Excess mortality during the coronavirus pandemic (COVID-19) in Poland

Abstract   The COVID-19 pandemic, has begun a global changes in the mortality model, exceeding its predicted levels under standard conditions. The aim of the study was to assess the phenomenon of excess mortality in Poland in 2020 and in the first half of 2021 compared to 2016-2019 based on the data of the Central Statistical Office. The number of excess deaths was defined as the difference between the deaths in 2021 and the average number of deaths in the previous years. In accordance with the Eurostat methodology the 2016-2019 average was taken as the reference point. In 2020, the number of deaths in Poland amounted to 485,259 and was higher by 14.9% than expected on the basis of mortality in 2016-2019 (the absolute excess number of deaths amounted to 67,112). 43% of the excess deaths were deaths caused by Sars-Cov-2, 27% other deaths among infected people, and 30% deaths among those without confirmed infection. In this group, the highest increases were recorded for deaths due to cardiovascular diseases, neurological diseases and mental disorders. In the first half of 2021, 270,662 people died in Poland, i.e. 23.9% more than in the corresponding period in 2016-2019 and 22.9% more than in the first half of 2020, whereas 58,096 people died due to COVID-19 (22% of all deaths). The highest increases for non-viral deaths compared to 2016-2019 were recorded for blood diseases and immune mechanisms (121.53%), infectious and parasitic diseases (90.76%), mental disorders (34.93%) and cardiovascular diseases (11.65%). Excess mortality is a very serious problem of the public health. The increased mortality in 2020 and 2021 was closely related to the pandemic, as direct COVID-19 victims accounted for the majority of the observed increases in mortality. However, attention should be paid to the growth in mortality related to other causes, mainly mental disorders, for which mortality increases most rapidly, which requires immediate action. Key messages • The increased mortality in 2020 and 2021 was closely related to the pandemic, as direct COVID-19 victims accounted for approximately 90% of the observed increases in mortality in Poland. • In the group of no-related with COVID-19 deaths the highest increases were recorded for mortality due to cardiovascular diseases, neurological diseases and mental disorders.

The COVID-19 pandemic, has begun a global changes in the mortality model, exceeding its predicted levels under standard conditions. The aim of the study was to assess the phenomenon of excess mortality in Poland in 2020 and in the first half of 2021 compared to 2016-2019 based on the data of the Central Statistical Office. The number of excess deaths was defined as the difference between the deaths in 2021 and the average number of deaths in the previous years. In accordance with the Eurostat methodology the 2016-2019 average was taken as the reference point. In 2020, the number of deaths in Poland amounted to 485,259 and was higher by 14.9% than expected on the basis of mortality in 2016-2019 (the absolute excess number of deaths amounted to 67,112). 43% of the excess deaths were deaths caused by Sars-Cov-2, 27% other deaths among infected people, and 30% deaths among those without confirmed infection. In this group, the highest increases were recorded for deaths due to cardiovascular diseases, neurological diseases and mental disorders. In the first half of 2021, 270,662 people died in Poland, i.e. 23.9% more than in the corresponding period in 2016-2019 and 22.9% more than in the first half of 2020, whereas 58,096 people died due to COVID-19 (22% of all deaths). The highest increases for non-viral deaths compared to 2016-2019 were recorded for blood diseases and immune mechanisms (121.53%), infectious and parasitic diseases (90.76%), mental disorders (34.93%) and cardiovascular diseases (11.65%). Excess mortality is a very serious problem of the public health. The increased mortality in 2020 and 2021 was closely related to the pandemic, as direct COVID-19 victims accounted for the majority of the observed increases in mortality. However, attention should be paid to the growth in mortality related to other causes, mainly mental disorders, for which mortality increases most rapidly, which requires immediate action. Key messages: The increased mortality in 2020 and 2021 was closely related to the pandemic, as direct COVID-19 victims accounted for approximately 90% of the observed increases in mortality in Poland.
In the group of no-related with COVID-19 deaths the highest increases were recorded for mortality due to cardiovascular diseases, neurological diseases and mental disorders.

Background:
Binge drinking by adolescents in Belgium is an increasing problem, according to emergency physicians who have recently alerted society about the increasing numbers of adolescents admitted to hospital due to acute alcohol intoxication (AAI). Until now, only estimations of the prevalence of AAI in adolescents are known and research about potential risk factors has not yet been conducted in Belgium.

Methods:
To gain more insight into the prevalence, medical characteristics, and context of AAI, a retrospective study in hospitals in the city of Antwerp was conducted. Medical charts of 10 to 18year-old patients admitted with AAI between 2015 and 2021 were investigated and analysed.

Results:
Between 2016 and 2021, 547 adolescents with AAI were admitted to 5 of the 8 hospitals in Antwerp. In the University Hospital of Antwerp (n = 177) mean age at admittance was 15.9 years. Older patients had a significantly higher BAC than younger patients (U:2357, 1, p-value: <0.001). In 10% of the patients combined drug use was proven and in this group, BAC was significantly lower (U:209, 1, p-value: <0.001). 60% of the patients were transmitted to the hospital by ambulance and in 31% the ambulance was assisted by specialised medical care. In 18% of the cases, the police were involved. The results of the other hospitals are not yet known at the time of submission but will be presented at the EPH conference.

Conclusions:
According to the data so far, younger patients and patients with comorbid drug use are admitted with a lower BAC, which could be seen as a potential risk factor. This should be considered in developing preventive measures like sensitization. Moreover, in a noteworthy percentage, ambulances, specialized care, and police are involved, which contributes to high medical and social costs. However, data addressing demographics and the context of AAI were mostly missing. Therefore, prospective research is required to further investigate potential risk factors for AAI. Key messages: A significant amount of adolescents with AAI are admitted in the city of Antwerp every year, with a mean age of 15.9 years old, which is below the legal alcohol age.
Considering the high prevalence of AAI and the major impact it has on adolescents health and medical and social costs, it is necessary to decrease the prevalence of binge drinking in adolescents.
iii492 European Journal of Public Health, Volume 32 Supplement 3, 2022