IDEAS home Printed from https://ideas.repec.org/a/nat/natcom/v14y2023i1d10.1038_s41467-023-39322-7.html
   My bibliography  Save this article

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
    as

    Download full text from publisher

    File URL: https://www.nature.com/articles/s41467-023-39322-7
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1038/s41467-023-39322-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Correia, Sergio & Luck, Stephan & Verner, Emil, 2022. "Pandemics Depress the Economy, Public Health Interventions Do Not: Evidence from the 1918 Flu," The Journal of Economic History, Cambridge University Press, vol. 82(4), pages 917-957, December.
    2. Gómez-Lobo, Andrés & Gutiérrez, Mauro & Huamaní, Sandro & Marino, Diego & Serebrisky, Tomás & Solís, Ben, 2022. "Access to water and COVID-19: a regression discontinuity analysis for the peri-urban areas of Metropolitan Lima, Peru," IDB Publications (Working Papers) 12332, Inter-American Development Bank.
    3. Andrea M. Tilstra & Antonino Polizzi & Sander Wagner & Evelina T. Akimova, 2024. "Projecting the long-term effects of the COVID-19 pandemic on U.S. population structure," Nature Communications, Nature, vol. 15(1), pages 1-10, December.
    4. Beryne Odeny, 2021. "Closing the health equity gap: A role for implementation science?," PLOS Medicine, Public Library of Science, vol. 18(9), pages 1-4, September.
    5. Kozlov Vladimir & Pahomii Irina & Gagauz Olga & Šmit Jelena, 2024. "Covid-19 Mortality Shock: Demographic and Economic Losses in Moldova," Comparative Southeast European Studies, De Gruyter, vol. 72(1), pages 135-148, March.
    6. Thomas B. Foster & Leticia Fernandez & Sonya R. Porter & Nikolas Pharris-Ciurej, 2022. "Age, Sex, and Racial/Ethnic Disparities and Temporal-Spatial Variation in Excess All-Cause Mortality During the COVID-19 Pandemic: Evidence from Linked Administrative and Census Bureau Data," Working Papers 22-18, Center for Economic Studies, U.S. Census Bureau.
    7. Tamás Hajdu & Judit Krekó & Csaba G. Tóth, 2023. "Inequalities in regional excess mortality and life expectancy during the COVID-19 pandemic in Europe," CERS-IE WORKING PAPERS 2316, Institute of Economics, Centre for Economic and Regional Studies.
    8. Matthew J. Cummings & Barnabas Bakamutumaho & Julius J. Lutwama & Nicholas Owor & Xiaoyu Che & Maider Astorkia & Thomas S. Postler & John Kayiwa & Jocelyn Kiconco & Moses Muwanga & Christopher Nsereko, 2024. "COVID-19 immune signatures in Uganda persist in HIV co-infection and diverge by pandemic phase," Nature Communications, Nature, vol. 15(1), pages 1-18, December.
    9. Alexandre Gori Maia & Jose Daniel Morales Martinez & Leticia Junqueira Marteleto & Cristina Guimaraes Rodrigues & Luiz Gustavo Sereno, 2023. "Can the Content of Social Networks Explain Epidemic Outbreaks?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(1), pages 1-34, February.
    10. Claudio Barbiellini Amidei & Ugo Fedeli & Nicola Gennaro & Laura Cestari & Elena Schievano & Manuel Zorzi & Paolo Girardi & Veronica Casotto, 2023. "Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared," IJERPH, MDPI, vol. 20(11), pages 1-13, May.
    11. Andrea Bellucci & Gianluca Gucciardi, 2023. "A Turning Point for Banking: Unravelling the Changing Landscape of Banking Activity in Europe since the COVID-19 pandemic," Mo.Fi.R. Working Papers 183, Money and Finance Research group (Mo.Fi.R.) - Univ. Politecnica Marche - Dept. Economic and Social Sciences.
    12. Janine Aron & John Muellbauer, 2022. "Excess Mortality Versus COVID‐19 Death Rates: A Spatial Analysis of Socioeconomic Disparities and Political Allegiance Across U.S. States," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 68(2), pages 348-392, June.
    13. Mario Coccia, 2023. "COVID-19 Vaccination is not a Sufficient Public Policy to face Crisis Management of next Pandemic Threats," Public Organization Review, Springer, vol. 23(4), pages 1353-1367, December.
    14. Bratti, Massimiliano & Brunetti, I. & Corvasce, A. & Maida, Agata & Ricci, Andrea, 2024. "Did COVID-19 (Permanently) Raise the Demand for "Teleworkable" Jobs?," IZA Discussion Papers 16906, Institute of Labor Economics (IZA).
    15. M. Otiende & A. Nyaguara & C. Bottomley & D. Walumbe & G. Mochamah & D. Amadi & C. Nyundo & E. W. Kagucia & A. O. Etyang & I. M. O. Adetifa & S. P. C. Brand & E. Maitha & E. Chondo & E. Nzomo & R. Ama, 2023. "Impact of COVID-19 on mortality in coastal Kenya: a longitudinal open cohort study," Nature Communications, Nature, vol. 14(1), pages 1-9, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-39322-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.nature.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.