Excess all-cause mortality in 21 countries during 2022: COVID-19 impact by C-MOR project

Abstract National published COVID-19 mortality estimates do not fully encompass the extent of the pandemic’s impact on mortality. To address this challenge, calculating excess all-cause mortality at the national level is important. Our focus was on understanding total weekly excess mortality for 2022, by analysing mortality data across 2020-2022, from 21 countries participating in the international consortium (C-MOR), which provided data for examination. Excess mortality was calculated by comparing the weekly 2022 age-standardized mortality rates per 100,000 population against a baseline mortality, estimated using historical data from 2015-2019. Excess cumulative mortality for 2022 was found in all 21 countries. The excess mortality for the total population varied between 8.6 and 116.2, with the minimum excess belonging to Peru and the maximum to Georgia. Australia, Austria, Cyprus, Denmark, Estonia, Georgia, Greece, Israel, and Norway showed a higher excess in 2022 than in 2020, while Australia, Austria, Cyprus, Denmark, Israel, Italy, Norway, Spain, and Sweden also showed a higher excess in 2022 than in 2021. Mauritius showed a significant excess mortality for the first time in 2022. For all countries, but Australia, the % of COVID-19 deaths out of all deaths decreased in 2022 compared to 2021. Contrary to the ‘harvesting effect’, which would expect a decline in mortality rates post-pandemic, our results underscore a sustained excess mortality throughout 2022. The 2022 excess deaths are mainly non-COVID-related, stemming from broader pandemic impacts on healthcare systems and other factors. Conversely, in Australia, international boarders reopened in 2022, resulting in the first community-wide transmission and a substantial rise in excess deaths. Our study reveals nuanced excess mortality dynamics post-vaccination, providing crucial insights for policymakers and stressing the necessity of continued vigilance and adaptive strategies against COVID-19’s diverse impacts. Key messages • All countries investigated experienced continued all-cause excess mortality during 2022, compared to pre-pandemic years. For most, excess mortality in 2022 was higher than in 2021 and 2020. • For all countries, except Australia, the contribution of COVID-19 deaths to the mortality estimates in 2022 is decreased, highlighting the impact of indirect pandemic related effects on mortality.