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• W4386122945 abstract "In 2020, New Zealand adopted an elimination strategy using a wide range of public health interventions in response to the COVID-19 pandemic. This approach successfully eliminated COVID-19,1Baker MG Wilson N Anglemyer A Successful elimination of COVID-19 transmission in New Zealand.N Engl J Med. 2020; 383: e56Crossref PubMed Scopus (217) Google Scholar resulted in an 11% reduction in all-cause mortality over a 30-week period in 2020,2Kung S Doppen M Black M Hills T Kearns N Reduced mortality in New Zealand during the COVID-19 pandemic.Lancet. 2021; 397: 25Summary Full Text Full Text PDF PubMed Google Scholar and enabled the country to ease restrictions by late 2020.1Baker MG Wilson N Anglemyer A Successful elimination of COVID-19 transmission in New Zealand.N Engl J Med. 2020; 383: e56Crossref PubMed Scopus (217) Google Scholar In December, 2021, after reaching high vaccination rates (ie, 87% of the eligible population fully vaccinated), New Zealand moved from an elimination strategy to a mitigation strategy. It was unclear whether mortality would subsequently increase to higher than historical rates due to a postponement of death among vulnerable individuals, return to baseline, or remain low due to ongoing public health measures. We compared weekly all-cause mortality rates in New Zealand in 2020, 2021, and 2022, with historical figures from 2011 to 2019 using data from Stats New Zealand Tatauranga Aotearoa.3Stats New Zealand Tatauranga AotearoaCOVID-19 data portal.https://www.stats.govt.nz/experimental/covid-19-data-portalDate: 2020Date accessed: February 10, 2023Google Scholar Weekly and annual excess mortality were calculated as the mortality rate for each of the years, minus the mean historical mortality rate (figure A), using the median annual population in New Zealand as denominator data from Stats New Zealand Tatauranga Aotearoa.4Stats New Zealand Tatauranga AotearoaPopulation.https://www.stats.govt.nz/topics/populationDate accessed: September 28, 2022Google Scholar Weekly mortality rates for deaths attributed to COVID-19 from 2020 to 2022 were calculated from Ministry of Health data.5New Zealand Ministry of HealthWeekly deaths.https://github.com/minhealthnz/nz-covid-data/blob/main/cases/weekly-deaths.csvDate accessed: February 10, 2023Google Scholar In 2020, there was a negative excess mortality with 439·4 fewer deaths per million, potentially due to several factors including the elimination of COVID-19, markedly reduced burden of influenza and other respiratory viruses, and fewer deaths from road traffic accidents, occupational causes, air pollution, and post-surgical complications.1Baker MG Wilson N Anglemyer A Successful elimination of COVID-19 transmission in New Zealand.N Engl J Med. 2020; 383: e56Crossref PubMed Scopus (217) Google Scholar, 2Kung S Doppen M Black M Hills T Kearns N Reduced mortality in New Zealand during the COVID-19 pandemic.Lancet. 2021; 397: 25Summary Full Text Full Text PDF PubMed Google Scholar, 6Hills T Hatter L Kearns N Bruce P Beasley R COVID-19 border controls prevent a 2021 seasonal influenza epidemic in New Zealand.Public Health. 2021; 200: e6-e7Crossref PubMed Scopus (4) Google Scholar, 7Huang QS Wood T Jelley L et al.Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand.Nat Commun. 2021; 121001Google Scholar In 2021, less than 0·25% of the population was diagnosed with COVID-19, and weekly mortality rates fluctuated around the historical mean with a negative excess mortality of 7·6 fewer deaths per million population. In January, 2022, with 93% of the eligible population in New Zealand fully vaccinated, widespread community transmission of the omicron (B.1.1.529) variant occurred, and public health restrictions were progressively relaxed. There was excess mortality of 662·4 deaths per million population, predominantly due to COVID-19-attributable deaths. The total mortality rate minus COVID-19-attributable deaths was –444·5 deaths per million population in 2020, –11·7 deaths per million population in 2021, and 209·3 deaths per million population in 2023 compared with historical rates. In New Zealand, total mortality during the pandemic was reduced in 2020 and 2021, and then increased in 2022, leading to a modest increase in all-cause mortality during the 3-year period of the pandemic. The excess mortality observed in 2022 appears to have been largely driven by deaths attributable to COVID-19 after widespread SARS-CoV-2 transmission, suggesting that there has not been a substantive rebound in deaths from non-COVID-19-attributable causes (figure B). This interpretation is limited by several factors such as clinical uncertainty determining whether COVID-19 was the cause of death, background variability of annual mortality rates, population ageing, and differences in immigration and emigration patterns across the years of observation and historical reference. To better understand the effects of different stages of New Zealand's pandemic response strategy on COVID-19-attributable and non-COVID-19-attributable deaths, an examination of demographic differences in excess mortality and detailed cause of death data will be required. All authors reviewed and approved the final manuscript. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. RB has received personal fees from CSL Seqirus for attendance at an Advisory Board meeting. All other authors declare no competing interests. Data was obtained from Stats New Zealand Tatauranga Aotearoa and the New Zealand Ministry of Health. No individual data was obtained. Data will be available to researchers who provide a methodologically sound proposal that has been approved by the study steering committee to achieve the aims outlined in the approved proposal. Data can be obtained through a signed data access agreement. The agreement can be obtained by emailing the Corresponding Author. The Medical Research Institute of New Zealand receives Health Research Council of New Zealand independent research organisation funding." @default.
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• W4386122945 title "New Zealand's COVID-19 elimination strategy and mortality patterns" @default.
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