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10.1136/bmjgh-2020-004564

http://scihub22266oqcxt.onion/10.1136/bmjgh-2020-004564
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33758012!7992372!33758012
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suck abstract from ncbi


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pmid33758012      BMJ+Glob+Health 2021 ; 6 (3): ä
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  • Excess mortality during the COVID-19 pandemic: a geospatial and statistical analysis in Aden governorate, Yemen #MMPMID33758012
  • Koum Besson ES; Norris A; Bin Ghouth AS; Freemantle T; Alhaffar M; Vazquez Y; Reeve C; Curran PJ; Checchi F
  • BMJ Glob Health 2021[Mar]; 6 (3): ä PMID33758012show ga
  • BACKGROUND: The burden of COVID-19 in low-income and conflict-affected countries remains unclear, largely reflecting low testing rates. In parts of Yemen, reports indicated a peak in hospital admissions and burials during May-June 2020. To estimate excess mortality during the epidemic period, we quantified activity across all identifiable cemeteries within Aden governorate (population approximately 1 million) by analysing very high-resolution satellite imagery and compared estimates to Civil Registry office records. METHODS: After identifying active cemeteries through remote and ground information, we applied geospatial analysis techniques to manually identify new grave plots and measure changes in burial surface area over a period from July 2016 to September 2020. After imputing missing grave counts using surface area data, we used alternative approaches, including simple interpolation and a generalised additive mixed growth model, to predict both actual and counterfactual (no epidemic) burial rates by cemetery and across the governorate during the most likely period of COVID-19 excess mortality (from 1 April 2020) and thereby compute excess burials. We also analysed death notifications to the Civil Registry office over the same period. RESULTS: We collected 78 observations from 11 cemeteries. In all but one, a peak in daily burial rates was evident from April to July 2020. Interpolation and mixed model methods estimated approximately 1500 excess burials up to 6 July, and 2120 up to 19 September, corresponding to a peak weekly increase of 230% from the counterfactual. Satellite imagery estimates were generally lower than Civil Registry data, which indicated a peak 1823 deaths in May alone. However, both sources suggested the epidemic had waned by September 2020. DISCUSSION: To our knowledge, this is the first instance of satellite imagery being used for population mortality estimation. Findings suggest a substantial, under-ascertained impact of COVID-19 in this urban Yemeni governorate and are broadly in line with previous mathematical modelling predictions, though our method cannot distinguish direct from indirect virus deaths. Satellite imagery burial analysis appears a promising novel approach for monitoring epidemics and other crisis impacts, particularly where ground data are difficult to collect.
  • |*Cemeteries[MESH]
  • |*Satellite Imagery[MESH]
  • |COVID-19/*mortality[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*mortality/virology[MESH]
  • |Registries[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]


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