Mortality in Norway and Sweden during the COVID-19 pandemic 2020-22: A comparative study
2024 (English) In: Journal of Infection and Public Health, ISSN 1876-0341, E-ISSN 1876-035X, Vol. 17, no 4, p. 719-726Article in journal (Refereed) Published
Abstract [en]
Background: Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV2 virus. Norway introduced the strictest lockdown in Europe with strict border controls and intense virus tracking of all local outbreaks while Sweden did not. That resulted in 477 COVID-19 deaths (Norway) and 9737 (Sweden) in 2020, respectively. Methods: Weekly number of COVID-19 related deaths and total deaths for 2020-22 were collected as well as weekly number of deaths for 2015-19 which were used as controls when calculating excess mortality. During the first 12-18 months with high rate of virus transmission in the society, excess mortality rates were used as substitute for COVID-19 deaths. When excess mortality rates later turned negative because of mortality displacement, COVID-19 deaths adjusted for bias due to overreporting were used. Results: There were 17521 COVID-19 deaths in Sweden and 4272 in Norway in the study period. The rate ratio (RR) of COVID-19 related deaths in Sweden vs. Norway to the end of week 43, 2022, was 2.11 (95% CI 2.05-2.19). RR of COVID-19 related deaths vs. excess number of deaths were 2.5 (Sweden) and 1.3 (Norway), respectively. RR of COVID-19 deaths in Sweden vs. Norway after adjusting for mortality displacement and lockdown, was 1.35 (95% CI 1.31-1.39), corresponding to saving 2025 life in Norway. If including all deaths in 2022, RR= 1.28 (95% CI 1.24-1.31). Conclusions: Both COVID-19 related mortality and excess mortality rates are biased estimates. When adjusting for bias, mortality differences declined over time to about 30% higher mortality in Sweden after 30 months with pandemics. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/).
Place, publisher, year, edition, pages ELSEVIER SCIENCE LONDON , 2024. Vol. 17, no 4, p. 719-726
Keywords [en]
COVID-19, Excess mortality, Norway, Sweden, Epidemics, Public health
National Category
Health Sciences
Identifiers URN: urn:nbn:se:mdh:diva-66649 DOI: 10.1016/j.jiph.2023.10.033 ISI: 001218235900001 PubMedID: 38262870 Scopus ID: 2-s2.0-85183564501 OAI: oai:DiVA.org:mdh-66649 DiVA, id: diva2:1859566
2024-05-222024-05-222024-05-22 Bibliographically approved