Tipping the Scales: A Theoretical Model to Describe the Opposing Effects of the COVID-19 Pandemic on Mortality

Abstract Background. The COVID-19 pandemic has resulted in changes in almost every aspect of life. The fatal consequences of the pandemic have been clearly reported, with direct and indirect effects; however, there is some evidence of a positive secondary impact, such as fewer motor accidents and reduced air pollution. Methods. We present a model to describe the opposing effects of the COVID-19 pandemic on mortality, taking into account external pressures and internal resources and their relationship with resilience and health behaviors, which affect mortality risk. Individuals with lower resources and from more deprived communities are likely to be more negatively affected by the external changes occurring. Results. The COVID-19 pandemic has had both a positive and negative impact on mortality. Conclusions. Decision makers should consider ways to incorporate the positive changes which occurred as part of the exit strategy. Special emphasis should be given to populations most affected by external changes, in order to build resilience and reduce disparities.