It is difficult to count deaths and attribute them to the catastrophe or another source during a disaster. In addition to preventing or causing deaths, catastrophe responses can also prevent or cause deaths (the so-called disaster after the disaster).
During the first two years of the pandemic, when hospitals were operating at full capacity and routine health services were interrupted, there were about 95,577 more fatalities each year in the Philippines than the average of the preceding five years. These deaths were caused not just by COVID-19, but also by other health issues for which they lacked timely access to treatment.
In contrast, there were fewer fatalities from some illnesses, presumably as an unexpected effect of the COVID-19 prevention measures.
To calculate excess mortality, subtract the predicted number of deaths from the actual number of deaths. The projected number of deaths is the average number of deaths over the five years preceding the pandemic, or the average number of deaths from 2015 to 2019. Determining the excess mortality enables us to determine the causes of fatalities that most likely arose from the epidemic or its response. Unintended outcomes of the pandemic initiatives, such as masking, also prevented several fatalities.
The World Health Organization (WHO) estimates a significant increase in worldwide excess mortality. In 2020 and 2021, during the height of the epidemic, the number reached around 14,9 million. In the Philippines, the number of fatalities was 40,147 fewer than anticipated in 2020, while it was 213,984 higher than projected in 2021. Among terms of excess mortality, the Philippines are in the top 28 percent of lower middle-income nations.
According to WHO calculations, the net number of fatalities over two years is 173,837; this estimate is within 9% of the PSA’s estimate. The PSA’s estimations are based only on death certificates, whereas the WHO’s are somewhat modeled. However, PSA levels fall within the error range of WHO estimations.
The rise in mortality attributable to certain causes is indicative of the categories of individuals who were at danger during the pandemic: the elderly and the young. The number of fatalities attributable to non-communicable diseases (NCDs) increased between 2020 and 2021 compared to the average number of deaths over the preceding five years.
Vascular disorders such as ischemic heart disease (heart attacks), cerebrovascular diseases (strokes), and hypertension accounted for the majority of extra mortality. In addition, mortality due to endocrine disorders, notably diabetes, rose. Multiple lockdowns may have impeded patients’ access to care for these noncommunicable diseases (NCDs), which require frequent treatment and monitoring.
In addition, there was a rise in the number of malnutrition-related fatalities, most likely due to the loss of income and food insecurity. We do not have a breakdown by age, however we know that extremely young malnourished patients have a greater mortality risk than older patients.
Meanwhile, infectious illnesses, or so-called “ailments of poverty,” such as pneumonia, TB, and chronic respiratory diseases, caused fewer fatalities. The same preventative strategies, such as masking and social distance, that were helpful in reducing the risk of COVID-19 infection might have avoided deaths from these illnesses. Also, mortality from diarrheal infections and sepsis may have been reduced if cleanliness habits had been better.
While mortality from communicable illnesses reduced in general, there was a significant increase in HIV-related deaths, which may be attributable to difficulty obtaining antiretroviral medicine during the lockdowns.
As a result of the majority of people staying at home during lockdown times, there were fewer deaths from all types of injuries, including automobile accidents, drowning, and attacks. Injuries that regularly occur at home, such as falls, self-harm, and unintentional poisoning, led to an increase in fatalities.
Notably, a significant proportion of additional fatalities were attributable to unknown or unclassified causes, which may be attributable to problems in determining the exact cause of death.
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