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| - Background Excess mortality from all-cause has been estimated at national level for different countries, to provide a picture of the total burden of the COVID-19 pandemic. Nevertheless, there have been no attempts at modelling it at high spatial resolution, needed to understand geographical differences in the mortality patterns, to evaluate temporal lags and to plan for future waves of the pandemic. Methods This is the first subnational study on excess mortality during the COVID-19 pandemic in Italy, the third most-hit country. We considered municipality level and estimated all-cause mortality weekly trends based on the first four months of 2016 -- 2019. We specified a Bayesian hierarchical model allowing for spatial heterogeneity as well as for non-linear smooth spatio-temporal terms. We predicted the weekly mortality rates at municipality level for 2020 based on the modelled spatio-temporal trends (i.e.~in the absence of the pandemic) and estimated the excess mortality and the uncertainty surrounding it. Results We found strong evidence of excess mortality for Northern Italy, with higher mortality rates than expected from the end of February in Lombardia, with total excess deaths of 23,946 (23,013 -- 24,786), and the beginning of March for North East and North West with total excess deaths of 8,033 (7,061 -- 9,044) and 1,588 (404 -- 2,700) respectively. We found marked geographical differences, with percent excess of up to 88.9% (81.9% -- 95.2%) at the peak of the pandemic, in the city of Bergamo (Lombardia).
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