Spillover Effects of Epidemics: Impact of COVID-19 on Mortality of Non-COVID Diseases in China

Background: With the seeming end of the COVID-19 epidemic, international focus is rethinking its spillover consequences, such as on the routine provision and usage of healthcare. This study aims to estimate the potential spillover effects of the COVID-19 pandemic on the mortality of non-COVID diseases in China, focusing on chronic diseases and mental disorders.Methods: The mortality data are from China's Disease Surveillance Points (DSPs) system. The data used for the robustness check include socio-economic factors, policies to mitigate COVID-19, and air pollution data. We employed baseline and flexible models for each study using the difference-in-difference approach (DID).Findings: The results showed a sizeable increase in total non-COVID deaths and mortality from cardiovascular diseases, chronic kidney disease, diabetes, mental diseases, and suicide. Notably, the deaths from diabetes and suicide increased by 4·60% and 7·08%, respectively, relative to the regions without pandemic cases in the first outbreak and escalated by 3·57% and 5·00%, respectively, when the control group switched to the same period in 2019.Interpretation: These results documented adverse spillover effects of COVID-19 on mortality of non-COVID diseases, suggesting inadequate provision and utilization of regular health care. The government and healthcare industry should adopt the expediency of policies for non-epidemic diseases and reallocate health resources to mitigate future pandemics like COVID-19.Funding: This study was funded by the Humanities and Social Sciences Foundation of the Ministry of Education of China (21YJC630082). The funds have no role in any of the study design; in the collection, analysis, and interpretation of data; in the writing of the articles; and in the decision to submit it for publication.Declaration of Interest: We declare no competing interests.