Leticia Cuéllar1, Irene Torres2, Ethan Romero-Severson3, Riya Mahesh3,4, Nathaniel Ortega3,5, Sarah Pungitore3,6, Nicolas Hengartner3, Ruian Ke3. 1. A-1 Information Systems and Modeling, Analytics, Intelligence and Technology Division, Los Alamos National Laboratory, NM87545, USA. 2. Fundación Octaedro, Quito, Ecuador. 3. T-6 Theoretical Biology and Biophysics, Theoretical Division, Los Alamos National Laboratory, NM87545, USA. 4. Department of Biology, University of Texas, Austin, Texas, 78712, USA. 5. University of California Santa Barbara, Santa Barbara, CA 93106, USA. 6. Program in Applied Mathematics, University of Arizona, Tucson, Arizona 85721, USA.
Abstract
BACKGROUND: In early 2020, Ecuador reported one of the highest surges of per capita deaths across the globe. METHODS: We collected a comprehensive dataset containing individual death records between 2015 and 2020 from the Ecuadorian National Institute of Statistics and Census and the Ecuadorian Ministry of Government. We computed the number of excess deaths across time, geographical locations and demographic groups using Poisson regression methods. RESULTS: Between January 1 st and September 23 rd , 2020, the number of excess deaths in Ecuador is 36,402 (95% CI: 35,762-36,827) or 208 per 10 5 population, which is 171% of the expected deaths in that period in a typical year. Only 20% of the excess deaths are attributable to confirmed COVID-19 deaths. Strikingly, in provinces that were most affected by COVID-19, such as Guayas and Santa Elena, the all-cause deaths are more than double the expected number of deaths that would have occurred in a normal year. The extent of excess deaths in men is higher than in women, and the number of excess deaths increases with age. Indigenous populations had the highest level of excess deaths among all ethnic groups. CONCLUSIONS: Overall, the exceptionally high level of excess deaths in Ecuador highlights the enormous burden and heterogeneous impact of COVID-19 on mortality especially in older age groups and indigenous populations in Ecuador that was not fully revealed by COVID-19 death counts. Together with the limited testing in Ecuador, our results suggest that the majority of the excess deaths were likely to be undocumented COVID-19 deaths.
BACKGROUND: In early 2020, Ecuador reported one of the highest surges of per capita deaths across the globe. METHODS: We collected a comprehensive dataset containing individual death records between 2015 and 2020 from the Ecuadorian National Institute of Statistics and Census and the Ecuadorian Ministry of Government. We computed the number of excess deaths across time, geographical locations and demographic groups using Poisson regression methods. RESULTS: Between January 1 st and September 23 rd , 2020, the number of excess deaths in Ecuador is 36,402 (95% CI: 35,762-36,827) or 208 per 10 5 population, which is 171% of the expected deaths in that period in a typical year. Only 20% of the excess deaths are attributable to confirmed COVID-19 deaths. Strikingly, in provinces that were most affected by COVID-19, such as Guayas and Santa Elena, the all-cause deaths are more than double the expected number of deaths that would have occurred in a normal year. The extent of excess deaths in men is higher than in women, and the number of excess deaths increases with age. Indigenous populations had the highest level of excess deaths among all ethnic groups. CONCLUSIONS: Overall, the exceptionally high level of excess deaths in Ecuador highlights the enormous burden and heterogeneous impact of COVID-19 on mortality especially in older age groups and indigenous populations in Ecuador that was not fully revealed by COVID-19 death counts. Together with the limited testing in Ecuador, our results suggest that the majority of the excess deaths were likely to be undocumented COVID-19 deaths.
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