In a previous article I introduced the concept of looking at mortality from non-respiratory causes (i.e., not deaths from flu, Covid or other similar pathogens) as a better indicator of core mortality changes in the U.K. population than either excess deaths alone (or even excess non-Covid deaths). This is because most of the variation in the number of deaths between winter and summer and from year to year are due to respiratory causes; thus, take those out and you get a clearer picture of the underlying health of the population and whether people are generally getting sick and dying more or less than in recent years from causes such as cardiovascular problems, cancer, Alzheimer’s and so on.
I decided to go back and re-analyse the data in order to see how excess non-respiratory mortality has accumulated over the last few years. I discovered that this showed a total for 2021, 2022 and 2023 (thus far) of 49,696 deaths. When one takes into account the mortality displacement for this time period (owing to the pandemic bringing expected deaths forward; explained here), which I estimate as 23,650 deaths, the non-respiratory excess mortality reaches 73,346 deaths.
Comparing this to the number of deaths due to Covid (as underlying cause) over the same time period, which total 89,629 deaths, we see that the Covid figure is just 16,283 or 22% higher. Bearing in mind that it is widely acknowledged that there has been overcounting of Covid deaths (and thus conversely undercounting of non-respiratory deaths), the two tallies are now broadly similar, and thus an emergency situation at least as dangerous as the pandemic itself has arisen, which must surely now be addressed by the authorities.
To highlight the overcounting of Covid deaths, one only need compare the data for ‘deaths due to’ against ‘deaths with’ for COVID-19, and contrast it with the figures for other respiratory diseases. For Covid around 82% of deaths ‘with Covid’ are claimed to be ‘due to’ Covid over the course of the pandemic, yet with all other respiratory diseases only 34% of deaths ‘with’ the disease are claimed to be ‘due to’ it. The reason for the considerable discrepancy is unclear and suggests Covid is being significantly over-attributed as underlying cause.
For this article I calculated the number of excess non-respiratory deaths (relative to 2015-2019 pre-Covid averages) for each week of the year, and then calculated the cumulative values over the course of a full year. These charts confirm the suitability of the concept of non-respiratory mortality to serve as a stable core mortality rate that does not normally vary significantly from year to year. This is because there is a clear tendency (pre-Covid) for the cumulative non-respiratory mortality values to tend back to zero (i.e., the x-axis) if there has been a period of abnormal positive or negative values for an extended time. This indicates the role of mortality displacement in causing overall deaths to even out over time.
In fact, even in 2020 the shape of the curve (orange) looks very similar to the pre-Covid curves, excepting for the sudden spike at the beginning of the first wave of the pandemic when chaotic counting was arguably occurring. Without this the curve would hug the x-axis pretty much all through the year.
When we look at the curves for 2021, 2022 and 2023, however, the pattern changes radically. From week 18 in the spring of 2021 onwards the curve begins to point only upwards, and it further accelerates from the spring of 2022 and once again in the early part of 2023.
Please note all these curves are generated from the raw data from the ONS weekly reports for England and Wales. They are not adjusted for mortality displacement or anything else.
Putting all these curves together on one chart illustrates the changing pattern over the course of the pandemic, and in particular the striking upward turn in the spring of 2021.
Note that there appears to be little evidence of any need for an age-standardised adjustment to prevent an upward drift in death rates owing to an ageing population. Even after six years from the beginning of 2015 through to the end of 2020, the cumulative non-respiratory mortality is still around the zero mark, and even dips a little below in the first three months of 2021 (remember this is mortality with the respiratory deaths including Covid taken out).
Recent articles from Dr. Noah Carl have questioned whether mortality was unusually high in 2022 because, when the figures are adjusted for an ageing population using the age-standardised mortality rate (ASMR), excess deaths come out low. The ASMR is a hypothetical construct that is used to adjust crude mortality data for changes in the age structure of a population. It relies on a standardised population model that provides the weightings in the population of different age groups. This is a very useful model that can make sense of changing mortality rates over time when studying the demography of a population.
However, I would argue that it is not a useful model during times of exceptional change, as it relies on assumptions of weightings that change only incrementally over time and doesn’t take into account when a large number of deaths occur unexpectedly in older age groups. During the Covid pandemic there have been nearly 200,000 excess deaths (relative to the 2015-2019 average), and these are largely concentrated in the oldest age groups, i.e., the groups that provide the bulk of ‘normal’ mortality.
In particular, the over-80 age group comprises just 4.6% of the U.K. population yet delivers almost 60% of deaths in a normal year. As the U.K. population is roughly 67 million people, this puts the over-80s at about three million persons. The occurrence of 200,000 excess deaths in this age group implies a drop in the ‘weighting’ of this age group in the age make-up of the population of some 6.5%.
As the mortality in the U.K. in recent times has averaged about 600,000 deaths per year, a 6.5% adjustment in 60% of them would represent about 24,000 fewer deaths to be expected in 2022 than standardised models would predict, counteracting the ASMR expectation that the number of deaths should rise owing to an ageing population. 2022 has, however, seen something of a record year in overall mortality figures.
This is why, instead of looking at a misleading age-standardised mortality rate, we get a much better picture of what’s going on if we look at non-respiratory mortality as a measure of ‘core’ mortality, taking out the highly variable respiratory deaths. It’s worth noting here that it’s possible that the reason ‘core’ non-respiratory mortality has remained stable over recent years rather than rising as the age-standardised model would predict is because stronger winter flu seasons such as 2017-18 have naturally counteracted the effect of ageing on ‘core’ mortality.
The actuarial profession certainly seems to agree that there is a negative trend in underlying life expectancy based on what has been happening in 2022.
The upshot of this analysis of non-respiratory mortality is that something extraordinary has been occurring in the trends in core mortality since spring 2021, notably around the time of the Covid vaccination rollout. This worrying trend is currently accelerating and requires an urgent inquiry into whether the vaccinations themselves are playing a part or, if not, what is going on.
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