The current outbreak of COVID-19 has called renewed attention to the need for sound statistical analysis for monitoring mortality patterns and trends over time. Excess mortality has been suggested as the most appropriate indicator to measure the overall burden of the pandemic on mortality. As such, excess mortality has received considerable interest during the first months of the COVID-19 pandemic. Previous approaches to estimate excess mortality are somewhat limited, as they do not include sufficiently long-term trends, correlations among different demographic and geographic groups, and the autocorrelations in the mortality time series. This might lead to biased estimates of excess mortality, as random mortality fluctuations may be misinterpreted as excess mortality. We present a blend of classical epidemiological approaches to estimating excess mortality during extraordinary events with an established demographic approach in mortality forecasting, namely a Lee-Carter type model, which covers the named limitations and draws a more realistic picture of the excess mortality. We illustrate our approach using weekly age- and sex-specific mortality data for 19 countries and the current COVID-19 pandemic as a case study. Our proposed model provides a general framework that can be applied to future pandemics as well as to monitor excess mortality from specific causes of deaths.
翻译:目前COVID-19的爆发要求人们重新注意需要健全的统计分析来监测死亡率的格局和趋势,认为过高的死亡率是衡量这一流行病对死亡率的总体负担的最适当的指标,因此,在COVID-19大流行的头几个月中,过量死亡率引起了相当大的兴趣。以前估计超额死亡率的方法有些有限,因为它们没有包括足够长期的趋势、不同人口和地理群体之间的相互关系以及死亡率时间序列中的自动关系。这可能导致对超额死亡率的偏差估计,因为随机死亡率波动可能被误解为超额死亡率。我们提出了一种典型的流行病学方法,用以估计非常事件期间超额死亡率,同时在死亡率预测中采用既定的人口统计方法,即Lee-Carter型模型,其中涵盖已点名的局限性,并更现实地描绘超额死亡率。我们用19个国家按年龄和性别分类的每周死亡率数据以及目前的COVID-19大流行数据作为案例研究,说明我们的方法。我们提议的模型提供了一个总的框架,可以适用于未来的流行病,并监测特定死因造成的超额死亡率。