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Estimation of Excess All-Cause Mortality Due to COVID-19 in Thailand.

ABSTRACT: Thailand has experienced the most prominent COVID-19 outbreak in 2021, resulting in a new record for COVID-19 cases and deaths. To assess the influence of the COVID-19 outbreak on mortality, we estimated excess all-cause and pneumonia mortality in Thailand during the COVID-19 outbreak from April to October 2021. We used mortality from the previous 5 years to estimate the baseline number of deaths using generalized linear mixed models. The models were adjusted for seasonality and demographics. We found that, during the outbreak in 2021, there was a significant rise in excess fatalities, especially in the older age groups. The estimated cumulative excess death was 14.3% (95% CI: 8.6-18.8%) higher than the baseline. The results also showed that the excess deaths in males were higher than in females by approximately 26.3%. The excess deaths directly caused by the COVID-19 infections accounted for approximately 75.0% of the all-cause excess deaths. Furthermore, excess pneumonia deaths were also found to be 26.2% (95% CI: 4.8-46.0%) above baseline.

SUBMITTER: Wilasang C

PROVIDER: S-EPMC9322618 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThere is a limited body of research specifically examining gender inequality in excess mortality and its variations across age groups and geographical locations during the COVID-19 pandemic. This study aims to fill this gap by analyzing the patterns of gender inequality in excess all-cause mortality in Thailand during the COVID-19 pandemic.MethodsData pertaining to all-cause deaths and population between January 1, 2010, and December 31, 2021, were obtained from Thailand's Bureau of Registration Administration. A seasonal autoregressive integrated moving average (SARIMA) technique was used to estimate excess mortality during the pandemic between January 2020 to December 2021. Gender differential excess mortality was measured as the difference in age-standardized mortality rates between men and women.ResultsOur SARIMA-based estimate of all-cause mortality in Thailand during the COVID-19 pandemic amounted to 1,032,921 deaths, with COVID-19-related fatalities surpassing official figures by 1.64 times. The analysis revealed fluctuating patterns of excess and deficit in all-cause mortality rates across different phases of the pandemic, as well as among various age groups and regions. In 2020, the most pronounced gender disparity in excess all-cause mortality emerged in April, with 4.28 additional female deaths per 100,000, whereas in 2021, the peak gender gap transpired in August, with 7.52 more male deaths per 100,000. Individuals in the 80 + age group exhibited the largest gender gap for most of the observed period. Gender differences in excess mortality were uniform across regions and over the period observed. Bangkok showed the highest gender disparity during the peak of the fourth wave, with 24.18 more male deaths per 100,000.ConclusionThe findings indicate an overall presence of gender inequality in excess mortality during the COVID-19 pandemic in Thailand, observed across age groups and regions. These findings highlight the need for further attention to be paid to gender disparities in mortality and call for targeted interventions to address these disparities.

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Estimation of Excess All-Cause Mortality Due to COVID-19 in Thailand.

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