Ikke-COVID-19-relateret overdødelighed

Nyt interessant studie fra Mulligan og Arnott (2022). Her er abstract (min fremhævning):

From April 2020 through at least the end of 2021, Americans died from non-Covid causes at an average annual rate 97,000 in excess of previous trends. Hypertension and heart disease deaths combined were elevated 32,000. Diabetes or obesity, drug-induced causes, and alcohol-induced causes were each elevated 12,000 to 15,000 above previous (upward) trends. Drug deaths especially followed an alarming trend, only to significantly exceed it during the pandemic to reach 108,000 for calendar year 2021. Homicide and motor-vehicle fatalities combined were elevated almost 10,000. Various other causes combined to add 18,000. While Covid deaths overwhelmingly afflict senior citizens, absolute numbers of non-Covid excess deaths are similar for each of the 18-44, 45-64, and over-65 age groups, with essentially no aggregate excess deaths of children. Mortality from all causes during the pandemic was elevated 26 percent for workingage adults (18-64), as compared to 18 percent for the elderly. Other data on drug addictions, nonfatal shootings, weight gain, and cancer screenings point to a historic, yet largely unacknowledged, health emergency.

Min første tanke, da jeg havde læst abstractet, var, at man nok skal være påpasselig med at konkludere, at de ekstra dødsfald skyldes nedlukningerne, da vi ved, at frivillige adfærdsændringer var særdeles fremtrædende under pandemien. Det er også noget, forfatterne bemærker (igen min fremhævning).

Critics will likely suggest that the public policy choices did not lead to the large number of non-Covid excess deaths, that these excess deaths were a consequence of personal choices, driven by fear or boredom. We do not disagree that this may be a key driver of excess non-Covid deaths. But, we would point out that this is no excuse for ignoring this soaring death toll, or pushing an examination of these deaths to the back burner

Man skal dog huske, at nedlukningerne på mange måder har gjort det meget mere omkostningsfuldt for den enkelte at passe på. Mest åbenlyst er dette i lande, der har haft udgangsforbud, på trods af at man længe (vel i realiteten længe før corona) har vidst, at risikoen for at blive smittet udendørs er stort set nul. Udendørs forsamlingsforbud har også øget omkostningerne, fordi man ikke har kunnet mødes med sine venner under sikre forhold.

Hvor stor en del af de samlede omkostninger, der skyldes nedlukningerne – og ikke selve pandemien – har jeg ikke set et videnskabeligt bud på endnu. Men endnu et resultat fra Mulligan og Arnott (2022) giver et hint om, at omkostningerne ved nedlukningerne kan have været relativt store (min fremhævning).

The estimate for Sweden is -33, meaning that non-Covid causes of death were somewhat low during the pandemic. We suspect that some of the international differences are due to the standard used to designate a death as Covid, but perhaps also Sweden’s result is related to minimizing the disruption of its citizen’s normal lifestyles.

Om den lave ikke-COVID-19-dødelighed i Sverige kan tilskrives deres manglende nedlukning er usikkert. Men svenskerne havde i store dele af pandemien mulighed for at mødes, og faren ved COVID-19 blev – bl.a. fordi de undervurderede sygdommen i starten af pandemien – omtalt langt mere afdæmpet i Sverige, hvilket også kan have påvirket svenskernes (mentale) helbred til det bedre.

Det bliver interessant at følge forskningen på dette område fremadrettet.

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