Impacts of COVID-19 pandemic through decomposition of life expectancy according to leading causes and place of death in Czechia

While the direct effects of the pandemic are well documented, less is known about the indirect ones, including changes in healthcare provision or human behavior. This paper aims to study the impact of indirect consequences on mortality, focusing on two leading causes (cardiovascular diseases, COVID-19) and places of death in Czechia, during the COVID-19 pandemic, one of the most severely affected European countries. The analysis was performed using data from the Czech Statistical Office and the Institute of Health Information and Statistics. The study compares annual mortality changes during three time periods: pre-pandemic (2018-2019), pandemic beginning and peaking (2020-2021), and pandemic fading (2022). Pandemic years were covered by the WHO public health emergency of international concern. Abridged life tables were computed, and Pollard's decomposition was used to calculate the contributions of causes and places of death on annual differences in life expectancy. Seasonal decomposition of monthly time series revealed an increase in cardiovascular mortality at home or in social care facilities corresponding to limitations in healthcare. While COVID-19 had a systemic negative effect on life expectancy during the pandemic, the impact of cardiovascular mortality according to place of death changed over time. This study contributes to the evidence base of systemic risks during health crises and emergency response.

The age structure of cases as the key of COVID-19 severity: Longitudinal population-based analysis of European countries during 150 days

AIMS

Over a million confirmed cases of the coronavirus disease (COVID-19) across 16 European countries were observed during the first wave of the pandemic. Epidemiological measures like the case fatality rate (CFR) are generally used to determine the severity of the illness. The aim is to investigate the impact of the age structure of reported cases on the reported CFR and possibilities of its demographic adjustment for a better cross-country comparison (age-standardized CFRs, time delay between cases detection and death).

METHODS

This longitudinal study uses prospective, population-based data covering 150 days, starting on the day of confirmation of the 100th case in each country. COVerAGE-DB and the Human Mortality Database were used in this regard. The age-standardized CFRs were calculated with and without the time delay of the number of deaths after the confirmation of the cases.

RESULTS

The observed decline in the CFRs at the end of the first wave is partly given by the changes in the age structure of confirmed cases. Using the adjusted (age-standardized) CFRs with time delay, the risk of death among confirmed cases is much more stable in comparison to crude (observed) CFRs.

CONCLUSIONS

Preventing the spread of COVID-19 among the elderly is an important way to positively influence the overall fatality rate, decrease the number of deaths, and not overload the health systems. The crude CFRs (still often presented) are not sufficient for a proper evaluation of the development across populations nor as a means of identifying the influencing factors.

The Czech Republic and Slovakia in Terms of Mortality from Malignant Neoplasms: Similar or Opposite Tendencies?

In Europe, a steady mortality decline has been observed from the 1950s, however, Central and Eastern Europe underwent a period of stagnation or even worsening from the 1960s to 1980s. Since that time an evident mortality decline could be observed in that part of Europe too. Within the post-communist countries, mortality development has been most favourable in Slovenia, the Czech Republic and Slovakia. The aim of this study is to describe the latest development of cancer mortality in two selected countries - the Czech Republic and Slovakia. These two countries have much in common, including many similar long term trends in demographic or social indicators' development. The study evaluates whether cancer mortality development differs in the two countries or rather follows a similar trend. From the presented results it is clear that the development apparently differs namely according to sex. The results according to selected particular causes of death (from the group of malignant neoplasms) are presented as well. It could be assumed that many aspects could be improved by prevention programmes or screening.