<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2504-3145</journal-id>
<journal-title><![CDATA[Portuguese Journal of Public Health]]></journal-title>
<abbrev-journal-title><![CDATA[Port J Public Health]]></abbrev-journal-title>
<issn>2504-3145</issn>
<publisher>
<publisher-name><![CDATA[Escola Nacional de Saúde Pública]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2504-31452020000400051</article-id>
<article-id pub-id-type="doi">10.1159/000515656</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Excess non-COVID-19 mortality in Portugal: seven months after the first death.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Excesso de mortalidade não-COVID-19: sete meses após o primeiro óbito.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vieira]]></surname>
<given-names><![CDATA[André]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peixoto]]></surname>
<given-names><![CDATA[Vasco Ricoca]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguiar]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[Paulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abrantes]]></surname>
<given-names><![CDATA[Alexandre]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade NOVA de Lisboa NOVA National School of Public Health Public Health Research Center]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>38</volume>
<fpage>51</fpage>
<lpage>57</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2504-31452020000400051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2504-31452020000400051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2504-31452020000400051&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  On March 16, 2020, the first death from CO­VID-19 was recorded in Portugal. Since then, there has been a reorganization of health services, changing the normal approach for the different cases of public health. Excess deaths recorded without a COVID-19 diagnosis are called excess mortality without COVID-19 (EM non-COVID-19). This study aims to estimate the EM non-COVID in the 7-month period after the first registered Covid-19 death.  Methods:  The following 2 methods were used to estimate the excess mortality in this period: the daily historical average of reported deaths and an adapted auto regressive integrated moving average (ARIMA) model, considering the previous 5 years of records until October 16. For this model, after March 16, data was replaced with the daily historical average deaths from the previous 5 years, simulating the closest scenario possible as there was no pandemic. Only deaths from natural causes were selected for these estimations. For EM non-COVID-19 estimation, we subtracted the COVID-19 deaths from the overall excess mortality.  Results:  Between March 16, 2020, and October 16, 2020, there was an excess of 6,330 deaths from natural causes, i.e., nearly 12% more than expected. Both methods estimated an EM non-COVID-19 of around 66-67% in this period, with a greater relevance in mid-July and mid-September.  Conclusions:  Excess mortality was present almost every day during the study period. EM non-COVID-19 seemed to vary over time, showing some inadequacy of healthcare services in management of other patients free of COVID-19 in Portugal during periods with a greater patient volume. It is necessary to take care and monitor COVID-19 cases but also non-COVID-19 cases.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Em 16 de março de 2020 foi registado em Portugal o primeiro óbito por COVID-19. Desde então, houve uma reorganização dos serviços de saúde, resultando numa alteração do funcionamento dos serviços de saúde pública. O excesso de óbitos registados sem CO­VID-19 é denominado de Excesso de Mortalidade não-COVID-19 (EM não-COVID-19). O objetivo deste estudo é estimar a EM não-COVID-19 nos primeiros 7 meses após o primeiro óbito por COVID-19 em Portugal.  Métodos:  Dois métodos foram utilizados para estimar a Mortalidade Excessiva neste período: A média histórica diária de óbitos notificados e um modelo Autorregressivo Integrado de Média Móvel (ARIMA) adaptado, considerando os 5 anos anteriores de registos até 16 de outubro. Para este modelo, a partir de 16 de março, os dados foram substituídos pela média histórica diária de mortes dos 5 anos anteriores, simulando um cenário mais aproximado possível caso não existisse pandemia. Apenas mortes devido a causas naturais foram selecionadas. Para a estimativa do EM não-COVID-19, subtraímos as mortes por COVID-19 à mortalidade geral em excesso.  Resultados:  Entre 16 de março de 2020 e 16 de outubro de 2020, houve um excedente de 6 330 mortes por causas naturais, cerca de 12% a mais do que o esperado. Ambos os métodos estimaram um EM não-COVID-19 em torno de 66-67% neste período, com maior relevância em meados de julho e meados de setembro.  Conclusões:  O excesso de mortalidade esteve presente quase todos os dias no período de estudo. O EM-não COVID-19 pareceu ter alguma variação ao longo do tempo, evidenciando que momentos com maior volume se possam dever a alguma inadequação dos serviços de saúde na gestão de outros doentes sem COVID-19 em Portugal. É necessário continuar a cuidar e a monitorar os casos COVID-19, mas também os outros casos não CO­VID-19.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Excess mortality]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[Epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Public health surveillance]]></kwd>
<kwd lng="en"><![CDATA[Portugal]]></kwd>
<kwd lng="pt"><![CDATA[Excesso de mortalidade não-COVID-19 · COVID-19 · Epidemiologia · Monitorização em saúde pública · Portugal]]></kwd>
</kwd-group>
</article-meta>
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<year>2020</year>
<publisher-loc><![CDATA[Lisbon ]]></publisher-loc>
<publisher-name><![CDATA[Fundação Francisco Manuel dos Santos]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
