Covid deaths higher at weekends than weekdays, global study finds

Global Covid deaths on weekends have been higher compared to weekdays during the pandemic, according to a study.

Researchers accepted that reporting delays could be a contributing factor, but said shortfalls in clinical staffing, capacity, and experience at weekends are also likely to play a role.

Overall, the average number of global deaths from coronavirus were 6% higher on weekends compared to weekdays – 8,532 compared to 8,083 – throughout the pandemic, researchers said.

Experts from the University of Toronto in Canada analysed all deaths reported to the World Health Organisation Covid-19 database between March 7, 2020 and March 7, 2022.

The findings, which are due to be presented at this year's European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Portugal later this month, suggest the US had on average 1,483 weekend deaths compared to 1,220 on weekdays – a 22% increase.

Brazil had an average of 1,061 weekend deaths compared to 823 on weekdays, which is a 29% increase, and the UK had on average 239 weekend deaths compared to 215 on weekdays – an 11% increase.

Further study looking at the average number of Covid deaths on individual days of the week found the increase was particularly big when comparing Sunday to Monday – 8,850 compared to 7,219 deaths – and Friday to Monday – 9,086 compared to 7,219.

One of the researchers, Dr Fizza Manzoor, said delays in reporting deaths on weekends do not account completely for differences in different countries – with Germany reporting fewer average deaths at weekends (137) compared to weekdays (187).

Dr Manzoor said: "Bureaucratic delays on weekends alone do not explain why there are fewer documented Covid-19 deaths on Mondays compared to Fridays, and reporting lags alone cannot explain why the increase in weekend deaths was so substantial in the USA and not seen in Germany.

"Instead, the 'weekend effect' is also likely to be due to shortfalls in clinical staffing, capacity, and experience. What's more, our findings suggest that this problem is not resolving despite improved health system performance and awareness over the course of the pandemic.

"There is an opportunity for health systems to further improve clinical care on all days of the week."

The researchers accepted the conclusions of the study, which has been peer-reviewed, could be limited by false-negative results, missed cases, and data entry errors, and that the available data does not account for disease severity or explore the impact of local policies and public health interventions in individual countries.