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. 2022 Jan:202:52-57.
doi: 10.1016/j.puhe.2021.03.025. Epub 2021 Apr 21.

Mortality comparisons of COVID-19 with all-cause and non-communicable diseases in Cyprus, Iceland and Malta: lessons learned and forward planning

S Cuschieri  1 , E Pallari  2 , A Hatziyianni  3 , R Sigurvinsdottir  4 , I D Sigfusdottir  5 , Á K Sigurðardóttir  6
Affiliations

Mortality comparisons of COVID-19 with all-cause and non-communicable diseases in Cyprus, Iceland and Malta: lessons learned and forward planning

S Cuschieri et al. Public Health. 2022 Jan.

Abstract

Objectives: The COVID-19 pandemic has spread throughout the world, including Cyprus, Iceland and Malta. Considering the small population sizes of these three island countries, it was anticipated that COVID-19 would be adequately contained and mortality would be low. This study aims to compare and contrast COVID-19 mortality with mortality from all causes and common non-communicable diseases (NCDs) over 8 months between these three islands.

Methods: Data were obtained from the Ministry of Health websites and COVID dashboards from Cyprus, Iceland and Malta. The case-to-fatality ratio (CFR) and years of life lost (YLLs) were calculated. Comparisons were made between the reported cases, deaths, CFR, YLLs, swabbing rates, restrictions and mitigation measures.

Results: Low COVID-19 case numbers and mortality rates were observed during the first wave and transition period in Cyprus, Iceland and Malta. The second wave saw a drastic increase in the number of confirmed cases and mortality rates, especially for Malta, with high CFR and YLLs. Similar restrictions and measures were evident across the three island countries. Results show that COVID-19 mortality was generally lower than mortality from NCDs.

Conclusions: The study highlights that small geographical and population size, along with similar restrictive measures, did not appear to have an advantage against the spread and mortality rate of COVID-19, especially during the second wave. Population density, an ageing population and social behaviours may play a role in the burden of COVID-19. It is recommended that a country-specific syndemic approach is used to deal with the local COVID-19 spread based on the population's characteristics, behaviours and the presence of other pre-existing epidemics.

Keywords: Case fatality rate; Coronavirus; Cyprus; Iceland; Islands; Malta; Mortality; Non-communicable disease; Syndemic.

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Figures

Fig. 1
Fig. 1
COVID-19–positive cases: 7-day moving average for Cyprus, Iceland and Malta between March and November 2020., ,
Fig. 2
Fig. 2
COVID-19 average PCR swabbing rate for Cyprus, Iceland and Malta between March and November 2020., , PCR, polymerase chain reaction.
Fig. 3
Fig. 3
COVID-19 mortality cases and CFR in Cyprus, Iceland and Malta between March and November 2020. CFR, case-to-fatality ratio.
Fig. 4
Fig. 4
COVID-19 mortality by age groups and gender in Cyprus, Iceland and Malta between March and November 2020.
See this image and copyright information in PMC

References

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