Excess mortality in Europe and Serbia during the COVID-19 pandemic in 2020

Abstract

The 2020 pandemic came at a huge demographic cost, particularly regarding the increase in mortality. In this paper we examine excess deaths in Serbia and 34 other European countries in 2020. Methodological inconsistencies and big differences in how COVID-19 deaths were recorded across different countries make it difficult to make any cross-country comparisons, even with the scope limited only to Europe. Since the number of total deaths is a methodologically solid indicator, we looked at the differences between the total number of deaths in 2020 and compared that to deaths in 2019. The lowest increase in mortality - below 5% - occurred in countries in the north of Europe (Norway, Denmark, Finland, Latvia), while the highest increase - over 18% - was recorded in the southern and central parts of the continent (Albania, Northern Macedonia, Spain, Belgium, Poland, Slovenia, Russia). There is no clear geographical regularity. In 2020, Serbia had 12.6% more deaths compared to 2019, which was close to the European average. Within Serbia, statistical differences between regions were not large. Measuring the contribution of COVID-19 deaths to excess mortality is much more problematic. The excess death ratio is more helpful for understanding methodological and data-gathering issues than finding evidence about composition and divergence in mortality. According to this indicator (based on preliminary data), only 25% of excess deaths in Serbia in 2020 were caused by COVID-19, while the European average was 54%. However, in many (primarily Eastern European) countries in 2020, the indirect consequences of COVID-19 on the health of the population were more significant than the direct ones. It is precisely the ratio of COVID-19 diagnoses that led to death in total mortality that shows this. The final results may confirm this statement or indicate potential data manipulation. While this paper focuses only on the year 2020, as of Q1 of 2021, the pandemic is not nearing its end. Based on preliminary data published daily, Serbia had more COVID-19 deaths in the first four months of 2021 than for the whole of 2020. This indicates that the consequences of the pandemic for Serbia will be dire in 2021, regardless of the course the pandemic takes.