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2020 ; 34
(9
): 1193-1201
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English Wikipedia
Changing patterns of mortality during the COVID-19 pandemic: Population-based
modelling to understand palliative care implications
#MMPMID32706299
Bone AE
; Finucane AM
; Leniz J
; Higginson IJ
; Sleeman KE
Palliat Med
2020[Oct]; 34
(9
): 1193-1201
PMID32706299
show ga
BACKGROUND: COVID-19 has directly and indirectly caused high mortality worldwide.
AIM: To explore patterns of mortality during the COVID-19 pandemic and
implications for palliative care, service planning and research. DESIGN:
Descriptive analysis and population-based modelling of routine data. PARTICIPANTS
AND SETTING: All deaths registered in England and Wales between 7 March and 15
May 2020. We described the following mortality categories by age, gender and
place of death: (1) baseline deaths (deaths that would typically occur in a given
period); (2) COVID-19 deaths and (3) additional deaths not directly attributed to
COVID-19. We estimated the proportion of people who died from COVID-19 who might
have been in their last year of life in the absence of the pandemic using simple
modelling with explicit assumptions. RESULTS: During the first 10?weeks of the
pandemic, there were 101,614 baseline deaths, 41,105 COVID-19 deaths and 14,520
additional deaths. Deaths in care homes increased by 220%, while home and
hospital deaths increased by 77% and 90%, respectively. Hospice deaths fell by
20%. Additional deaths were among older people (86% aged???75?years), and most
occurred in care homes (56%) and at home (43%). We estimate that 22% (13%-31%) of
COVID-19 deaths occurred among people who might have been in their last year of
life in the absence of the pandemic. CONCLUSION: The COVID-19 pandemic has led to
a surge in palliative care needs. Health and social care systems must ensure
availability of palliative care to support people with severe COVID-19,
particularly in care homes.