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@article{Watson:2021:10.1038/s41467-021-22474-9,
author = {Watson, O and Alhaffar, M and Mehchy, Z and Whittaker, C and Akil, Z and Brazeau, N and Cuomo-Dannenburg, G and Hamlet, A and Thompson, H and Baguelin, M and Fitzjohn, R and Knock, E and Lees, J and Whittles, L and Mellan, T and Winskill, P and COVID-19, Response Team IC and Howard, N and Clapham, H and Checchi, F and Ferguson, N and Ghani, A and Walker, P and Beals, E},
doi = {10.1038/s41467-021-22474-9},
journal = {Nature Communications},
pages = {1--10},
title = {Leveraging community mortality indicators to infer COVID-19 mortality and transmission dynamics in Damascus, Syria},
url = {http://dx.doi.org/10.1038/s41467-021-22474-9},
volume = {12},
year = {2021}
}

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TY  - JOUR
AB  - The COVID-19 pandemic has resulted in substantial mortality worldwide. However, to date, countries in the Middle East and Africa have reported considerably lower mortality rates than in Europe and the Americas. Motivated by reports of an overwhelmed health system, we estimate the likely under-ascertainment of COVID-19 mortality in Damascus, Syria. Using all-cause mortality data, we fit a mathematical model of COVID-19 transmission to reported mortality, estimating that 1.25% of COVID-19 deaths (sensitivity range 1.00% – 3.00%) have been reported as of 2 September 2020. By 2 September, we estimate that 4,380 (95% CI: 3,250 – 5,550) COVID-19 deaths in Damascus may have been missed, with 39.0% (95% CI: 32.5% – 45.0%) of the population in Damascus estimated to have been infected. Accounting for under-ascertainment corroborates reports of exceeded hospital bed capacity and is validated by community-uploaded obituary notifications, which confirm extensive unreported mortality in Damascus.
AU  - Watson,O
AU  - Alhaffar,M
AU  - Mehchy,Z
AU  - Whittaker,C
AU  - Akil,Z
AU  - Brazeau,N
AU  - Cuomo-Dannenburg,G
AU  - Hamlet,A
AU  - Thompson,H
AU  - Baguelin,M
AU  - Fitzjohn,R
AU  - Knock,E
AU  - Lees,J
AU  - Whittles,L
AU  - Mellan,T
AU  - Winskill,P
AU  - COVID-19,Response Team IC
AU  - Howard,N
AU  - Clapham,H
AU  - Checchi,F
AU  - Ferguson,N
AU  - Ghani,A
AU  - Walker,P
AU  - Beals,E
DO  - 10.1038/s41467-021-22474-9
EP  - 10
PY  - 2021///
SN  - 2041-1723
SP  - 1
TI  - Leveraging community mortality indicators to infer COVID-19 mortality and transmission dynamics in Damascus, Syria
T2  - Nature Communications
UR  - http://dx.doi.org/10.1038/s41467-021-22474-9
UR  - https://www.nature.com/articles/s41467-021-22474-9
UR  - http://hdl.handle.net/10044/1/86632
VL  - 12
ER  -

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