Excess mortality during the coronavirus pandemic

When looking at the development of excess mortality in the Slovak Republic, the pandemic can be declared as poorly managed. The exception was the first wave of the COVID-19 pandemic (March-May 2020), during which the hard lockdown introduced very quickly brought the expected results and numbers remained low. The second wave (September 2020 - May 2021) and later also the third wave (September 2021 - May 2022) had a completely different course and Slovakia recorded a high number of infected persons and deaths. While the strong second wave is primarily the result of neglected preparation (planning, contact tracing, testing), chaotic political decisions often without a scientific basis (population-wide rapid antigen testing), inappropriate communication to the public and the late introduction of a hard lockdown, in the third wave the main problem was the COVID-19 vaccine politicization (inconsistent support for vaccination across the political spectrum, scandal with Sputnik V vaccine, the unsuccessful vaccination lottery) and again the late-introduced lockdown.

Although all EU countries recorded an increased excess mortality during the pandemic, a more detailed comparison shows that the situation in Slovakia was particularly unfavourable (reaching 70% at the peak of the wave, a total of 26,786 excess deaths were recorded). Hypothetically, it is even possible to quantify the number of lives that could potentially be saved if the same anti-pandemic measures as in selected EU countries were introduced in Slovakia. For instance, if we were to proceed as Estonia, up to 12,391 human lives could have been saved in Slovakia. Even more lives could have been saved if we vaccinated our population as Portugal did (14,483 lives) or manged the pandemic as well as Denmark (21,308 human lives).

Using a logistic regression model based on data from health insurance companies (Dôvera and Union HIC), the mortality rate from COVID-19 could be examined. The results of the model shows that the key factors improving the survival prognosis were contact with a general practitioner within 14 days after the confirmation of COVID-19 (also via telemedicine, a little less with a specialist), the prescription of selected drugs from ATC groups, which were based on the recommendations made by the doctor, vaccination and also previous overcoming of coronavirus infection. On the other hand, the presence of another serious diagnosis (oncology patients, patients with chronic renal failure and patients with primary pulmonary hypertension), a visit to the emergency room indicating the search for emergency medicine by a patient already in a critical condition, the increasing age of the patient and also the prescription of antibiotics (those not recommended in guidelines) can be considered as risk factors.