By Thiemo Fetzer et al.
Abstract
Seasonal infectious diseases can cause demand and supply pressures that reduce the ability of healthcare systems to provide high-quality care. This may generate negative spillover effects on the health outcomes of patients seek- ing medical help for unrelated reasons. Separating these indirect burdens from the direct consequences for infected patients is usually impossible because of a lack of suitable data and an absence of population testing. However, this paper finds robust empirical evidence of excess mortality among non-COVID-19 pa- tients in an integrated public healthcare system: the English NHS. Analysing the forecast error in the NHS’ model for predicted mortality, we find at least one additional excess death among patients who sought medical help for reasons unrelated to COVID-19 for every 42 COVID-19-related deaths in the popula- tion. We identify COVID-19 pressures as a key driver of non-COVID-19 excess mortality in NHS hospitals during the pandemic, and characterise the hospital populations and medical conditions that are disproportionately affected. Our findings have substantive relevance in shaping our understanding of the wider burden of COVID-19, and other seasonal diseases more generally, and can con- tribute to debates on optimal public health policy.
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