Leveraging community mortality indicators to infer COVID-19 mortality and transmission dynamics in Damascus, Syria
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
The COVID-19 pandemic has resulted in substantial mortality worldwide. However, to date, countries in the Middle East and Africa have reported considerably lower mortality rates than in Europe and the Americas. Motivated by reports of an overwhelmed health system, we estimate the likely under-ascertainment of COVID-19 mortality in Damascus, Syria. Using all-cause mortality data, we fit a mathematical model of COVID-19 transmission to reported mortality, estimating that 1.25% of COVID-19 deaths (sensitivity range 1.00% – 3.00%) have been reported as of 2 September 2020. By 2 September, we estimate that 4,380 (95% CI: 3,250 – 5,550) COVID-19 deaths in Damascus may have been missed, with 39.0% (95% CI: 32.5% – 45.0%) of the population in Damascus estimated to have been infected. Accounting for under-ascertainment corroborates reports of exceeded hospital bed capacity and is validated by community-uploaded obituary notifications, which confirm extensive unreported mortality in Damascus.
Date Issued
2021-04-22
Date Acceptance
2021-03-15
Citation
Nature Communications, 2021, 12 (1), pp.1-10
ISSN
2041-1723
Publisher
Nature Research
Start Page
1
End Page
10
Journal / Book Title
Nature Communications
Volume
12
Issue
1
Copyright Statement
© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Wellcome Trust
Medical Research Council (MRC)
Identifier
https://www.nature.com/articles/s41467-021-22474-9
Grant Number
221350/Z/20/Z
MR/R015600/1
Subjects
Imperial College COVID-19 Response Team
Publication Status
Published
Article Number
2394
Date Publish Online
2021-04-22