Excess mortality due to COVID-19 in Germany

Abstract

Objectives: The first wave of the SARS-CoV-2 pandemic in Germany lasted from week 10 to 23 in 2020. The aim is to provide estimates of excess mortality in Germany during this time.

Methods: We analyzed age-specific numbers of deaths per week from 2016 to week 26 in 2020. We used weekly mean numbers of deaths of 2016-2019 to estimate expected weekly numbers for 2020. We estimated standardized mortality ratios (SMR) and 95% confidence intervals.

Results: During the first wave observed numbers of deaths were higher than expected for age groups 60-69, 80-89, and 90+. The age group 70-79 years did not show excess mortality. The net excess number of deaths for weeks 10-23 was +8,071. The overall SMR was 1•03 (95%CI 1•03-1•04). The largest increase occurred among people aged 80-89 and 90+ (SMR=1•08 and SMR=1•09). A sensitivity analysis that accounts for demographic changes revealed an overall SMR of 0•98 (95%CI 0•98-0•99) and a deficit of 4,926 deaths for week 10-23, 2020.

Conclusions: The excess mortality existed for two months. The favorable course of the first wave may be explained by a younger age at infection at the beginning of the pandemic, lower contact rates, and a more efficient pandemic management.

Keywords: COVID-19; Corona virus; Germany; Mortality; Pandemic.

Fig. 1

Weekly confirmed SARS-CoV2 infections, weekly number of deaths associated with COVID-19 (Fig. 1a) daily treated COVID-19 patients in intensive care units and in Germany, week 10–23. 2020 (Fig. 1b). Legend: weekly new ICU cases were available starting from week 13, 2020; before week 17, 2020, the reported number of weekly new ICU cases may underestimate the true number because of incompleteness of registration.

Fig. 2

Average number of weekly deaths in 2016–2019 and number of weekly death in 2020 by age group and weekly number of SARS-CoV-2 confirmed new cases in Germany, week 1–26, 2020. Legend Fig. 2: gray graph shows the average number of weekly deaths of the years 2016–2019; red graph shows the weekly number of death in 2020; blue graphs shows the weekly number of SARS-CoV-2 confirmed new cases in Germany. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 3

Weekly standardized mortality ratios and 95% confidence intervals for overall mortality in Germany, week 1–26 in 2020 and weekly number of newly confirmed SARS-CoV-2 cases weeks 10–26, 2020 in Germany. Legend Fig. 3: bold negative or positive numbers of death indicate whether during week 10–23 in 2020 there were more or less deaths compared to the average number of deaths in these weeks during 2016–2019; gray bands indicate 95% confidence intervals.