Nowcasting daily mortality on real-time for public health surveillance

This work was financially supported by national funds from FCT: projects PEst-OE/MAT/UI0006/2014 and PTDC/MAT/118335/2010It is well described in the literature that during health-related events, like influenza epidemics or occurrence of extreme weather events, such as heat waves or cold spells, the observed “all causes” mortality increases above the expected, presenting excess deaths of 20-40%.These facts have triggered the development of Public Health surveillance systems, with the objective of early detection of such events, so that public health measures can be taken in time, as well the estimation of its impact. Since the 2003 heat wave, the Department of Epidemiology of INSA has been developing a daily mortality monitoring system (VDM), which came fully operational in 2007. In this system INSA receives electronically, on a daily basis, all deaths registered in the previous day at the Conservatories of the Civil Registry. Previous studies have showed that 95% of the deaths that occurred in specific day are registered up to 6 days after, with an average and median delay of 8 and 2 days respectively. Given that the detection of the impact of the events are dependent on these delays, it would be very important to have, on a daily basis, the estimate of the number of deaths occurred but not yet registered in the system.Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Portugal; Centre of Statistics and Applications of the University of Lisbon, Portugal; FCT Research Unit of the Institute of Preventive Medicine of the University of Lisbon, Portuga