Leveraging Community Mortality Indicators to Infer COVID-19 Mortality and Transmission Dynamics in Damascus, Syria

Overview

Journal Nat Commun

Specialty Biology

Date 2021 Apr 23

PMID 33888698

Citations 25

Authors

Oliver J Watson

Mervat Alhaffar

Zaki Mehchy

Charles Whittaker

Zack Akil

Nicholas F Brazeau

Gina Cuomo-Dannenburg

Arran Hamlet

Hayley A Thompson

Marc Baguelin

Richard G FitzJohn

Edward Knock

John A Lees

Lilith K Whittles

Thomas Mellan

Peter Winskill

Natasha Howard

Hannah Clapham

Francesco Checchi

Neil Ferguson

Azra Ghani

Emma Beals

Patrick Walker

Affiliations

Soon will be listed here.

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.

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