Karen Cutter Profile picture
Oct 5, 2022 20 tweets 7 min read Read on X
Our latest analysis of excess mortality is now out, covering all cause mortality to the end of June 2022, plus COVID-19 only mortality for July-Sept.
#COVID19Aus #excessdeaths
TLDR: +11,200 excess deaths in first half of 2022 (13%)
actuaries.digital/2022/10/06/cov…
Our excess deaths are measured relative to pre-pandemic expectations of mortality.
Includes allowance for continuation of mortality improvement/decline for each cause of death.
Allows for changes in the size and age composition of the population.
Excess mortality in the month of June 2022 was again very high, almost as bad as January 2022.
Needed to change my y-axis for this one.
Total excess deaths in June of 2,400 (16%):
- a lower share of excess deaths were due to COVID-19 (about a third, compared with 54% earlier in 2022);
- there were more flu deaths in June than predicted, reflecting an early flu season; we do not expect a bad flu year
- dementia deaths were much higher than predicted, possibly impacted by the reappearance of flu in the community and high COVID-19 cases in aged care homes in June;
- ischaemic heart disease and other causes also made a significant contribution.
In the six months to June, total excess of 11,200 deaths (13%):
- half due to COVID-19 (98 from long Covid)
- respiratory down, despite flu deaths in May and June
- deaths from all other causes significantly higher than predicted.
Here's weekly deaths from COVID (doctor-certified only). About 200 per week in May and June.
For context, in Australia we have about 1,200 deaths from motor vehicle accidents PER YEAR.
Here's weekly respiratory deaths (flu, pneumonia, chronic lower, other - not COVID).
Deaths were higher than predicted in June - a first since March 2020.
Flu surveillance indicates this is due to an earlier flu season rather than an indication of excess mortality for the year.
Here's all non-Covid, non-respiratory.
Another one where I needed to change my y-axis. Terrible.
This shows the excess before and after removing deaths "with" Covid.
It is unclear how many people with COVID-19 would have died during this period anyway, and how many may have had their death hastened by COVID-19.
Thus, the table may ...
... overstate the contribution of COVID-19 to excess mortality from other causes.
However, it indicates that after removing with COVID-19 deaths:
•there remains significant excess from heart disease, dementia and other diseases; but
•excess for diabetes is very low.
This shows the breakdown of excess deaths into those due to COVID-19, those from COVID-19, and those where COVID-19 was not a cause listed on the death certificate.
June 2022 has the highest number of excess deaths not involving COVID-19.
What could be causing the non-COVID excess?
Multiple factors are likely in play, and different factors may be more or less pronounced at various times.
The blog in my first tweet discusses these potential factors in more detail.
What about beyond June?
In the last three months there have been about 5,300 surveillance COVID deaths (including an estimate for the last 1-3 days of Sept).
Of these, we expect 74% to be "from" rather than "with" COVID, resulting in a estimated 3,900 deaths from COVID-19 in Q3 2022. Equivalent to 8% excess, before we include any excess from other causes.
Estimated excess deaths across the pandemic are 13,800 (3%).
This shows the cumulative age standardised mortality rates for each year since 2015, expressed relative to the 2019 year.
Noting that, pre-pandemic, mortality was falling by 1.5%-2% pa, experience for the first half of 2022 is higher than for any other year shown.
Covid is expected to be the third leading cause of death in 2022. Behind dementia and ischaemic heart disease. Above strokes, lung cancer, colon cancer.
The end. Any questions?
Pre-emptively, no, we cannot do good analysis by age or state as we dont have data by age&cause or state&cause. So it makes it hard to interpret.
Here's a thread from last month on age, and I'll do something by state this month.
And congratulations if you got this far - it was a long one this month.

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More from @KarenCutter4

Apr 12
Some fact checking on this article.
TLDR: Australia has not reached a 'significant' COVID milestone
A short thread/
"Australia appears to have had at least a week where no COVID-associated deaths were recorded for the first time in more than two years."
This is simply not true. The statement is based on this Fed Health graph. Image
Yes, it does show a 7-day average of zero deaths for the most recent data points. But this ignores the fact that the graph is compiled using date of death, and it is almost impossible for someone to die, have their death registered, and included in the Fed data within a week! Image
Read 11 tweets
Apr 5
The Mortality Working Group of the Actuaries Institute has released our estimate of excess mortality for the full year 2023.
TLDR: Excess mortality for 2023 is 5% (95% CI: 3%-7%) or +8,400 deaths.
A thread/
actuaries.digital/2024/04/05/exc…
Note that our expected number of deaths (baseline) is our expectation had the pandemic not happened.
The baseline allows for changes in the age and size composition of the population over time, plus allows for pre-pandemic mortality trend to continue.
We finished the year with deaths being much higher than expected for each of the four weeks in December (as they were in November). Image
Read 15 tweets
Mar 27
Australian deaths counts: surveillance vs death certificates.
For some time now I have been quizzically looking at the death surveillance reporting, thinking the numbers looked too low.
A thread/
This is because of the relationship between hospitalisations and deaths.
Normally deaths track hospital admissions quite closely, but with a little bit of a lag. But for Dec23 and Jan24, this relationship changed - deaths are lower than expected based on hospitalisations. Image
A few theories were floating around about why (eg. JN.1 less severe), but it also didnt make sense to me from looking at the Vic death reporting, and knowing the Vic wave was a bit earlier than the rest of Aust. Things just werent stacking up nicely.
Read 8 tweets
Mar 1
The Mortality Working Group* of the Actuaries Institute has estimated Australian excess mortality to 30 November 2023.

A thread/

* re-branded as we plan to look at more than just Covid
Total excess mortality for the first 11 months of 2023 is estimated at 5% (95% confidence interval: 3% to 7%).
This is about 7,400 more deaths than expected if the pandemic had not happened.
This compares to excess mortality for 2022 of 11%.
With only one month of data still to be reported for 2023, we expect that excess mortality for the full year 2023 will be about half the level of 2022.
Read 11 tweets
Feb 21
The ONS has released a new methodology for calculating excess deaths.
A thread/
First off, I am going to say that this is NOT a conspiracy to hide excess deaths.
This is a government institution doing its best to estimate excess deaths in a sensible way, noting where we are in the pandemic.
Now that we are going into the fifth year post-pandemic, those of us measuring excess mortality are needing to make hard decisions on how to do it.
We are in a difficult phase (measurement wise) as we cant reliably estimate a pre-pandemic baseline (pre-pandemic was ...
Read 13 tweets
Jan 17
Last week the OECD published this paper on recent mortality trends, including yet another estimate of excess mortality.
How do the OECD results for Australia differ to the Actuaries working group results?
A thread/
oecd-ilibrary.org/docserver/78f6…
I'm going to start by saying there is no "right" answer to how to measure excess mortality.
By definition, excess mortality is the difference between actual deaths that occurred in a period, and a predicted number of deaths. And the predicted number is just that - a prediction
Depending on what you are doing, there may be valid reasons for choosing one particular prediction method over another.
In the case of the OECD, they are trying to form estimates for all OECD countries, and so choice of method can become very restricted. This is because...
Read 16 tweets

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