Estimating excess mortality during the Covid-19 pandemic in Aotearoa New Zealand.

Estimating excess mortality during the Covid-19 pandemic in Aotearoa New Zealand.

Publication date: Jun 11, 2025

The excess mortality rate in Aotearoa New Zealand during the Covid-19 pandemic is frequently estimated to be among the lowest in the world. However, to facilitate international comparisons, many of the methods that have been used to estimate excess mortality do not use age-stratified data on deaths and population size, which may compromise their accuracy. We used a quasi-Poisson regression model for monthly all-cause deaths among New Zealand residents, controlling for age, sex, and seasonality. We fitted the model to deaths data for 2014-19. We estimated monthly excess mortality for 2020-23 as the difference between actual deaths and projected deaths according to the model. We conducted sensitivity analysis on the length of the pre-pandemic period used to fit the model. We benchmarked our results against a simple linear regression on the standardized annual mortality rate. We estimated cumulative excess mortality in New Zealand in 2020-23 was 1040 [95% confidence interval (-1134, 2927)], equivalent to 0. 7% (-0. 8%, 2. 0%) of expected mortality. Excess mortality was negative in 2020-21. The magnitude, timing, and age-distribution of the positive excess mortality in 2022-23 were closely matched with confirmed Covid-19 deaths. Negative excess mortality in 2020-21 reflects very low levels of Covid-19 and major reductions in seasonal respiratory diseases during this period. In 2022-23, Covid-19 deaths were the main contributor to excess mortality, and there was little or no net non-Covid-19 excess. Overall, New Zealand experienced one of the lowest rates of pandemic excess mortality in the world.

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Concepts Keywords
Covid Adolescent
Mortality Adult
Zealand Age Distribution
age-standardized mortality rate
Aged
Aged, 80 and over
Cause of Death
Child
Child, Preschool
COVID-19
excess deaths
Female
generalized linear model
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mortality
New Zealand
Pandemics
Poisson Distribution
Poisson regression
SARS-CoV-2
SARS-CoV-2
Young Adult

Semantics

Type Source Name
disease MESH Covid-19 pandemic
disease MESH respiratory diseases
disease MESH death
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
pathway REACTOME Translation
disease IDO site
drug DRUGBANK L-Valine
disease IDO country
drug DRUGBANK Albendazole
drug DRUGBANK Fenamole
disease MESH influenza
disease MESH causes
drug DRUGBANK Ranitidine
disease MESH Infectious Diseases
disease MESH privacy
drug DRUGBANK L-Asparagine
pathway REACTOME Release
disease MESH Infection
drug DRUGBANK Polyethylene glycol
drug DRUGBANK L-Aspartic Acid
disease MESH Cause of Death

Original Article

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