all local outbreaks while Sweden did not. That resulted in 477 COVID-19 deaths (Norway) and 9737 (Sweden) in 2020, respectively.
METHODS: Weekly number of COVID-19 related deaths and total deaths for 2020-22 were collected as well as weekly number of deaths for 2015-19 which were used as controls when calculating excess mortality. During the first 12-18 months with high rate of virus transmission in the society, excess mortality rates were used as substitute for COVID-19 deaths. When excess mortality rates later turned negative because of mortality displacement, COVID-19 deaths adjusted for bias due to overreporting were used.
RESULTS: There were 17521 COVID-19 deaths in Sweden and 4272 in Norway in the study period. The rate ratio (RR) of COVID-19 related deaths in Sweden vs. Norway to the end of week 43, 2022, was 2.11 (95% CI 2.05-2.19). RR of COVID-19 related deaths vs. excess number of deaths were 2.5 (Sweden) and 1.3 (Norway), respectively. RR of COVID-19 deaths in Sweden vs. Norway after adjusting for mortality displacement and lockdown, was 1.35 (95% CI 1.31-1.39), corresponding to saving 2025 life in Norway. If including all deaths in 2022, RR= 1.28 (95% CI 1.24-1.31).
CONCLUSIONS: Both COVID-19 related mortality and excess mortality rates are biased estimates. When adjusting for bias, mortality differences declined over time to about 30% higher mortality in Sweden after 30 months with pandemics.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Journal of infection and public health - 17(2024), 4 vom: 28. März, Seite 719-726 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zahl, Per-Henrik [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 25.03.2024 Date Revised 25.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jiph.2023.10.033 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM367532867 |
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| 100 | 1 | |a Zahl, Per-Henrik |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mortality in Norway and Sweden during the COVID-19 pandemic 2020-22 |b A comparative study |
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| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND: Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV-2 virus. Norway introduced the strictest lockdown in Europe with strict border controls and intense virus tracking of all local outbreaks while Sweden did not. That resulted in 477 COVID-19 deaths (Norway) and 9737 (Sweden) in 2020, respectively | ||
| 520 | |a METHODS: Weekly number of COVID-19 related deaths and total deaths for 2020-22 were collected as well as weekly number of deaths for 2015-19 which were used as controls when calculating excess mortality. During the first 12-18 months with high rate of virus transmission in the society, excess mortality rates were used as substitute for COVID-19 deaths. When excess mortality rates later turned negative because of mortality displacement, COVID-19 deaths adjusted for bias due to overreporting were used | ||
| 520 | |a RESULTS: There were 17521 COVID-19 deaths in Sweden and 4272 in Norway in the study period. The rate ratio (RR) of COVID-19 related deaths in Sweden vs. Norway to the end of week 43, 2022, was 2.11 (95% CI 2.05-2.19). RR of COVID-19 related deaths vs. excess number of deaths were 2.5 (Sweden) and 1.3 (Norway), respectively. RR of COVID-19 deaths in Sweden vs. Norway after adjusting for mortality displacement and lockdown, was 1.35 (95% CI 1.31-1.39), corresponding to saving 2025 life in Norway. If including all deaths in 2022, RR= 1.28 (95% CI 1.24-1.31) | ||
| 520 | |a CONCLUSIONS: Both COVID-19 related mortality and excess mortality rates are biased estimates. When adjusting for bias, mortality differences declined over time to about 30% higher mortality in Sweden after 30 months with pandemics | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Epidemics | |
| 650 | 4 | |a Excess mortality | |
| 650 | 4 | |a Norway | |
| 650 | 4 | |a Public health | |
| 650 | 4 | |a Sweden | |
| 700 | 1 | |a Hemström, Örjan |e verfasserin |4 aut | |
| 700 | 1 | |a Johansen, Rune |e verfasserin |4 aut | |
| 700 | 1 | |a Mamelund, Svenn-Erik |e verfasserin |4 aut | |
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