Excess mortality associated with the COVID-19 pandemic (2020-2021) in an urban community of Bangladesh: Evidence from cemetery-based death registration

Measurement of COVID-19-attributed mortality is vital for public health policy decisions. Unlike high-income countries, the magnitude of COVID-19-related mortality is largely unknown in many low- and middle-income countries due to inadequate COVID-19 testing capacity and a lack of robust civil registration and vital statistics systems. COVID-19-associated excess mortality was investigated in an urban setting in Bangladesh using a cemetery-based death registration dataset. A total of 6,271 deaths (3,790 male and 2,481 female) recorded between January 2015 and December 2021 were analyzed by using the Bayesian structural time series model (BSTS). During the pre-COVID-19 period, the average monthly number of deaths was 69, whereas, during the COVID-19 period, this number significantly increased to 92. Overall, according to model-based results, during COVID-19 period, the number of deaths increased on average by 17% (95% CrI: -18%, 57%): males 29% (95 % CrI: -15%, 75%) and 2.9% for females (95% CrI: -61%, 70%). This first-of-its-kind study in Bangladesh has revealed the excess mortality due to the COVID-19 pandemic (2020-2021) in an urban community. It appears that cemetery-based death registration could help track various crises (e.g., COVID-19), especially when collecting data on the ground is challenging for resource-limited countries.