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The excess mortality connected with COVID-19 pandemic

Background: During COVID‑19 pandemic all countries of the world face increase in mortality of the population for different kinds of causes in comparison with previous years, but this increase could be explained not only by the registered COVID‑19 death cases. In this article the problem of excess mortality in the period of COVID‑19 pandemic for all reasons is discussed.Objective: Assessment of the average scale and structure of excess mortality in the period of COVID‑19 pandemic in terms of International Classification of Diseases – 10 (ICD‑10) in the Russian Federation and also in the certain territorial subjects of the Russian Federation including those of the Southern Federal District.Material and methods: Data of the state mortality statistics during 2019–2020 are used. Level of excess mortality was defined as a difference between the number of the dead from the particular reasons during the analyzed period of time (2020) in comparison with the same period of time in previous year. Cartograms and charts are constructed by free service Datawrapper (https://app.datawrapper. de/).Results: In total in the year 2021 there were by 340279 death cases more, than in 2019. The general average mortality rate in Russia from all kinds of causes was 1460.2 ± 299.0 (variation coefficient 0.19) in 100 thousand people. That is 19.2% higher, than in 2019 (1225.1 in 100 thousand people). In structure of the excess death reasons the first place took the death causes connected with the new coronavirus infection – 42.5% of all excessive death cases. The second and third places belong to such causes as blood circulatory system diseases (28.6%) and diseases of respiratory organs (11.0%). In 2020 the number of working‑age people who died from blood circulatory system diseases was by 23432 more, than in 2019. In some types of diseases, the level of the general mortality decreased. Malignant neoplasms dominate in terms of the decrease of the number of mortal cases – in 2020 died 2939 people less, than in 2020. At the same time, the specific weight of number of the working‑age people who died of malignant neoplasms in 2020 in comparison with 2019 increased by 1.9% and was 22.0%. The general intensive indicator of mortality across Russia in such disease as “neoplasms” in 2020 was 202.0 cases, which is 2.5% higher than a target indicator of the federal project “Fight with Oncological Diseases”. This causes the need to increase the efficiency of participants activity in implementation of this federal project.Conclusion: The pandemic of such disease as COVID‑19, disproportionately affected different territories of the country in terms of death rate of the population both from the death causes connected with the new coronavirus infection and from other reasons, first of all – from blood circulatory system diseases. Despite the additional financing of oncological service from the federal budget, during the pandemic mortality of adults of working‑age from malignant neoplasms grew, which can be connected not only with weak immune system of people with cancer but also with low efficiency of participants activity of the federal project “Fight with Oncological Diseases”.