Deaths from non-respiratory causes are projected to be a massive 10% higher than expected in 2022. Non-respiratory mortality typically varies little from year to year, changing by a maximum of just 1.3% in each of the six years from 2015 to 2020. However 2021 has registered a 3.72% increase and 2022 is projected to show a catastrophic 10.0% increase.
Because it is usually so stable, non-respiratory mortality is a useful way of showing that the ongoing excess mortality currently being experienced in the U.K. is unprecedented and unrelated to normal seasonal variation. It also shows that it has been happening ever since Covid vaccinations began in earnest in early 2021.
Respiratory disease (which is largely seasonal) is the largest component of variability in mortality statistics during the normal course of events. This means we can be justified in grouping all other mortality events together and terming them ‘core mortality’, regarding them as perhaps a better marker of the nation’s overall health. This is especially useful for the purposes of analysing the pandemic years, because Covid has replaced other respiratory diseases to some extent in the mortality statistics.
Looking at the pre-Covid data from 2015 -2019 it is possible to subtract the data for all respiratory disease (ICD code 10 J00-99), and arrive at a figure for non-respiratory mortality (NRM) for each week of the year. An average for the five pre-Covid years can then be calculated and compared with each individual year. Note we use the pre-Covid average as a baseline to avoid the unusual mortality of the pandemic years. (All data from the ONS.)
Here are the charts for those six years, 2015-2020, which demonstrate the relative stability of NRM statistics.
The large spike in non-respiratory mortality during weeks 14-18 of 2020 (the first five weeks of the pandemic), which resulted in 11,817 non-respiratory excess deaths compared to the 2015-2019 average, is likely a result of Covid death counting errors plus some deaths due to pandemic interventions (withdrawal of treatment, neglect, isolation etc.), as the rest of the year proceeds completely normally.
Turning to 2021 when the vaccination rollout began, the situation with non-respiratory mortality begins to change to a very erratic pattern from week 10, and then starts to show a steady increase above normal pre-Covid patterns in the latter half of the year.
This trend then continues into 2022, with a gradually increasing excess above the pre-Covid average developing as the spring and then autumn booster campaigns are rolled out.
There is one more significant factor to take account of, namely mortality displacement, as I have mentioned in previous posts. Overall mortality in 2020 was 81,478 above the five-year pre-Covid average, and in 2021 there was a further excess mortality of 53,263.
2022 is projected to end with another 42,500 excess deaths. All this excess mortality puts downward pressure on subsequent mortality statistics as it brings deaths forwards, especially because of the concentration of excess deaths during the pandemic on the elderly cohort of the population, when the average age of death has been around 83 years old.
In order to correct for this displacement, the actual mortality figures have to be revised upwards by a displacement factor of approximately 9% of the excess mortality per year, to allow accurate comparison of the mortality statistics with previous years. Doing this for the three years of the pandemic, the revised charts look like this.
Note that as the population as a whole ages, more deaths are expected each year so mortality statistics are ideally altered to reflect this trend, i.e., are age-adjusted. However the acceleration of untimely deaths of the oldest part of the population during the pandemic has significantly changed the median age of the population so this may be unnecessary.
Putting all three years together on one chart and condensing the data to four weekly aggregate figures to smooth out weekly fluctuations in the statistics, it is easy to see how the problem with excess non-respiratory ‘core’ mortality has been growing since 2021, rather than receding. 2021 shows a 3.72% increase and 2022 is projected to show a 10.0% increase. To state the obvious, this is not normal.
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