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Reaction to INE figures on deaths by cause of death

This week the National Statistics Institute (INE) shared the final figures for deaths by cause of death for the year 2021: 39,444 people died from identified covid-19, 34.6% less than in 2020. It also offered preliminary data for the first six months of 2022.

20/12/2022 - 21:57 CET
Expert reactions

Óscar Zurriaga - muertes INE EN

Óscar Zurriaga

Epidemiologist, researcher at the Department of Preventive Medicine, Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia and president of the Spanish Society of Epidemiology.

Science Media Centre Spain

The publication of mortality figures in Spain by the National Statistics Institute (INE) serves to take stock of the annual period of 2021. In this case we have to celebrate that, for the first time at the same time, a preview of data for the first six months of 2022 is being published. It should also be noted that the INE intends to maintain, according to its press release, these half-yearly previews on a regular basis. The importance of these data from a health point of view should also be highlighted, even more so at a time when deaths by cause of death have become a matter of concern for the media and the public.

The 2021 data reveal that, although pre-pandemic trends are recovering, this is still a year in which COVID-19 has marked the situation. This is also seen in the 2022 advance figures. This is despite an 8.7% decrease in the absolute number of deaths between 2020 and 2021. This trend is not maintained in the 2022 preview, where the number of fatalities increased by 2 % compared to the same period in 2021. 

Excess mortality due to summer temperatures in 2022 is not yet clearly visible in this published period. It will be necessary to wait for the next data preview in the second half of 2022 to fully appreciate it.

As a specific cause of death, "COVID-19, identified virus" was the most frequent cause of death in both 2021 and the first half of 2022. This is despite a decrease in the number of people dying from this cause in 2021 compared to 2020, and in the first six months of 2022 compared to the same period in 2021. In 2022 there is an increase in the group "infectious and parasitic diseases" in May and June compared to the same months in 2021, which is similar to the covid-19 wave in the spring of 2022. This means that the long-awaited normality has not yet been recovered and that it is still necessary to continue making efforts to protect the population, mainly through vaccination boosters, especially for the most vulnerable people.

By large groups of causes of death, both in 2021 and in the first half of 2022, tumours and diseases of the circulatory system are the leading causes, both in men and in women. In both periods, the large group of infectious and parasitic diseases, which includes COVID-19, ranks third in frequency of deaths.

Deaths due to diseases of the respiratory system, as a large group of causes, are in fourth place and have experienced a higher increase in women than in men in the first half of 2022 compared to 2021. It is worth highlighting the importance that this large group may have in relation to covid-19, as it is possible that, in certain cases, in the absence of specific diagnostic tests, the death may not have been certified as covid-19 and may have been certified as one of the causes included among the respiratory system diseases.

A more detailed analysis will be necessary in order to observe the real impact that the pandemic has had on some more specific causes, such as tumours or circulatory system diseases, which may have been affected by delays in diagnosis or treatment.

In the first half of 2022, there was also an increase in deaths due to so-called "external causes" (accidents, suicides, drowning, etc.) compared to 2021. Although the largest increase within this group (20.7%) is in "accidental drowning, drowning, submersion and suffocation", the leading cause within this group (22.8% of deaths from this group of causes) are suicides, with an increase of 5.1%. It should be stressed that these are avoidable deaths and that more efforts should be made to prevent them from occurring.

Óscar Zurriaga is the president of the Spanish Society of Epidemiology.

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