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. 2023 May 25;18(5):e0272752.
doi: 10.1371/journal.pone.0272752. eCollection 2023.

Assessing COVID-19 pandemic excess deaths in Brazil: Years 2020 and 2021

Saditt Rocio Robles Colonia  1 , Lara Morena Cardeal  1 , Rogério Antonio de Oliveira  2 , Luzia Aparecida Trinca  2
Affiliations

Assessing COVID-19 pandemic excess deaths in Brazil: Years 2020 and 2021

Saditt Rocio Robles Colonia et al. PLoS One. .

Abstract

We estimated the impact of the COVID-19 pandemic on mortality in Brazil for 2020 and 2021 years. We used mortality data (2015-2021) from the Brazilian Health Ministry for forecasting baseline deaths under non-pandemic conditions and to estimate all-cause excess deaths at the country level and stratified by sex, age, ethnicity and region of residence, from March 2020 to December 2021. We also considered the estimation of excess deaths due to specific causes. The estimated all-cause excess deaths were 187 842 (95% PI: 164 122; 211 562, P-Score = 16.1%) for weeks 10-53, 2020, and 441 048 (95% PI: 411 740; 470 356, P-Score = 31.9%) for weeks 1-52, 2021. P-Score values ranged from 1.4% (RS, South) to 38.1% (AM, North) in 2020 and from 21.2% (AL and BA, Northeast) to 66.1% (RO, North) in 2021. Differences among men (18.4%) and women (13.4%) appeared in 2020 only, and the P-Score values were about 30% for both sexes in 2021. Except for youngsters (< 20 years old), all adult age groups were badly hit, especially those from 40 to 79 years old. In 2020, the Indigenous, Black and East Asian descendants had the highest P-Score (26.2 to 28.6%). In 2021, Black (34.7%) and East Asian descendants (42.5%) suffered the greatest impact. The pandemic impact had enormous regional heterogeneity and substantial differences according to socio-demographic factors, mainly during the first wave, showing that some population strata benefited from the social distancing measures when they could adhere to them. In the second wave, the burden was very high for all but extremely high for some, highlighting that our society must tackle the health inequalities experienced by groups of different socio-demographic statuses.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Weekly all-cause mortality in Brazil from week 1, 2015 to week nine, 2020.
Recorded and fitted mortality by the LMM and the GEE approach.
Fig 2
Fig 2. Weekly all-cause mortality in Brazil from week 1, 2015 to week 52, 2021.
Recorded and baseline mortality forecast by the LMM and the forecast plus observed COVID-19 deaths including 95% prediction intervals (PI) for 2020 and 2021.
Fig 3
Fig 3. Weekly mortality in Brazil, stratified by death cause, from week 1, 2015 to week 52, 2021.
Recorded and baseline mortality forecast by the LMM including 95% prediction intervals (PI) for 2020 and 2021.
Fig 4
Fig 4. P-Score (left panel) and RatioEC (center panel) for each state, accumulated for two periods, weeks 10–53, 2020 (left in both panels) and weeks 1–52, 2021 (right in both panels).
Human Development Index (for year 2017) and Vaccination Coverage (2 doses), population share by 21 January 2023, for each state (right panel). The vertical lines mark the values at the country level.
Fig 5
Fig 5. Weekly mortality in Brazil, stratified by sex (A) and race/color (B), from week 1, 2015 to week 52, 2021.
Recorded and baseline mortality forecast by the LMM including 95% prediction intervals (PI) for 2020 and 2021.
Fig 6
Fig 6. Weekly mortality in Brazil, stratified by age group, from week 1, 2015 to week 52, 2021.
Recorded and baseline mortality forecast by the LMM including 95% prediction intervals (PI) for 2020 and 2021.
See this image and copyright information in PMC

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