Excess mortality in Israel associated with COVID-19 in 2020-2021 by age group and with estimates based on daily mortality patterns in 2000-2019

Chava Peretz, Naama Rotem, Lital Keinan-Boker, Avner Furshpan, Manfred Green, Michal Bitan, David M. Steinberg

Research output: Contribution to journalArticlepeer-review


Background: We aimed to build a basic daily mortality curve in Israel based on 20-year data accounting for long-Term and annual trends, influenza-like illness (ILI) and climate factors among others, and to use the basic curve to estimate excess mortality during 65 weeks of the COVID-19 pandemic in 2020-2021 stratified by age groups. Methods: Using daily mortality counts for the period 1 January 2000 to 31 December 2019, weekly ILI counts, daily climate and yearly population sizes, we fitted a quasi-Poisson model that included other temporal covariates (a smooth yearly trend, season, day of week) to define a basic mortality curve. Excess mortality was calculated as the difference between the observed and expected deaths on a weekly and periodic level. Analyses were stratified by age group. Results: Between 23 March 2020 and 28 March 2021, a total of 51 361 deaths were reported in Israel, which was 12% higher than the expected number for the same period (expected 45 756 deaths; 95% prediction interval, 45 325-46 188; excess deaths, 5605). In the same period, the number of COVID-19 deaths was 6135 (12% of all observed deaths), 9.5% larger than the estimated excess mortality. Stratification by age group yielded a heterogeneous age-dependent pattern. Whereas in ages 90+ years (11% excess), 100% of excess mortality was attributed to COVID-19, in ages 70-79 years there was a greater excess (21%) with only 82% attributed to COVID-19. In ages 60-69 and 20-59 years, excess mortality was 14% and 10%, respectively, and the number of COVID-19 deaths was higher than the excess mortality. In ages 0-19 years, we found 19% fewer deaths than expected. Conclusion: The findings of an age-dependent pattern of excess mortality may be related to indirect pathways in mortality risk, specifically in ages <80 years, and to the implementation of the lockdown policies, specifically in ages 0-19 years with lower deaths than expected.

Original languageEnglish
Pages (from-to)727-736
Number of pages10
JournalInternational Journal of Epidemiology
Issue number3
StatePublished - 13 Jun 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s) 2022; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.


  • COVID-19
  • Israel
  • age
  • excess mortality
  • mortality curve

ASJC Scopus subject areas

  • Epidemiology


Dive into the research topics of 'Excess mortality in Israel associated with COVID-19 in 2020-2021 by age group and with estimates based on daily mortality patterns in 2000-2019'. Together they form a unique fingerprint.

Cite this