Excess deaths reveal unequal impact of COVID-19 in Ecuador

Author:

Cuéllar LeticiaORCID,Torres IreneORCID,Romero-Severson EthanORCID,Mahesh Riya,Ortega Nathaniel,Pungitore SarahORCID,Ke RuianORCID,Hengartner NicolasORCID

Abstract

Latin America has struggled to control the transmission of COVID-19. Comparison of excess death (ED) rates during the pandemic reveals that Ecuador is among the highest impacted countries. In this analysis, we update our previous findings with the most complete all-cause mortality records available for 2020, disaggregated by sex, age, ethnicity and geography. Our study shows that in 2020, Ecuador had a 64% ED rate (95% CI 63% to 65%) or 64% more deaths than expected. Men had a higher ED rate, 75% (95% CI 73% to 76%), than women’s 51% (95% CI 49% to 52%), and this pattern of higher EDs for men than women held for most age groups. The only exception was the 20–29 age group, where women had 19% more deaths, compared to 10% more deaths for men, but that difference is not statistically significant. The analysis provides striking evidence of the lack of COVID-19 diagnostic testing in Ecuador: the confirmed COVID-19 deaths in 2020 accounted for only 21% of total EDs. Our significant finding is that indigenous populations, who typically account for about 5% of the deaths, show almost four times the ED rate of the majority mestizo group. Indigenous women in each age group have higher ED rates than the general population and, in ages between 20 and 49 years, they have higher ED rates than indigenous men. Indigenous women in the age group 20–29 years had an ED rate of 141%, which is commensurate to the ED rate of indigenous women older than 40 years.

Funder

Laboratory Directed Research and Development

Publisher

BMJ

Subject

Public Health, Environmental and Occupational Health,Health Policy

Reference8 articles.

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4. Cuéllar L , Torres I , Romero-Severson E . Excess deaths reveal the true spatial, temporal, and demographic impact of COVID-19 on mortality in Ecuador. International Journal of Epidemiology. In Press 2021;2021.

5. National Academies of Sciences, Engineering, and Medicine . Evaluating data types: a guide for decision makers using data to understand the extent and spread of COVID-19. Washington, DC: The National Academies Press, 2020.

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