Excess mortality during the COVID-19 pandemic in Israel, March–November 2020: when, where, and for whom?

Abstract

Background: Excess all-cause mortality has been used in many countries as an estimate of mortality effects from COVID-19. What was the excess mortality in Israel in 2020 and when, where and for whom was this excess? Methods: Mortality rates between March to November 2020 for various demographic groups, cities, month and week were compared with the average rate during 2017–2019 for the same groups or periods. Results: Total mortality rates for March–November were significantly higher by 6% in 2020, than the average of 2017–2019, 14% higher among the Arab population and 5% among Jews and Others. Significantly higher monthly mortality rates were found in August, September and October by 11%, 13% and 19%, respectively, among Jews and Others, and by 19%, 64% and 40% in the Arab population. Excess mortality was significant only at older ages, 7% higher rates at ages 65–74 and 75–84 and 8% at ages 85 and above, and greater for males than females in all ages and population groups. Interestingly, mortality rates decreased significantly among the younger population aged under 25. The cities with most significant excess mortality were Ramla (25% higher), Bene Beraq (24%), Bat Yam (15%) and Jerusalem (8%). Conclusion: Israel has seen significant excess mortality in August–October 2020, particularly in the Arab sector. The excess mortality in March–November was statistically significant only at older ages, over 65. It is very important to protect this susceptible population from exposure and prioritize them for inoculations. Lockdowns were successful in lowering the excess mortality. The excess mortality is similar to official data on COVID-19 deaths.