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. 2025 May 29;47(2):217-221.
doi: 10.1093/pubmed/fdaf015.

All-cause excess mortality following Storm Daniel flood event in Greece

Evdoxia Valavani  1 , Vasilis Bellos  2 , Fani Apostolidou-Kiouti  3 , Alexis Benos  1 , Elias Kondilis  1
Affiliations

All-cause excess mortality following Storm Daniel flood event in Greece

Evdoxia Valavani et al. J Public Health (Oxf). .

Abstract

Background: Storm Daniel, characterized as the most severe 21st century flood event in Greece, struck the Regions of Thessaly and Central Greece in early September 2023, resulting in 17 reported direct fatalities.

Methods: This study evaluated all-cause excess mortality in the prefectures of Fthiotida, Karditsa/Trikala and Magnesia affected by Storm Daniel. We compared weekly deaths during the first week and the 90 days following the flood, to expected deaths based on historical trends 2015-2019.

Results: During the week of the flooding event, Fthiotida, Karditsa/Trikala and Magnesia prefectures experienced mortality increases of 57% (95%CI: 19%-95%), 40% (95%CI: 13%-66%) and 39% (95%CI: 7%-70%) over expected levels, respectively. A total of 54 (95% CI: 31-77) excess deaths were recorded during the week of Storm Daniel's landfall, with the cumulative number of excess deaths reaching to 335 (95% CI: 250-420) over subsequent 90 days.

Conclusion: Conventional approaches that focus solely on immediate and direct flood fatalities underestimate the overall and actual health risks faced by flood-affected communities. Floods have complex and long-term health effects, necessitating continuous monitoring of the affected communities.

Keywords: Storm Daniel; excess deaths; excess mortality; floods.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
(A) Percentage change over expected mortality in Karditsa/Trikala, Magnesia, and Fthiotida (September 2022 – December 2023). The blue lines and the blue ribbons correspond to the percent change over expected mortality and the corresponding 95% CI, respectively. The red dashed lines correspond to the landfall of Storm Daniel. The grey dots represent the observed weekly death counts. B) Cumulative excess deaths from September 5th, 2023, to December 3rd, 2023, in Karditsa/Trikala, Magnesia, and Fthiotida. The red points and red ribbons correspond to the estimated cumulative excess deaths and the corresponding 95% CI, respectively.
Figure 2
Figure 2
Cumulative excess deaths from 5 September 2023 to 3 December 2023, across the prefectures of Greece. The black points and gray ribbons correspond to the estimated cumulative excess deaths and the corresponding 95% CI, respectively. For the flood-affected areas, magnesia, Karditsa/Trikala, and Fthiotida, the red lines and the red ribbons correspond to the estimated cumulative excess deaths and the corresponding 95% CI, respectively.
See this image and copyright information in PMC

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