Excess mortality - statistics


Data extracted on 13 September 2021

Planned article update: 15 October 2021

Highlights


In July 2021, excess mortality in the EU further decreased to 4.4%, the lowest rate since July 2020.

Excess mortality continues to vary across Member States: from -3% in Belgium and Sweden to +25% in Greece and +26% in Cyprus in July 2021.

In the whole period between January 2020 and July 2021, the highest rates of excess mortality were recorded in April 2020 (25.3%) and November 2020 (40.0%).


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In this article, excess mortality refers to the number of deaths from all causes measured during a crisis, above what could be observed under ‘normal’ conditions. The excess mortality indicator, part of the European Statistical Recovery Dashboard, highlights the magnitude of the health crisis by providing a comprehensive comparison of additional deaths among the European countries and allows for further analysis of its causes. While the international comparability of data directly associated with COVID-19 may still be arguable due to the possibility of different rules of causes of death classification and coverage issues, this approach gives a general measure of the impact of the crisis on the mortality rate because it includes all deaths regardless of their cause.

In 2020, responding to the demand for timely data on the health crisis, Eurostat set up the ‘excess mortality’ indicator, for Member States of the European Union (EU) and the European Free Trade Association (EFTA). The excess mortality indicator is based on a new data collection, in which national statistical institutes transmit weekly deaths data to Eurostat on a voluntary basis. The currently available dataset that Eurostat publishes with high frequency is used to compute the monthly excess mortality indicator by mapping the deaths of each week to a full month. The data covered in this analysis include all deaths that have occurred since January 2020.

Excess mortality is expressed as the percentage rate of additional deaths in a month, compared to a “baseline” in a period not yet affected by the pandemic. The baseline adopted consists of the average number of deaths that occurred in each of the 12 months during the period 2016-2019. The higher the value, the higher the amount of additional deaths compared to the baseline. If the indicator is negative, it means that fewer deaths occurred in a particular month compared with the baseline period.


Full article


Excess mortality in the European Union between January 2020 and July 2021

During the month of March 2020, the number of deaths rose rapidly in some European countries. In some parts of the EU, deaths were exceptionally high, when compared to the average mortality rate from the period 2016 to 2019. The COVID-19 pandemic affected every part of the EU; however, its impact was not evenly spread. In 2020, the EU experienced two cycles of excess mortality: the first between March and May 2020 (reaching 25 % excess rate in April), then a longer one between August 2020 and the end of the year (reaching 40 % excess rate in November 2020).

The highest peaks of additional deaths, during the early increase in COVID-19 cases, were recorded between March and April 2020, initially in Italy and Spain, then France, Belgium and the Netherlands. During the following period, May-July 2020, a lower level of excess mortality was registered on average. At the end of summer 2020, in August and September, another surge in excess mortality began, with the average indicator reaching 17 % in October and 40 % in November (the highest rate for the whole year), before a slight decrease in December (almost 30 %). The indicator rose in all Member States, this time with a geographical prevalence in eastern Europe (Poland, Bulgaria and Slovenia reached a 90% excess in November 2020). At the end of the year 2020, approximately 550 000 additional deaths were officially recorded in the EU, compared with the average in the period 2016-2019. Considering that January and February 2020 actually had a negative balance, from March to December 2020 the excess mortality reached more than 580 000 deaths. In 2021, excess mortality reached a new peak in April (20.4 %) then decreased to 9.9 % in May, 5.9 % in June and 4.4 % in July.


Figure 1: Monthly excess mortality in the EU
Source: Eurostat (demo_mexrt)

The annual demographic balances published in July 2020 confirmed the results of the weekly deaths rapid exercise. In 2020, the population of the EU slightly decreased from 447.3 million to 447.0 million, interrupting a long growth led by a positive net migration. This time, the negative natural change (more deaths than births) outnumbered the positive net migration. The annual excess mortality for the EU as a whole, in 2020, was 11.9 % higher than the 2016-2019 average, with a variety of national differences (from Poland, Slovenia, Italy and Spain showing rates around 18 %, down to Estonia, Denmark and Latvia with less than 2 %). More detailed information on population change is available in the respective article.

The peaks of the outbreak vary greatly across Member States

The comparison of the number of deaths in 2020-2021 with data from the period 2016-2019 shows, at aggregate level, the exceptional situation in the first months of 2020 across the EU. While important disparities existed between countries and regions, the first two months of the year presented lower values than those observed in the previous years. However, while mortality normally starts declining at the beginning of March, in 2020 – on the contrary – the number of deaths started to rise sharply. In March, the values of 2020 exceeded those recorded on average in the previous years, and this gap was at its height in April 2020, while in the following month and in May there was a sharp decrease. Values for the summer period of 2020 showed a lower level of mortality, compared to the average of the previous period, but a new upward trend began again at the end of August and increased in October, reaching its peak in November at 40.0 %, the highest rate in 2020. This second wave continued until January 2021, and it was more geographically balanced than the first wave, with a prevalence of higher excess mortality rate in the eastern regions.

Table 1: Excess mortality indicator
Source: Eurostat (demo_mexrt)

During the initial phase of the COVID-19 pandemic, some of the highest excess mortality rates in the EU were recorded in the Italian and Spanish regions. In April 2020, three countries had more than 50 % excess mortality: Spain (80.5 %), Belgium (73.1 %) and the Netherlands (53.8 %). Four other countries exceeded a 35 % increase in mortality in April, namely Italy (41.7 %, although the highest increase had already occurred in March at 49.6 %), Sweden (38.2 %), Ireland (37.1 %) and France (36.4 %). In April 2020, Luxembourg experienced an excess mortality level of 18.5 %, Austria 11.0 % and Germany 9.0 %. Several countries, however, spiked in excess mortality in other months of 2020: Malta (16.7 %) in March, Cyprus (25.0 %) in May, Lithuania (8.2 %) and Slovenia (9.5 %) in June, and Portugal (25.8 %) in July. In all these countries, a relatively stable early summer period (compared to the 2016-2019 baseline) followed the high increase of mortality in spring. Then, a second sharp increase took place in most Member States, even in those not particularly concerned by springtime peaks. More than a 10 % increase, compared to the baseline, was registered for the first time in Romania in July, in Poland in August, and in Czechia and Greece in September 2020. Starting from September 2020, the increase was higher and more widespread, reaching new peaks in November, with significant rates in Poland (97.0 %), Bulgaria (94.0 %), Slovenia (91.3 %), Czechia (75.8 %), Romania (62.6 %) and Hungary (59.2 %). Countries that were already strongly affected in spring 2020 recorded high excess mortality rates again in November: see Belgium (58.8 %), Italy (51.6 %), Austria (47.8 %), Malta (38.3 %), France (31.3 %) and Spain (24.2 %).

In January and February 2021, a slight decrease in the excess mortality curve was observed for most countries, continuing the trend of the end of 2020. A new smaller spike then followed in March and April 2021, reaching 20% of excess mortality compared to the baseline period 2016-2019: some countries had very high rates, with excess mortality rates above 50 % in Bulgaria (76.2 %), Poland (65.3 %), Czechia (61.4 %), Slovakia (54.6 %) and Hungary (50.6 %), while others (e.g. Portugal, Denmark, Sweden and Finland) had no excess deaths at all.

In May 2021, the overall trend started to decline, with the number of deaths getting closer to the baseline recorded between 2016 and 2019. In June and July, the overall number of deaths in the European Union declined further, reaching an overall rate of 4.4 % in July 2021, the lowest rate in the year since July 2020. In spite of the decline at EU level, the range of values varied considerably across countries, with, Greece, Cyprus, Malta, Croatia, Estonia, Lithuania, Latvia, Poland and Slovenia still recording excess mortality rates between 13 % and 26 % in June-July 2021 (see Table 1).


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Further releases

Data for the most recent months are provisional and subject to revision. This article and related table are regularly updated on a monthly basis.

Source data for tables and figures

Data sources

The excess mortality indicator, covering EU and EFTA countries, is based on weekly deaths data transmitted to Eurostat by Member States on a voluntary basis. Data are classified by sex, five-year age groups and NUTS regions, and are continuously updated with more recent weeks of mortality statistics. These weeks are then attributed pro-rata to months for computing the excess mortality indicator. For the purpose of the excess mortality indicator, the death figures for the latest weeks available in a Member State are corrected for incompleteness. Data for 2020-2021 remain provisional and subject to revision.

Thirty-one countries provide weekly mortality data: Belgium, Bulgaria, Czechia, Denmark, Germany, Estonia, Ireland, Greece, Spain, France, Croatia, Italy, Cyprus, Latvia, Lithuania, Luxembourg, Hungary, Malta, the Netherlands, Austria, Poland, Portugal, Romania, Slovenia, Slovakia, Finland, Sweden, Iceland, Liechtenstein, Norway and Switzerland. Data received from candidate and neighbouring countries are not present in this article.

Data from Ireland were not included in the first phase of the excess mortality release: official timely data were not available because deaths in Ireland can be registered up to three months after the date of death. Because of the COVID-19 pandemic, the Central Statistics Office (CSO) of Ireland began to explore experimental ways of obtaining up-to-date mortality data. At the end of April 2021, CSO started publishing a time series from October 2019 until the most recent weeks, using death notices (see CSO website). For the purpose of this release, Eurostat is comparing the new 2020-2021 web-scraped series with a 2016-2019 baseline built using official data. CSO is periodically assessing the quality of these data.

Context

The COVID-19 pandemic has triggered tremendous interest in related statistics. Hence, in April 2020, in cooperation with the national statistical institutes of the European Statistical System, Eurostat set up a special data collection on weekly deaths, in order to support the policy and research efforts related to the pandemic. National statistical institutes regularly and voluntarily transmit data to Eurostat on weekly deaths, up to the latest available week.

‘Excess mortality’ has been identified as one of the most useful indicators for assessing additional deaths, complementing other regularly updated indicators of the European Statistical Recovery Dashboard. In order to capture the dynamics of mortality changes in a more comprehensive way, the excess mortality indicator is calculated for each month, no later than 45 days after the end of the reference period (depending on data available to Eurostat from the national statistical institutes). The indicator provides additional insight into the impact the crisis has had on European societies. It should be stressed again that, while a substantial increase largely coincides with a COVID-19 outbreak in each country, the indicator does not make a distinction between the causes of death and does not differentiate sex or age class. Statistics on excess deaths provide information about the burden of mortality potentially related to the COVID-19 pandemic, thereby covering not only deaths that are directly attributed to the virus but also those indirectly related to it. In addition to confirmed deaths, excess mortality captures COVID-19 deaths that were not correctly diagnosed and reported, as well as deaths from other causes that may be attributed to the overall crisis condition. It also accounts for the partial absence of deaths from other causes like accidents that did not occur due, for example, to the limitations in commuting or travel during the lockdown periods.


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