The actuarial profession's CMI has produced its weekly update on mortality during the pandemic. It reports that in the latest week (to 6th Nov) excess deaths were 9% above expectation. Some more context to follow. 1/11
The analysis uses age standardised mortality rates, which adjusts for changes in the size/age dist'n of the pop'n. This gives a better answer than using numbers of deaths - typically you get a lower excess as our population is ageing, so we would expect more deaths each yr. 2/11
This chart compares 2020 with the average of 10-19. Note that as mortality has improved over the decade you would expect more recent years to be lower, and vice versa. Note also how close 20 was tracking to 19 before late March. You can see the line drifting up again now. 3/11
A comparison of each yr with the previous yr helps assess how light mortality in one year (eg a "good flu year") might translate to heavy mortality the next yr. The speed and size of the shock we saw in the first wave is clearly unprecedented with anything that went before. 4/11
You can see that it's not just the very old who are dying. Excess mortality is up at all ages. And besides, once you reach 80, your expectation of life is still several years from that point, probably with some comorbidities, as that comes with the territory at that age. 5/11
The paper sets out how the 9% is derived and why 2019 is the preferred comparison (though it's also the same compared with 15-19 this week). The disparity between M (11%) and F (9%) is clear. You can see that the excess has risen from 6% to 9% in a week, a 50% jump. 6/11
The paper estimates the latest view of overall excess deaths as 57k for E&W and 63k for the UK. It also gives a foretaste of next week's numbers, with 26% more COVID deaths for the w/e 13/11 being reported by PHE currently. 7/11
To those wondering whether 9% additional deaths represents statistically significant excess mortality, PHE reports weekly on this point, and its latest report clearly states that the last four weeks (including W45) show excess mortality. 8/11 assets.publishing.service.gov.uk/government/upl…
The CMI has been studying mortality since the 1920s, in support of the life and pensions industry. Its suite of reporting is a standard methodology, though reporting has been stepped up for COVID and attracts a wider audience. But the graphs earlier are not newly developed. 9/11
In line with the Actuaries' Code, the CMI's work is independent, impartial and is not subject to bias. With so much misinformation, selective quoting of statistics etc regarding COVID, it's worth remembering this. There is no "agenda" in its paper or methodology. 10/11
So in summary, we are now in a period of increasing statistically significant excess mortality, which we can expect to continue for at least the next couple of weeks given leading indicators. 11/11 END

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More from @john_actuary

8 Nov
A summary of some key points from @ICNARC's latest weekly update on COVID patients in ICU, on behalf of @ActuaryByDay and @COVID19actuary. New admissions have now risen to 3129 since 1 Sep, with 1263 in the last 14 days. It's still heavily weighted towards the North. 1/9
The slower growth than in March is very apparent, though numbers are steadily climbing. The last few days will have reporting delays, so need to be taken with a degree of caution. We know that the picture is very varied regionally, so let's take a look at that data too. 2/9
Except for NI, all areas are well below their first wave peak. Note how London, by population, was hit much worse first time around, so any comparisons with it appear more favourable. In fact, this time rates are broadly consistent with most areas, except for the NW. 3/9
Read 9 tweets
6 Nov
The latest @ONS infectivity survey has been released. For England ONS suggests that new infections have levelled off at around 50,000 per day. (The estimate has reduced from 51,900 to 45,700, but this must be seen in the context of the confidence intervals around each one.) 1/6 Image
Overall infections have increased, albeit more slowly, from 568k to 619k, being 1 in 90 of the community. Remember that this survey excludes healthcare settings, including care homes. 2/6 Image
The regional picture shows a clear reduction in the NW, consistent with the levelling off in admissions that @COVID19actuary has been reporting of late. Other regions appear to be stabilising too. 3/6 Image
Read 6 tweets
29 Oct
The interim report of Round 6 of @imperialcollege's #REACT study makes grim reading. It estimates 96,000 new infections a day, with an R of 1.56, and doubling every 9 days. Nearly 1m are estimated to be infected. Covering 16-25 Oct, it's very up to date. Here's some detail. 1/8
Regionally, Yorks/Humber has overtaken the NW, consistent with admissions data @COVID19actuary has been reporting recently. Lower prevalence areas have higher growth rates, with R over 2, so there should be no complacency elsewhere, with short doubling times. 2/8
Similarly for age, although 18-24 is highest the most rapid growth is now at older ages, with a threefold increase at 55-64, and doubling above 65. It's these groups which will be driving the increases in admissions we've already seen (and sadly, subsequent deaths). 3/8
Read 8 tweets
27 Oct
The latest #REACT study by @imperialcollege shows decreasing levels of antibody prevalence. Overall levels fell by 24% over a 12 week period, from 6% to 4.8% in Round 2, and now 4.4%. Let's take a closer look in this short thread. 1/6
By age the % fall was greatest in the oldest groups, with an increasing trend from age 45. There is some variability though, eg in the data table in the report we see 75+ increased in Rd 3 by 25%, reflecting some wide CI's. 2/6
Showing the wide regional variation, London fell 27% from 13% to 9.5%, whereas at the other end of the spectrum, the SW fell 42% from 2.8% to 1.6%. Note again the increase in Rd 3 for the SW, with a very wide CI for the change we shouldn't read too much into this. 3/6
Read 6 tweets
23 Oct
The latest weekly report from @ONS on infectivity shows a further increase for England, with 433k (up from 336k) estimated to be infected in the most recent period. That's 1 in 130 (1 in 160), and with 35,200 (27,900) new infections per week. 1/6
The regional trends are starting to show some variation, with some signs of levelling in the last couple of weeks for the worst affected regions. Wider confidence intervals make these more uncertain though, but hopeful signs maybe. 2/6
By age there's a clear fall in early teens, a levelling off for younger adults, but still growth at older ages, albeit at a lower level. Those are the ages which matter in terms of hospitalisation though. 3/6
Read 7 tweets
23 Oct
I'm uncomfortable with comparisons with the 1st wave - there's an implication that as long as numbers are lower, everything's OK, which I disagree with. But with numbers in the NW rising, how do admissions compare? 1/7
At first sight much better. The peak day so far is much lower, and it's taken longer to get to even half that level. (I've assumed the peak was on D14 in the first wave as the later peak appears to be data catch up.) I'll discuss the current trend later. 2/7
If you look at the cumulative position, again we're well down on Wave 1. But interestingly, the total admissions are almost twice that seen by the first peak. They've just been much more spread out. Remember "flatten the curve" - it's clearly had a big effect this time. 3/7
Read 7 tweets

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