文章
时政

针对动态清零政策突然结束时的超量全因死亡估计, A Paper from JAMA

Link:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808734


下面是论文中结果部分的翻译:

在动态清零政策结束后的头 2 个月,中国 30 岁及以上人群的超额死亡人数估计为 187 万(95% CI,71 万-443 万;每千人 1.33 例)。超额死亡主要发生在老年人中,并且在中国大陆除西藏外所有省份都出现了超额死亡。

EDIT: 回复里补充了对论文中部分估计结果与实际公布数据的“交叉验证”。同时欢迎各位对上述“交叉验证”进行补充和修正,以得到更准确的结果。


下面是论文的英文摘要

Key Points Question Was the sudden end of China’s zero COVID policy associated with an increase in population all-cause mortality?

Findings In this cohort study across all regions in mainland China, an estimated 1.87 million excess deaths occurred among individuals 30 years and older during the first 2 months after the end of China’s zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China, with the exception of Tibet.

Meaning These findings suggest that the sudden lifting of the zero COVID policy in China was associated with significant increases in all-cause mortality.

Abstract Importance In China, the implementation of stringent mitigation measures kept COVID-19 incidence and excess mortality low during the first years of the pandemic. However, China’s decision to end its dynamic zero COVID policy (a proactive strategy that deploys mass testing and strict quarantine measures to stamp out any outbreak before it can spread) in December 2022 resulted in a surge in COVID-19 incidence and hospitalizations. Despite worldwide attention given to this event, the actual impact of this sudden shift in policy on population mortality has not been empirically estimated.

Objective To assess the association of the sudden shift in China’s dynamic zero COVID policy with mortality using empirical and syndromic surveillance data.

Design, Setting, and Participants This cohort study analyzed published obituary data from 3 universities in China (2 in Beijing and 1 in Heilongjiang) and search engine data from the Baidu index (BI; weighted frequency of unique searches for a given keyword relative to the total search volume on the Baidu search engine) in each region of China from January 1, 2016, to January 31, 2023. Using an interrupted time-series design, analyses estimated the relative change in mortality among individuals 30 years and older in the universities and the change in BI for mortality-related terms in each region of China from December 2022 to January 2023. Analysis revealed a strong correlation between Baidu searches for mortality-related keywords and actual mortality burden. Using this correlation, the relative increase in mortality in Beijing and Heilongjiang was extrapolated to the rest of China, and region-specific excess mortality was calculated by multiplying the proportional increase in mortality by the number of expected deaths. Data analysis was performed from February 10, 2023, to March 5, 2023.

Exposure The end to the dynamic zero COVID policy in December 2022 in China.

Main Outcomes and Measures Monthly all-cause mortality by region.

Results An estimated 1.87 million (95% CI, 0.71 million-4.43 million; 1.33 per 1000 population) excess deaths occurred among individuals 30 years and older in China during the first 2 months after the end of the zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China except Tibet.

Conclusions and Relevance In this cohort study of the population in China, the sudden lifting of the zero COVID policy was associated with significant increases in all-cause mortality. These findings provide valuable insights for policy makers and public health experts and are important for understanding how the sudden propagation of COVID-19 across a population may be associated with population mortality.

菜单
  1. 匿名用戶   We_are_Anonymous._We_are_Legion.

    好文章,文章的其它重点部分:

    问题: 中国突然结束零新冠政策是否与人口全因死亡率上升有关?

    实验设计: 这项追踪研究分析了中国3所大学发布的讣告数据以及2016年1月1日至2023年1月31日期间,中国各地区的百度指数搜索引擎数据。本文采用间断时间序列设计,分析估计了大学中30岁及以上人群死亡率的相对变化以及百度指数中死亡关键词的变化。分析显示,百度对死亡相关关键词的搜索量与实际死亡负担之间存在很强的相关性。利用这种相关性,将北京和黑龙江的死亡率相对增长推算到中国其他地区,并通过将死亡率增长比例乘以预期死亡人数来计算特定地区的超额死亡率。数据分析于2023年2月10日至2023年3月5日进行。

    优点和局限性: 我们的研究是首批对零新冠政策取消后,对中国超额死亡人数提供严格推导的实证估计的研究之一。鉴于缺乏来自中国的全面、公开的数据,我们估算超额死亡人数的新策略对于中国和国际公共卫生问题的这一话题既及时又重要,并展示了数据源的战略组合如何能够提供对看似的死亡人数的见解。不透明的公共卫生研究问题。

    然而,我们的研究有局限性。对北京和黑龙江三所大学员工讣告数据的依赖可能会导致超额死亡率被高估,因为大学员工的年龄高于总人口,或者因为员工的社会经济地位较高而导致超额死亡率的低估。如果这些变量在讣告数据中的表示模式随着时间的推移而发生变化,这种偏差可能会特别明显。此外,百度指数搜索的增加可能并未完全反映参考区域之外的死亡率增加,导致低估了其他区域的超额死亡率。一旦获得替代数据源(例如,国家或国家以下各级基于人口的死亡率数据),进一步验证我们的估计将至关重要。特别是,按年龄、性别和社会经济地位水平划分的数据将允许对这些重要的人口变量进行协变量调整。

    结果:这项针对中国大陆所有地区的追踪研究中,估计在中国零新冠政策结束后的前两个月内,30 岁及以上的人群中出现了 187 万例超额死亡。超额死亡主要发生在老年人中,除西藏以外,中国大陆所有省份均出现了这种情况。

    结论: 研究结果表明,中国突然取消零新冠病毒政策与全因死亡率的大幅上升有关。

  2. linda   rico y libre

    187万还好还好,我总以为比美帝还要严重,这个数字看来中国表现还不错,但是不知道这个数字本身是不是低估

  3. 匿名用戶 回复 linda /p/203793

    他们是用大学教职工讣告名单外推的,众所周知大学老师的医疗条件和退休后的精神健康,远高于中国平均水平……

  4. linda 回复 匿名用戶 /p/203798

    哦,那就没意思了,我还以为他去太平间里点人头。

  5. 豊聡耳神子 圣人
    豊聡耳神子   擅长治国理政,能同时听十个人说话的圣德太子再世,幻想乡道教教宗道士

    200万以内已经是难以接受的了

  6. 0xbeef  

    这里再针对论文中的数据做一些“交叉验证”。


    论文表2中,针对人口占全国约5%的浙江省,2022.12和2023.1两个月的预期死亡人数是52 962,估计死亡人数是145 367,预估超量死亡是92 405 (95%置信区间是36 005 - 217 513)。

    相应的,浙江省实际公布数据还表明2023年一季度公布的火化人数是17.1万具。额外的,2020、2021和2022年的第一季度,全省火化遗体数分别为8.83万、9.3万和9.9万具。(下面的链接不是原始链接。在浙江省统计局上的原始网页已经消失了。)

    https://www.voachinese.com/a/chinese-province-saw-cremations-jump-during-covid-surge-20230718/7185401.html

    需要注意的是,估计结果和实际公布结果在时间上有一定差距(2022.12-2023.1 vs 2023.1-2023.3)。同时,实际公布的火化人数严格小于死亡人数。

    实际数据在估计结果的置信区间上方。


    个人认为,两者能够相互印证,意味着论文中的估计结果比较可信。