Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 7, 2020
Date Accepted: Apr 3, 2021
Date Submitted to PubMed: Apr 21, 2021
The uncounted casualties of a hidden COVID-19 epidemic in China: a cross-sectional study on overwork deaths based on crowdsourced data
ABSTRACT
Background:
During COVID-19 response, non-clinical essential workers usually work overtime and face strong work stress, which will subsequently increase risk of dying from cardiovascular diseases, stroke, and pre-existing conditions. Deaths on duty, including overwork death(s), during the COVID-19 response, were usually reported online for public recognition and solidarity. Though no official statistics is collecting those causalities, an online list of on-duty deaths has been made publicly available by crowdsourcing.
Objective:
This study aims to understand the trends and characteristics of the overwork death(s) among the frontline non-clinical essential workers participating in non-pharmaceutical interventions during the first wave of COVID-19 in China.
Methods:
Based on an online crowdsourced list of deaths on duty during the first wave of COVID-19 response in China, we manually verified the overwork death records with the full text of the online reports from credible sources. After excluding deaths caused by COVID-19 infections and accidents, 340 overwork death(s) among non-clinical essential were attributed to combatting COVID-19. We coded the key characteristics of deceased workers including sex, age at death, location, causes of death, date of incidence et cetera. The temporal and spatial correlations between overwork death(s) and COVID-19 cases in China were also examined using Pearson correlation coefficient.
Results:
From January 20 to April 26, at least 340 non-clinical frontline workers in China were documented to have died from overwork when combatting COVID-19. The weekly overwork mortality was positively correlated with weekly COVID-19 infections (r=0.72, p= .005). Two-thirds of deceased workers were under 55 years old. Two major causes of overwork death(s) were cardiovascular diseases (40.6%), and cerebrovascular diseases (21.2%). Outside of Hubei there were almost 2.5 times as many deaths caused by COVID-19 related overwork (n=308) than by the disease itself (n=120).
Conclusions:
The high number of overwork death(s) among non-clinical essential workers on the front lines of the COVID-19 epidemic is alarming. Policies of occupational health protection against work hazards should be prioritized and enforced. Clinical Trial: NA
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