COVID deaths during the pandemic have been higher on weekends compared to weekdays, a global study has found.

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

The researchers said 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.

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The findings, which will be presented at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) event in Portugal later this month, suggest the UK had on average 239 weekend deaths compared to 215 on weekdays, which is an 11% increase.

The US had on average 1,483 weekend deaths compared to 1,220 on weekdays, a 22% increase, and Brazil had an average of 1,061 weekend deaths compared to 823 on weekdays, a 29% increase.

Further analysis that looked 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.

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‘This problem is not improving despite awareness’

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 added they accepted the conclusions of the study, which has been peer reviewed, may 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.

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