Dynamics of morbidity and mortality of the population during the pandemic period in the Far Eastern Federal District (on the fifth anniversary of the coronavirus disease 2019 (COVID-19) pandemic)

Introduction. The pandemic of the novel viral respiratory infection declared in 2020 demonstrated that coronaviruses are extremely dangerous human pathogens. They are characterised by high lethality and present a considerable medico-social threat owing to life-threatening complications.
Aim. To assess the impact of the COVID-19 pandemic on morbidity and mortality levels in the population of the Far Eastern Federal District (FEFD).
Materials and methods. A set of analytical, epidemiological and statistical studies was performed, together with a content analysis of relevant publications. Morbidity and mortality were evaluated according to ICD-10, using data from the state statistical monitoring system for 2000–2023 and the databases of the Federal State Statistics Service and the Ministry of Health of the Russian Federation.
Results. In the first pandemic year overall morbidity among adults fell sharply across all ICD-10 classes except “Diseases of the respiratory system”, which in the FEFD rose by 48.7% over the entire pandemic period. In 2020 the prevalence of COVID-19 among adults in the FEFD and in the Russian Federation was 2.4- and 3.2-fold higher, respectively, than among children. The pandemic was marked by high virulence and, accordingly, high adult case-fatality from COVID-19, which differed five-fold between FEFD regions. Among persons aged ≥ 60 years, COVID-19 accounted for 83.3% of deaths, whereas in the working-age group it accounted for 15.2% and in the 0- to 15-year group for 0.04%. The greatest share of deaths from respiratory diseases occurred in the 1- to 4-year age group (7.04%), while deaths from COVID-19 predominated in the 70- to 74-year group (9.28%). On average, respiratory diseases accounted for 4.51% of all deaths and COVID-19 for 6.76%. The pandemic markedly affected both the level and the structure of mortality across the full spectrum of causes. Particularly unprecedented was the rise in deaths from respiratory diseases: after years of steady decline (2000–2019), the rate increased by 48.7% in both Russia overall and the FEFD. During the pandemic years, total mortality among men in the region grew by 16.6% in 2021 versus 2019, and among women by 22.4%, reversing previous downward trends. The contribution of COVID-19 to overall mortality more than doubled the respective age-standardised death rates for respiratory and digestive diseases. In 2021 COVID-19 accounted for 14.6 % of all deaths in the FEFD, with regional shares ranging from 7.0% to 20.9%.
Conclusion. The COVID-19 pandemic substantially altered the level and structure of morbidity and mortality across all major nosological categories in the region. Socio-economic and natural-climatic conditions of the Far East produce wide inter-regional variation in these indicators. Forecasts that the recorded decline in morbidity during the pandemic would have negative consequences were confirmed: delayed detection and late diagnosis of chronic pathologies have led to progression, life-threatening complications and, consequently, increased mortality among people who did not receive timely and adequate medical care.

1. World Health Organization. Coronavirus disease (COVID-19) pandemic. Available at: https://www.who.int/emergencies/ diseases/novel-coronavirus-2019

2. Zhmerenetskiy K.V., Sazonova YE.N., Voronina N.V., Tomilka G.S., Sen'kevich O.A., Gorokhovskiy V.S., D'yachenko S.V., Kol'tsov I.P., Kutsyy M.B. [COVID-19: scientific facts only]. Dal'nevostochnyy meditsinskiy zhurnal 2020; 1:5–12 (in Russian).

3. Starodubov V.I., Kadyrov F.N., Obukhova O.V., Bazarova I.N., Endovitskaya Yu.V., Nesvetailo N.Ya. [The effect of coronavirus СOVID 19 on the situation in Russian healthcare]. Menedzher zdravookhraneniya = Manager of Health care 2020; 4:58–71 (in Russian).

4. Minakir P.A. [Pandemic economy: The Russian way]. Prostranstvennaya ekonomika = Spatial Economics 2020; 16(2):7–18 (in Russian). https://doi.org/10.14530/se.2020.2.007-018

5. Cherkashin A.K. [National characteristics of changes in the hazard of development of the COVID-19 coronavirus pandemic: mathematical modeling and statistical analysis]. Narodonaseleniye = Population 2020; 23(3):83–85 (in Russian). https://doi.org/10.19181/population.2020.23.3.8

6. [Morbidity of the population of Russia in 2000-2023: statistical materials]. Moscow: FGBU Tsentral'nyy NII organizatsii i informatizatsii zdravookhraneniya MZ RF, 2024. Available at: http: //www.mednet.ru

7. [Natural movement of the population of the Russian Federation in 2000-2023]. In: Statisticheskiy byulleten' Federal'noy sluzhby gosudarstvennoy statistiki. 2001-2024. Moscow (in Russian). Available at: http://www.gks.ru/

8. Medik V.A., Tokmachev M.S. [Mathematical statistics in medicine]. Moscow: Finansy i statistika; 2007 (in Russian). ISBN: 978-5-279-03195-5.

9. Medik V.A., Tokmachev M.S. [Guide to Health and Health Statistics]. Moscow: Meditsina; 2006 (in Russian). ISBN: 5-225-03984-7.

10. Kolosov V.P., Manakov L.G., Polyanskaya Ye.V., Perel'man Yu.M. [Dynamics of morbidity of the population with respiratory diseases in the pandemic COVID-19 period in the far Eastern Federal district]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2021; 81:8–18 (in Russian). https://doi.org/10.36604/1998-5029-2021-81-8-18

11. Kolosov V.P., Manakov L.G., Polyanskaya Ye.V., Perel'man Yu.M. [Impact of the COVID-19 pandemic on mortality dynamics in the Far Eastern Federal District]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2021; 82:8–20 (in Russian). https://doi.org/10.36604/1998-5029-2021-82-8-20