Excess Deaths associated with the COVID-19 Pandemic in Ukraine in 2020

  1. Neil K. Mehta
  2. Ihor Honchar
  3. Olena Doroshenko
  4. Igor Brovchenko
  5. Khrystyna Pak
  6. Maria Danyuk
  7. Pavlo Polikarchuk

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Abstract

COVID-19 related mortality has been understudied in Ukraine. As part of a World Bank project, we estimated excess mortality in Ukraine during 2020. Data on all deaths registered in government-controlled Ukraine from 2016-2020 (N=2,946,505) were utilized. We predicted deaths in 2020 by five-year age groups, sex, and month and calculated the number of deaths that deviated from expected levels (excess deaths). We compared excess deaths with the number of recorded COVID-19 deaths on death certificates and with published estimates for 30 European countries. We estimated 38,095 excess deaths in 2020 (6% of all deaths). Death rates were above expected levels in February and from June-December and lower in January and March-May. From June-December, we estimated 52,124 excess deaths with a peak in November (16,891 deaths). COVID-19 recorded deaths were approximately one-third of excess deaths in June-December (18,959 vs. 52,124). Higher than expected mortality was detected for all age groups 40-44 years and above and for those ages 0-4, 15-19, and 20-24. Ukraine’s excess mortality was about average compared to 30 other European countries. Excess deaths may be attributed directly to SARS-COV2 infection or indirectly to death causes associated with social and economic upheavals resulting in from the pandemic. Lower than expected mortality during the early part of 2020 is consistent with low influenza activity and reductions in deaths from restricted movement. Further studies are required to examine the causes of death that have contributed to positive excess mortality, particularly among younger aged groups.

Key Messages

  • Ukraine has experienced sizeable changes in its recent demography and the impact of the COVID-19 pandemic on the country’s aggregate mortality patterns is understudied

  • Based on recent death trends, we found that Ukraine experienced lower than expected mortality during the early part of 2020 and consistently higher than expected mortality from June-December with peak levels occurring in November

  • Positive excess mortality was observed for all age groups beginning at ages 40-44 as well as some younger age groups.

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    SciScore for 10.1101/2021.09.28.21264266: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our results need to be interpreted in the context of the strengths and limitations of the excess death metric and our approach. The main strength of the metric is that it does not rely on the capacity of a country to detect all COVID-19 cases and code deaths resulting from coronavirus infection on the death certificate accordingly. The metric also provides a yardstick to measure the full death toll of the pandemic including deaths directly attributable to the virus and deaths attributable to the broader social and economic shocks that nations underwent. By incorporating recent trends in our model, rather than the “average” approach that is commonly used, we leveraged the stability of mortality trends. The “average” approach using 2015-2019 data would have resulted in an estimate of 26,200 excess deaths for 2020, smaller than our estimate. A main limitation of the excess death metric is that it does not isolate the directly attributable to coronavirus infection from other deaths that may be associated with social and economic upheavals created by the pandemic. Ukraine’s aggressive action in terms of limiting social interactions in early March likely limited deaths during this early period. Unlike other European countries, Ukraine did not experience an early death surge. The country recorded its first confirmed COVID-19 coded deaths in March (24 deaths). Although 302 COVID-19 coded deaths were recorded in March and April combined, our estimates indicate that Ukraine experienced...

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    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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  2. Version published to 10.1101/2021.09.28.21264266v1 on medRxiv