Examining Population Health During the Global COVID-19 Pandemic: All-Cause, Pneumonia and Influenza, and Road Traffic Deaths in Taiwan

Background: Despite its proximity to China, as of August 2020, Taiwan has successfully contained the COVID-19 outbreak, with seven deaths and fewer than 500 infections. Its success is largely attributable to the timely implementation of effective non-pharmaceutical interventions. Our goal is to assess whether non-pharmaceutical interventions and behavioral changes affected all- and other causes of death. Methods: We collected historical data on all-cause, pneumonia and influenza, and road traffic deaths from three governmental agencies.  For each variable, data were aggregated on a yearly basis to match the corresponding availability in 2020 at the time of this study and a linear regression analysis was conducted excluding the 2020 value. The resulting equation was subsequently used to calculate the 2020 projection. The projected value, with its 95% prediction interval (PI), was compared to the value actually reported in 2020, to detect significant deviations during the COVID-19 pandemic. Findings: ll-cause deaths were lower than expected (103,088 vs. 106,200) but within the 95% PI (P-value>0.05) during the first seven months of 2020. Pneumonia and influenza deaths were significantly lower than expected (12,760 vs. 15,078, 95% PI = [13,088, 17,068], P-value<0.05), while road traffic deaths in the first five months of 2020 were significantly higher than expected (1,221 vs. 1,059, 95% PI= [917, 1,201], P-value<0.05). Interpretation: COVID-19 interventions may have prevented the spread of other respiratory infectious diseases and resulted in fewer than expected deaths in Taiwan. On the other hand, the pandemic may have pushed some people to prioritize private transportation over public, causing an increase in road traffic deaths. Funding Statement: The authors received no financial support for the research, authorship, and/or publication of this article. Declaration of Interests: All the authors declare no competing interests.