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Study: 2020 reduction in hospitalizations and a concurrent increase in deaths during the COVID-19 pandemic in Hong Kong


HKUMed researchers at the WHO Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine at The University of Hong Kong (HKUMed) found a significant reduction in public hospital admissions and an increase in mortality, particularly from cardiovascular diseases, during the first year of the COVID-19 pandemic in Hong Kong in 2020.

The findings, which may reflect avoidable deaths caused by changes in health care seeking during the early pandemic, are now published in The Lancet Regional Health—Western Pacific.

In addition to the respiratory morbidity and mortality caused by SARS-CoV-2 infection, there exists a broad range of direct (e.g., SARS-CoV-2 infection of the heart or brain) and indirect (e.g., increase in cancer mortality due to reduced cancer screening or delayed treatment) public health impacts of the COVID-19 pandemic and related policy responses.

To describe these impacts across many medical outcomes, the research team used comprehensive long-term hospitalization and mortality data collected from the Hospital Authority and the Census and Statistics Department of the Government of the Hong Kong Special Administration Region (HKSAR), to quantify the health impacts of the COVID-19 pandemic.

They found an absolute reduction of 359,790 hospitalizations in public hospitals largely from respiratory and cardiovascular diseases, and 1,873 additional deaths particularly from cardiovascular diseases in 2020, above what would have been expected in the absence of the pandemic. Children under five years of age and older adults aged over 65 years were most affected. Reductions in the number of deaths occurring inside public hospitals were accompanied by increases in deaths occurring outside of public hospitals, which may suggest a reluctance to seek care even when gravely ill.

The results of this study suggested important, indirect impacts of the COVID-19 pandemic on public health in Hong Kong, likely resulting from worry about SARS-CoV-2 exposure in hospitals or other barriers reducing timely access to medical services.

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