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Karen Cutter Profile picture
@KarenCutter4
Jan 19, 2023 • 17 tweets • 5 min read • Read on X
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NSW Health has released their epi report for the week ending 14 Jan. As I've been away for a while, this thread covers the last six weeks or so.
#Covid19Aus #Covid19NSW
You can find the full report here...
health.nsw.gov.au/Infectious/cov…
Note that for the two weeks ending 31 Dec, NSW Health reported a lot of metrics for these two weeks combined. So I have needed to estimate the split between the two weeks in some places.
In the most recent wave, cases grew quite steadily up until around 10 Dec, then we had a dramatic decline (-40%) in the week ending 31 Dec (a week that includes Christmas day and boxing day). The last two weeks have seen 30% reductions in cases. Image
PCR vs RAT cases: removing mandatory reporting of RATS resulted in an undercount of RATs relative to the previous wave.
The requirement for a doctor referral to get a PCR test since 1 Jan has reduced the number of PCR cases. RAT and PCR cases are now similar again. Image
It is very difficult/impossible to really understand the trend in case numbers in the last few weeks given the impact of Christmas, plus changes to access for PCR tests.
Healthcare workers furloughed (an early indicator of case trends) is on the decline, but the shape doesnt have the same big drop in the w/e 31 Dec as the cases graph.
This indicates prevalence is now similar to w/e 14 Nov, whereas the cases graph would indicate 29 Oct. Image
In good news, PCR positivity has reduced in the last three weeks. But still terribly high at 13%. Image
Cases by age band: loads more recorded cases in 60+ age band in this wave. And a lot less cases recorded in kids. Image
Hospital admissions have been falling for the last 3 weeks Image
The epi report no longer reports on how many people are in hospital.
Wrapping up 2022, this graph shows a breakdown of hospital/ICU admissions by age band since 22 May (when we have data). 20% of hospital admissions were in those aged under 40.
This age mix has been pretty consistent over the year. Image
There were 120 deaths recorded this week. Image
And here is the age mix of deaths from 22 May to 31 Dec.
Of the 4,622 covid deaths in the year, 29 were in people aged under 40. Image
Our homegrown BR.2 sublineage has been dominant over the last six weeks or so.
XBF has had some recent growth.
ends/ Image
A correction to this thread: PCR testing in NSW is still available without a GP referral. So it is unclear why PCR case numbers have dropped so much. Yes, there would have been a real reduction in cases, but the quantum appears too high…
Maybe people were like me and thought it had been implemented in NSW, so aren’t seeking PCR tests?
This should say 11%, not 13%. I incorrectly quoted last week’s positivity rate.

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More from @KarenCutter4

Karen Cutter Profile picture
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
Karen Cutter Profile picture
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
Karen Cutter Profile picture
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
Karen Cutter Profile picture
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
Karen Cutter Profile picture
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
Karen Cutter Profile picture
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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