The estimated disease burden of acute COVID-19 in the Netherlands in 2020, in disability-adjusted life-years

Projecting COVID-19 intensive care admissions for policy advice, the Netherlands, February 2020 to January 2021

BackgroundModel projections of coronavirus disease 2019 (COVID-19) incidence help policymakers about decisions to implement or lift control measures. During the pandemic, policymakers in the Netherlands were informed on a weekly basis with short-term projections of COVID-19 intensive care unit (ICU) admissions.AimWe aimed at developing a model on ICU admissions and updating a procedure for informing policymakers.MethodThe projections were produced using an age-structured transmission model. A consistent, incremental update procedure integrating all new surveillance and hospital data was conducted weekly. First, up-to-date estimates for most parameter values were obtained through re-analysis of all data sources. Then, estimates were made for changes in the age-specific contact rates in response to policy changes. Finally, a piecewise constant transmission rate was estimated by fitting the model to reported daily ICU admissions, with a changepoint analysis guided by Akaike's Information Criterion.ResultsThe model and update procedure allowed us to make weekly projections. Most 3-week prediction intervals were accurate in covering the later observed numbers of ICU admissions. When projections were too high in March and August 2020 or too low in November 2020, the estimated effectiveness of the policy changes was adequately adapted in the changepoint analysis based on the natural accumulation of incoming data.ConclusionThe model incorporates basic epidemiological principles and most model parameters were estimated per data source. Therefore, it had potential to be adapted to a more complex epidemiological situation with the rise of new variants and the start of vaccination.

Estimating the disability adjusted life years associated with COVID-19 in Iran for the first 2 years of the pandemic

Background

The World Health Organization (WHO) declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on 11 March 2020. Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The purpose of this study was to estimate DALYs due to COVID-19 in Iran for the first 2 years of the pandemic.

Methods

DALYs were estimated as the sum of Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) associated with COVID-19 in Iran from 19 February 2020 to 20 March 2022. The life expectancy for COVID-19 YLL estimations was based on the Global Burden of Disease (GBD) 2019 study.

Results

There were 15,639,243 outpatients and 1,170,602 hospitalized confirmed cases, of which 120,965 deaths were as a direct result of COVID-19. DALYs were estimated to be 2,376,552. Overall, YLL contributed to 99.34% of the DALYs, while the remaining 0.66% was attributed to YLD.

Conclusion

COVID-19 had a significant impact on population health in Iran during the first 2 years of the pandemic; this study provides a comprehensive depiction of COVID-19's burden and is helpful for comparing its impact with other diseases in the population and across populations.

The estimated disease burden of COVID-19 in Japan from 2020 to 2021

BACKGROUND

To date, it is not fully understood to what extent COVID-19 has burdened society in Japan. This study aimed to estimate the total disease burden due to COVID-19 in Japan during 2020-2021.

METHODS

We stratify disease burden estimates by age group and present it as absolute Quality Adjusted Life Years (QALYs) lost and QALYs lost per 100,000 persons. The total estimated value of QALYs lost consists of (1) QALYs lost brought by deaths due to COVID-19, (2) QALYs lost brought by inpatient cases, (3) QALYs lost brought by outpatient cases, and (4) QALYs lost brought by long-COVID.

RESULTS

The total QALYs lost due to COVID-19 was estimated as 286,782 for two years, 114.0 QALYs per 100,000 population per year. 71.3% of them were explained by the burden derived from deaths. Probabilistic sensitivity analysis showed that the burden of outpatient cases was the most sensitive factor.

CONCLUSIONS

The large part of disease burden due to COVID-19 in Japan from the beginning of 2020 to the end of 2021 was derived from Wave 3, 4, and 5 and the proportion of QALYs lost due to morbidity in the total burden increased gradually. The estimated disease burden was smaller than that in other high-income countries. It will be our future challenge to take other indirect factors into consideration.

Has COVID-19 increased inequality in mortality by income in the Netherlands?

BACKGROUND

In the Netherlands in 2020, COVID-19 deaths were more concentrated among individuals with a lower income. At the same time, COVID-19 was a new cause that also displaced some deaths from other causes, potentially reducing income-related inequality in non-COVID deaths. Our aim is to estimate the impact of the COVID-19 pandemic on the income-related inequality in total mortality and decompose this into the inequality in COVID-attributed deaths and changes in the inequality in non-COVID causes.

METHODS

We estimate excess deaths (observed minus trend-predicted deaths) by sex, age and income group for the Netherlands in 2020. Using a measure of income-related inequality (the concentration index), we decompose the inequality in total excess mortality into COVID-19 versus non-COVID causes.

RESULTS

Cause-attributed COVID-19 mortality exceeded total excess mortality by 12% for the 65-79 age group and by about 35% for 80+ in the Netherlands in 2020, implying a decrease in the number of non-COVID deaths compared with what was predicted. The income-related inequality in all-cause mortality was higher than predicted. This increase in inequality resulted from the combination of COVID-19 mortality, which was more unequally distributed than predicted total mortality, and the inequality in non-COVID causes, which was less unequal than predicted.

CONCLUSION

The COVID-19 pandemic has led to an increase in income-related inequality in all-cause mortality. Non-COVID mortality was less unequally distributed than expected due to displacement of other causes by COVID-19 and the potentially unequal broader societal impact of the pandemic.

Burden of COVID‐19 disease in Kurdistan province in west of Iran using disability‐adjusted life years

Background and Aims

During the coronavirus disease 2019 (COVID‐19) pandemic, about seven million people were infected with the disease, of which more than 133,000 died. Health policymakers need to know the extent and magnitude of the disease burden to decide on how much to allocate resources for disease control. The results of this investigation could be helpful in this field.

Methods

We used the secondary data released by the Kurdistan University of Medical Sciences between February 2020 to October 2021 to estimate the age‐sex standardized disability‐adjusted life years (DALY) by the sum of the years of life lived with disability (YLD) and the years of life lost (YLL). We also applied the local and specific values of the disease utility in the calculations.

Results

The total DALY was estimated at 23316.5 and 1385.5 per 100,000 populations The YLD and YLL constituted 1% and 99% of the total DALY, respectively. The DALY per 100,000 populations was highest in the men and people aged more than 65 years, but the prevalence was the highest in people under the age of 40.

Conclusions

Compared to the findings of the “burden of disease study 2019,” the burden of COVID‐19 in Iran is ranked first and eighth among communicable and noncommunicable diseases, respectively. Although the disease affects all groups, the elderly suffer the most from it. Given the very high YLL of COVID‐19, the best strategy to reduce the burden of COVID‐19 in subsequent waves should be to focus on preventing infection in the elderly population and reducing mortality.