Excess Mortality Associated With the COVID-19 Pandemic-Los Angeles County, March-September 2020

Elizabeth Traub; Aryana T Amoon; Louise Rollin-Alamillo; Meredith Haddix; Kathleen Poortinga; Mireille Ibrahim; Gustavo Feregrino; Chelsea Foo; Alison Itano; Rebecca Lee; Rebecca Fisher; Claire Jarashow; Sharon Balter; Prabhu Gounder

doi:10.1097/PHH.0000000000001344

Excess Mortality Associated With the COVID-19 Pandemic-Los Angeles County, March-September 2020

J Public Health Manag Pract. 2021 May-Jun;27(3):233-239. doi: 10.1097/PHH.0000000000001344.

Authors

Elizabeth Traub¹, Aryana T Amoon, Louise Rollin-Alamillo, Meredith Haddix, Kathleen Poortinga, Mireille Ibrahim, Gustavo Feregrino, Chelsea Foo, Alison Itano, Rebecca Lee, Rebecca Fisher, Claire Jarashow, Sharon Balter, Prabhu Gounder

Affiliation

¹ Acute Communicable Disease Control Program (Mss Traub, Haddix, Ibrahim, Foo, Itano, Lee, and Fisher, Mr Feregrino, and Drs Jarashow, Balter, and Gounder), Office of Health Assessment and Epidemiology (Dr Amoon and Ms Rollin-Alamillo), and Division of HIV and STD Programs (Ms Poortinga), Los Angeles County Department of Public Health, Los Angeles, California.

PMID: 33762539
DOI: 10.1097/PHH.0000000000001344

Abstract

Objective: To more comprehensively estimate COVID-19-related mortality in Los Angeles County by determining excess all-cause mortality and pneumonia, influenza, or COVID (PIC) mortality.

Design: We reviewed vital statistics data to identify deaths registered in Los Angeles County between March 15, 2020, and August 15, 2020. Deaths with an ICD-10 (International Classification of Diseases, Tenth Revision) code for pneumonia, influenza, or COVID-19 listed as an immediate or underlying cause of death were classified as PIC deaths. Expected deaths were calculated using negative binomial regression. Excess mortality was determined by subtracting the expected from the observed number of weekly deaths. The Department of Public Health conducts surveillance for COVID-19-associated deaths: persons who died of nontraumatic/nonaccidental causes within 60 days of a positive COVID-19 test result were classified as confirmed COVID-19 deaths. Deaths without a reported positive SARS-Cov-2 polymerase chain reaction result were classified as probable COVID-19 deaths if COVID-19 was listed on their death certificate or the death occurred 60 to 90 days of a positive test. We compared excess PIC deaths with the number of confirmed and probable COVID-19 deaths ascertained by surveillance.

Setting: Los Angeles County.

Participants: Residents of Los Angeles County who died.

Main outcome measure: Excess mortality.

Results: There were 7208 excess all-cause and 5128 excess PIC deaths during the study period. The Department of Public Health also reported 5160 confirmed and 323 probable COVID-19-associated deaths.

Conclusions: The number of excess PIC deaths estimated by our model was approximately equal to the number of confirmed and probable COVID-19 deaths identified by surveillance. This suggests our surveillance definition for confirmed and probable COVID-19 deaths might be sufficiently sensitive for capturing the true burden of deaths caused directly or indirectly by COVID-19.

MeSH terms

Adult
Aged
Aged, 80 and over
COVID-19 / epidemiology
COVID-19 / mortality*
Cause of Death*
Cities / epidemiology
Cities / statistics & numerical data
Female
Humans
Influenza, Human / epidemiology
Influenza, Human / mortality*
Los Angeles / epidemiology
Male
Middle Aged
Pandemics / statistics & numerical data*
Pneumonia / epidemiology
Pneumonia / mortality*
Population Surveillance*
Public Health / statistics & numerical data*
SARS-CoV-2