Showing posts with label excess death rate. Show all posts
Showing posts with label excess death rate. Show all posts

Monday, 10 April 2023

COVID-19 NSW 2023: Counting Dead People Part 5

 

 

The COVID dead are not published over Easter as Australia enjoys a four day break, so most of the data in this post doesn't go beyond 6 - 7 April 2023. 


Between 31 March and 6 April 2023 there were 9,876 newly confirmed COVID-19 infections recorded in New South Wales.


A total of 952 COVID-19 cases had been hospitalised with 20 in intensive care unit. Note: Between 27 March and 2 April 2023 NSW Health records show 46.6% of those admitted with COVID-19 infections had received 4 or more vaccination doses. As of 1 April XBB and its sub-lineages were the dominant variant group in community cases. This includes XBB.1.5, XBB.1.16 and XBB.1.9.


Another 36 people had died as a result of COVID-19 infection in the 7 days up to 6 April 2023. NOTE: There is no published data on gender, age or area health service published for this group to date. However, given past NSW Respiratory Surveillance Report data it is like between 1-3 people died in the Northern River region and that they were in the oldest age groupings.


Of those people newly infected during this 7 day period, est. 220 lived in the NSW Northern Rivers region.


NOTE: Given that NSW Health in its 4-week tables only publishes local government area infection statistics for people who tested positive by way of a PCR test and in the Northern Rivers region around half the people being tested rely on the Rapid Antigen Test (RAT) to confirm COVID-19 infection, the following numbers for the 7 local government areas in NE NSW are significant underestimates of total positive tests.


Northern NSW COVID-19 Infection in 4 weeks up to 7 April 2023:


Tweed Shire — 142 cases across postcodes 2484, 2485, 2486, 2487, 2488, 2489, 2490; 


Byron Shire  31 cases across postcodes 2479, 2481, 2482, 2483,


Ballina Shire  57 cases across postcodes 2477, 2478, 


Lismore City — 24 cases across postcodes 2472, 2480; 


Kyogle — 5 cases in postcode 2474;


Richmond Valley — 7 cases across postcodes 2469, 2470, 2471, 2473;


Clarence Valley — 32 cases across postcodes 2460, 2462, 2463, 2464, 2465;


Note: These postcodes are based on Data NSW COVID-19 cases datasets


Covid Live calculated that between 1 January 2020 and 8 April 2023 a total of 3,952,896 men, women and children resident in New South Wales are known to have been infected by SARS-CoV-2 or one of its variants and contracted COVID-19.


According to NSW Health total deaths due to COVID-19 in New South Wales since the beginning of the pandemic are est. 6,634 men, women and children. An estimated 31% of all these deaths occurred in the 12 months & 13 days between 24 March 2022 and 6 April 2023.


Actuaries Australia published the latest excess death rate for Australia and its states and territories which was calculated at the end of 2022. That excess death rate was 12% for Australia representing 20,000 excess deaths, and 12% for NSW in which state that represented 6,600 excess deaths.



Actuaries Australia, Actuaries Digital, 6 April 2023:


Overall summary of excess mortality in 2022


We estimate that there were just over 20,000 (12%) more deaths in Australia in 2022 than we would have expected if there had been no pandemic. Excess mortality is widely regarded as the best measure of the overall impact of a pandemic since it includes deaths both directly and indirectly due to the disease.


Of the 20,200 excess deaths in 2022, we estimate that:


  • 10,300 deaths (51%) were from COVID-19;

  • 2,900 deaths (15%) were COVID-19 related, meaning that COVID-19 contributed to the death; and

  • 7,000 deaths (34%) had no mention of COVID-19 on the death certificate.















Deaths from COVID-19 are those where COVID-19 is given as the underlying cause of death on the death certificate. Deaths from COVID-19 were the third leading cause of death in Australia in 2022. The main reason why the numbers do not match those derived from surveillance reports is that the latter includes almost all cases[1] where people had COVID-19 when they died. Reported surveillance deaths will include deaths from COVID-19, deaths that were COVID-19 related and other deaths where the doctor/coroner has determined that COVID-19 was incidental and had no role in the death of the person.


For most of the underlying causes of death reported on by the Australian Bureau of Statistics (ABS), the share of COVID-19 related deaths in 2022 is similar to the share of all non-COVID-19 deaths. The exceptions to this are dementia (which is over-represented in COVID-19 related deaths as frail dementia sufferers are also particularly vulnerable to COVID-19), respiratory disease (under-represented as COVID-19 is more likely to determined to be the underlying cause rather than a contributing cause) and coroner-referred deaths (under-represented, but the position could change as coroner findings are made).


It is unclear how close we are to reaching an endemic state when the impact of COVID-19 on mortality will become (more) predictable. Figure 2 shows that the latest wave of COVID-19 deaths continued in January 2023 (estimated at just over 1,000 deaths) but had ended by February 2023 (similar to the lowest month of 2022 at around 350 deaths).















The death certificates of about one-third of excess deaths in 2022 had no mention of COVID-19. These non-COVID-19 deaths represent excess mortality of 4%, which is extraordinarily high in itself, as can be seen in Figure 1. Non-COVID-19 excess deaths are particularly apparent in those aged over 75 for both genders and those aged under 65 for females only. We consider that the most likely reasons for these excess deaths are:


  • The impact of COVID-19 on subsequent mortality risk, particularly heart disease, stroke, diabetes and dementia, which have all been identified in studies;

  • Delays in emergency care, particularly at times of high prevalence of COVID-19 and/or influenza; and

  • Delays in routine care, which refers to missed opportunities to diagnose or treat non-COVID-19 diseases and the likelihood of consequent higher mortality from those conditions in future. We understand that disrupted prescription of medications may be particularly likely to be a major risk factor for those with chronic heart disease….


Leading causes of death


The ABS reports on the top 20 leading causes of death by grouping deaths based on their International Classification of Diseases, version 10 (ICD-10) code. Cancers are grouped based on the region of the body rather than included as a whole. In this section, we assess where COVID-19 sits in terms of leading causes of death in Australia and have followed the ABS classification system.


We have estimated deaths for the leading causes for 2022. To do this, we have:


  • Taken doctor-certified deaths by cause to 31 December as shown in Table 1;

  • Included an allowance for coroner-referred deaths (using the historical ratio of doctor-certified to coroner-referred deaths); and

  • For the leading cancer causes, we have estimated deaths from all cancers and then assumed lung cancers and colon cancers make up 18% and 12% respectively of all cancer deaths. These proportions have been stable over the recent period examined.


Click on image to enlarge


With around 10,300 deaths from COVID-19 in 2022, this puts COVID-19 as the third leading cause of death….


Excess deaths to 31 December 2022 by State/Territory


Table 3 shows our estimate of excess deaths by state/territory, before and after deducting from COVID-19 and COVID-19 related deaths.



Click on image to enlarge








In 2022, all states/territories apart from NT had significant levels of excess mortality ranging from 10% to 16% of predicted. Generally, about half of this is due to deaths from COVID-19, with another 1-2% due to COVID-19 related deaths......


In 2022:


  • Queensland had a large peak in non-COVID excess deaths in the middle of the year (at the time of flu and COVID-19 waves). NSW had a smaller peak at this time, but Victoria did not have a similar peak; and

  • Barring the winter peaks for NSW and Queensland, Victoria’s non-COVID-19 excess has tended to be higher than the other two large states…...


Read the full article here.