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Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity

U.K. 15.07.2020. Department of Health and Social Care, Office for National Statistics, Government Actuary’s Department and Home Office.

COVID-19 survivors may experience a range of health impacts following critical care and/or hospital admission, including cognitive, physical and mental health impairments. There may be additional long-term health impacts that are currently unknown. (40.000 )

There has been a significant reduction in accident and emergency attendances and emergency admissions. Some of this is unmet need, possibly due to patients’ reluctance to seek medical attention or other changes to protocols ( 140.000)

Healthcare staff are likely to be impacted as a result of the additional pressures on the sector, in terms of burn-out and mental health problems. ( 17.000 )

Adult social care users and people receiving informal care may be coping with reduced levels of support during the pandemic, which may have health impacts such as mental health, ability to maintaining hygiene and potential for falls. It has not been possible to quantify these impacts. Carers may be providing more care and may be experiencing increased stress and impacts on their mental health. The impact on this group has not been quantified. ( not quantified )

Adult social care staff are likely to be impacted as a result of the additional pressures on the sector, in terms of mental health problems ( 21.000 )

Patients waiting longer for non-urgent elective care will have to live with symptoms for longer and a significant impact on quality of life. There may be impacts on morbidity as a result of cancellation or postponement of elective care ( 90.000 )

It has only been possible to quantify the impacts of delayed cancer diagnosis from reduced GP referrals or emergency presentations and other morbidity impacts following changes primary and community care has not been quantified. However, changes to some services (e.g. GP services, dental services) may lead to worsening health outcomes; changes to other services such as optometry and audiology may have relatively limited health impacts depending on how long services are paused for and provided that appointments are caught up once services return. (300+)

The lockdown is expected result in an increase in musculoskeletal conditions, increased domestic abuse, and increased mental health problems. ( 134.000 )

The lockdown-induced recession is expected to result in an increase in mental health problems, but a reduction in unintentional injuries (mostly occupational injuries), chronic respiratory diseases, and transport injuries. ( 17.000 )

In the medium-term, due to lockdown-induced recession, there is expected to be an increase in musculoskeletal disorders and mental health problems and have been quantified ( 438.000 )

In the long-term there would be some morbidity impacts for the same cohort of younger people entering the labour market around the time of the recession ( not quantified ) total : 900.000 people ( + 3 x not quantified morbidities )

Zie ook: Table 2.

Abridged life table, with multipliers derived from Banerjee et al (2020) 'Standard mortality rate' volgens leeftijd : tussen 0,0002083% en 0,0293259 % 'Mortality rate with 1 comorbidity/conditions': tussen 1,80 %en 2,99% ( = kans om te sterven ) 'Mortality rate with 2 comorbidities/conditions': tussen 2,48 % en 8,47% 'Mortality rate with 3 comorbidities/conditions': tussen 3,36% en 57,58% (*)

Op 1 miljoen mensen die ziek worden door corona en voordien gezond waren, sterven er in de UK gemiddeld:

2,08 ( 0-9jaar )

77,46 ( 60-69 jaar )

256,06 ( 70-79 jaar )

en 293,0 ( + 80 )

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