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Excess Mortality and Containment Performance During the COVID-19 Pandemic: Evidence From 34 Countries.

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Title: Excess Mortality and Containment Performance During the COVID-19 Pandemic: Evidence From 34 Countries.
Authors: Cheng, Chieh, Wu, Hsiao-Yu, Kuo, Shu-Chen, Fan, Brandon, Hsu, Ya-Ting, Chen, Yi-Kai, Fan, Byron, Jang, Yung-An, Hung, Chih-Fan, Jiang, Wei-Ming, Chiou, Hung-Yi, Chen, Wei J., Tsou, Hsiao-Hui
Source: American Journal of Public Health. Sep2025, Vol. 115 Issue 9, p1518-1528. 11p.
Subjects: Causes of death, Hazardous substance safety measures, Descriptive statistics, Longitudinal method, Public health, Confidence intervals, COVID-19, Government regulation, COVID-19 pandemic
Abstract: Objectives. To expand COVID-19 containment indicators to evaluate the relationship between excess mortality and government response. Methods. We developed a longitudinal study analyzing excess mortality, COVID-19 containment, and structural conditions in 34 countries between 2020 and 2022. Results. The average excess mortality ratios of the 34 countries were 1.09, 1.14, and 1.11 in 2020, 2021, and 2022, respectively. Thirteen countries experienced continuous annual rises, while only 2 had consistent annual declines. Top-performing countries significantly reduced excess deaths by 5.7% (b = −0.06; 95% CI [confidence interval] = −0.10, −0.01; P =.02) in 2020 and 12.9% (b = −0.13; 95% CI = −0.17, −0.08; P <.001) in 2021, compared to bottom performers. Middle-performing countries saw reductions of 6.7% (b = −0.07; 95% CI = −0.11, −0.02; P =.01) and 10.6% (b = −0.11; 95% CI = −0.15, −0.06; P <.001). These findings suggest that better containment is associated with fewer excess deaths, even after accounting for preexisting structural differences. Conclusions. The COVID-19 containment indicators' precision emphasizes the association between better containment and lower excess mortality during early and postvaccine development periods. Public Health Implications. Our findings urge governments to utilize new metrics that balance flexibility and strictness for pandemic strategies, informing future policy interventions. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Excess Mortality and Containment Performance During the COVID-19 Pandemic: Evidence From 34 Countries.
– Name: Author
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cheng%2C+Chieh%22&quot;&gt;Cheng, Chieh&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wu%2C+Hsiao-Yu%22&quot;&gt;Wu, Hsiao-Yu&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kuo%2C+Shu-Chen%22&quot;&gt;Kuo, Shu-Chen&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fan%2C+Brandon%22&quot;&gt;Fan, Brandon&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hsu%2C+Ya-Ting%22&quot;&gt;Hsu, Ya-Ting&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chen%2C+Yi-Kai%22&quot;&gt;Chen, Yi-Kai&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fan%2C+Byron%22&quot;&gt;Fan, Byron&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jang%2C+Yung-An%22&quot;&gt;Jang, Yung-An&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hung%2C+Chih-Fan%22&quot;&gt;Hung, Chih-Fan&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jiang%2C+Wei-Ming%22&quot;&gt;Jiang, Wei-Ming&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chiou%2C+Hung-Yi%22&quot;&gt;Chiou, Hung-Yi&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chen%2C+Wei+J%2E%22&quot;&gt;Chen, Wei J.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tsou%2C+Hsiao-Hui%22&quot;&gt;Tsou, Hsiao-Hui&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22American+Journal+of+Public+Health%22&quot;&gt;American Journal of Public Health&lt;/searchLink&gt;. Sep2025, Vol. 115 Issue 9, p1518-1528. 11p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Causes+of+death%22&quot;&gt;Causes of death&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hazardous+substance+safety+measures%22&quot;&gt;Hazardous substance safety measures&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Descriptive+statistics%22&quot;&gt;Descriptive statistics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Longitudinal+method%22&quot;&gt;Longitudinal method&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Public+health%22&quot;&gt;Public health&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Confidence+intervals%22&quot;&gt;Confidence intervals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COVID-19%22&quot;&gt;COVID-19&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Government+regulation%22&quot;&gt;Government regulation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COVID-19+pandemic%22&quot;&gt;COVID-19 pandemic&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives. To expand COVID-19 containment indicators to evaluate the relationship between excess mortality and government response. Methods. We developed a longitudinal study analyzing excess mortality, COVID-19 containment, and structural conditions in 34 countries between 2020 and 2022. Results. The average excess mortality ratios of the 34 countries were 1.09, 1.14, and 1.11 in 2020, 2021, and 2022, respectively. Thirteen countries experienced continuous annual rises, while only 2 had consistent annual declines. Top-performing countries significantly reduced excess deaths by 5.7% (b = −0.06; 95% CI [confidence interval] = −0.10, −0.01; P =.02) in 2020 and 12.9% (b = −0.13; 95% CI = −0.17, −0.08; P &lt;.001) in 2021, compared to bottom performers. Middle-performing countries saw reductions of 6.7% (b = −0.07; 95% CI = −0.11, −0.02; P =.01) and 10.6% (b = −0.11; 95% CI = −0.15, −0.06; P &lt;.001). These findings suggest that better containment is associated with fewer excess deaths, even after accounting for preexisting structural differences. Conclusions. The COVID-19 containment indicators&#39; precision emphasizes the association between better containment and lower excess mortality during early and postvaccine development periods. Public Health Implications. Our findings urge governments to utilize new metrics that balance flexibility and strictness for pandemic strategies, informing future policy interventions. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.2105/AJPH.2025.308136
    Languages:
      – Code: eng
        Text: English
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        PageCount: 11
        StartPage: 1518
    Subjects:
      – SubjectFull: Causes of death
        Type: general
      – SubjectFull: Hazardous substance safety measures
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Public health
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Government regulation
        Type: general
      – SubjectFull: COVID-19 pandemic
        Type: general
    Titles:
      – TitleFull: Excess Mortality and Containment Performance During the COVID-19 Pandemic: Evidence From 34 Countries.
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            – D: 01
              M: 09
              Text: Sep2025
              Type: published
              Y: 2025
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