Of­fi­cial Covid-19 death toll likely to have been over­stated, re­port finds

Last­ing im­pact on health out­comes may take years to be seen, says Hiqa New data sug­gests num­ber of deaths from coro­n­avirus may be less than re­ported

The Irish Times - - Home News - PAUL CULLEN Health Ed­i­tor

Ire­land’s of­fi­cial death toll from Covid-19 may have been over­stated, ac­cord­ing to a new re­port that says there was a 13 per cent in­crease in deaths dur­ing the pan­demic.

Be­tween 1,100 and 1,200 more deaths than would have been ex­pected on his­tor­i­cal pat­terns oc­curred be­tween March 11th and June 16th, ac­cord­ing to the re­port by the Health In­for­ma­tion and Qual­ity Au­thor­ity (Hiqa).

How­ever, this is sub­stan­tially lower than the 1,709 Covid-19 deaths of­fi­cially re­ported to the Na­tional Pub­lic Health Emer­gency Team (Nphet) over this pe­riod.

Data on mor­tal­ity is usu­ally gleaned from death reg­is­tra­tion records but be­cause of a three-month lag in this process, Hiqa’s es­ti­mate of ex­cess deaths, and other re­cent es­ti­mates dur­ing the pan­demic, are based on data from the Rip.ie web­site.

Hiqa found the of­fi­cially re­ported Coivd-19 deaths “likely over-es­ti­mates” the true bur­den of ex­cess deaths caused by the virus.

This could be due to the in­clu­sion within of­fi­cial fig­ures of peo­ple who were in­fected with coro­n­avirus at the time of death but whose cause of death may have been “pre­dom­i­nantly” due to other fac­tors, it sug­gests.

At the peak of the cri­sis, from March 25th to May 5th, 33 per cent more peo­ple were dy­ing than nor­mal. Dur­ing this pe­riod, there was an in­crease of 1,200 deaths from ex­pected fig­ures, but 1,332 Covid-19 re­lated deaths were of­fi­cially re­ported.

Over the past four weeks, this trend has re­versed, with fewer deaths than ex­pected, Hiqa says. Covid-19 may have ac­cel­er­ated the time of death of frail and vul­ner­a­ble peo­ple over the peak pe­riod, and the cur­rent re­duced mor­tal­ity may be due to peo­ple have died “ear­lier than ex­pected”.

“How­ever, it is also pos­si­ble that the changes to health­care de­liv­ery dur­ing the Covid-19 epi­demic, such as the sus­pen­sion of elec­tive ac­tiv­ity in pub­lic acute hos­pi­tals, may have a last­ing im­pact on health out­comes, the ef­fect of which may take years to be seen,” ac­cord­ing to Hiqa chief sci­en­tist Conor Tel­jeur. Ire­land ranks mid-ta­ble in Europe for ex­cess mor­tal­ity dur­ing the pan­demic but our data is “con­sid­er­ably closer” to coun­tries re­port­ing no ex­cess mor­tal­ity than those at the ex­tremes of ex­cess mor­tal­ity, the re­port notes.

Eng­land and Spain have the high­est fig­ures for ex­cess mor­tal­ity, while Nor­way, Den­mark and Greece have the low­est.

A sep­a­rate anal­y­sis by the Cen­tral Statis­tics Of­fice pub­lished yes­ter­day, and also based on Rip.ie data, puts ex­cess mor­tal­ity at 1,072 up to the end of June.

It notes a “pro­nounced in­crease” in death no­tices on the web­site in April com­pared to pre­vi­ous years and says Dublin and sur­round­ing coun­ties were heav­ily af­fected, while there were also in­creases in Ca­van, Mon­aghan and Done­gal.

The CSO anal­y­sis also notes a big in­crease in the use of terms such as “pri­vate”, “broad­cast” and “we­b­cam” in death no­tices from March on.

It says Rip.ie can be used to ac­cu­rately record trends in mor­tal­ity but points out that us­age by mi­nor­ity com­mu­ni­ties is much lower than the gen­eral pop­u­la­tion.

Deaths re­ported to Nphet by the HSE in­clude cases con­firmed by lab­o­ra­tory tests to have Covid-19 but also prob­a­ble and pos­si­ble cases of the dis­ease. A cen­sus of deaths that oc­curred in nurs­ing homes was con­ducted dur­ing the cri­sis.

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