Age-adjusted mortality

Sweden Saw Second Smallest Increase in National Debt Out of All EU Countries

In 2020, the first year of the pandemic, almost every country in the world had a major recession. As this map from the IMF shows, most countries in Europe saw GDP decline by more than 3%, the only exception being Ireland (which in any case has an unusual way of counting GDP).

Despite this, unemployment in the EU only increased by a modest 1.2 percentage points, rising from 6.6% to 7.8% by the third quarter of 2020. One reason why unemployment didn’t rise more during months of lockdown is that governments spent unprecedented sums of money on furlough and other wage-support schemes.

February’s Age-Standardised Mortality Rate Was the Second Lowest on Record

The ONS announced last week that there were 43,081 deaths registered in England in February, which is 6,700 fewer than in January, and 7.2% less than the five-year average from 2016–2019 plus 2021.

Age-standardised mortality rates for leading causes of death other than Covid were again below their five-year averages. Though recall that the ONS now uses a new baseline for the five-year average, meaning that the latest figures are not directly comparable with those for previous months.

For the sake of consistency with previous posts, I will use the five-year average from 2015–2019 in the remainder of this post.

February’s overall age-standardised mortality rate was 10.1% lower than the five-year average, and the second lowest on record. This represents a continuation of the trend from January, which also saw the second lowest age-standardised mortality on record for that month. Here’s my updated chart of excess mortality in England since January of 2020:

Age-Adjusted Excess Mortality During the Pandemic in Sweden

One of the most startling facts of the pandemic is that, between January of 2020 and June of 2021, Sweden had negative excess mortality – the country’s age-standardised mortality rate was below the five-year average.

Despite all the warnings about “disaster” and “folly”, Sweden actually saw fewer deaths than usual over this eighteen month period. (The ONS data on which this conclusion is based only go up to June of 2021. But it’s a good bet the picture hasn’t changed much since then.)   

Even lockdown sceptics might find this difficult to believe. Sure, Sweden didn’t turn out to be the disaster that lockdown proponents claimed it would be. But can it really be true that there were fewer deaths than usual? What about those reports of Swedish hospitals “filling up with patients” in the winter of 2020?

It can really be true. And those reports are easy to reconcile with the mortality data. You just have to remember two phenomena: the ‘dry tinder’ effect, and mortality displacement.

For those who’ve forgotten, here’s a brief reminder. The ‘dry tinder’ effect refers to the tendency for mortality to increase following a period of unusually low mortality, due to the presence of large numbers of very frail elderly people, who ended up living longer than expected.

Mortality displacement is just the opposite. It refers to the tendency for mortality to decrease following a period of unusually high mortality – for deaths to be ‘brought forward’ by some deadly event, such as a pandemic, heat wave or unusually cold winter.

Once you’re familiar with these two phenomena, you realise it’s perfectly possible for hospitals to fill up temporarily without the mortality rate going up at all in the medium term (over a period of several months or a year, say.)

January’s Age-Standardised Mortality Rate Was the Second Lowest on Record

The ONS announced last week that there were 49,807 deaths registered in England in January, which is 380 more than in December, but 10.2% less than the five-year average.

Age-standardised mortality rates for leading causes of death other than Covid were well below their five-year averages. However, the ONS now computes the five-year averages from 2016–2019 plus 2021, rather than 2015–2019, meaning that the latest figures are not directly comparable with those for previous months.

In the remainder of this post, I will use the five-year average from 2015–2019 – for the sake of consistency with previous posts.

January’s overall age-standardised mortality rate was 14.3% lower than the five-year average, and the second lowest on record. This represents a marked change from the previous two months, when the age-standardised mortality rate exceeded the five-year average. Here’s my updated chart of excess mortality in England since January of 2020:

The substantial drop in excess mortality in the month of January suggests, once again, that deaths were ‘brought forward’ by the pandemic. In other words, some of those who died during the Omicron wave would have died soon anyway.

This commonly observed phenomenon is known as mortality displacement. Looking at the chart above, it can also be seen in the summer of 2020 and the spring of 2021.

In fact, if you take the average age-standardised mortality rate from June of 2020 to January of 2022, and compare it to the five-year average, there was only 2% excess mortality over this time period. In other words, there’ve been hardly any excess deaths since the end of the first wave.

Note that the official death toll in England increased by more than 100,000 between June of 2020 and January of 2022.  

The latest figures provide the strongest indication yet that the pandemic in England is over. Now we just have the collateral damage of lockdowns, mask mandates and vaccine passports to deal with.

This post has been updated.

Understanding the Covid Odds

Perhaps the biggest barrier to ending the pandemic and its related interventions and theatre is the irrational fear that many people still have of the virus, a fear that ironically (though not surprisingly from a psychological perspective) grips the vaccinated much more than the unvaccinated. John Tierney in City Journal has crunched the numbers to help people come to a rational assessment of their risk.

It’s obviously not easy to give up fear of COVID-19, to judge from a recent survey showing that the vaccinated are actually more frightened than the unvaccinated. Another survey found that most Democratic voters are so worried that they want to make it illegal for the unvaccinated to leave home. But before you don another mask or disinfect another surface, before you cheer on politicians and school officials enforcing mandates, consider your odds of a fatal Covid case once you’ve been vaccinated.

Those odds can be gauged from a study by researchers at the National Institutes of Health, published by the Centers for Disease Control. They tracked more than one million vaccinated adults in America over most of last year, including the period when the Delta variant was surging, and classified victims of Covid according to risk factors such as being over 65, being immunosuppressed, or suffering from diabetes or chronic diseases of the heart, kidney, lungs, liver or brain.

The researchers report that none of the healthy people under 65 had a severe case of Covid that required treatment in an intensive-care unit. Not a single one of these nearly 700,000 people died, and the risk was miniscule for most older people, too. Among vaccinated people over 65 without an underlying medical condition, only one person died. In all, there were 36 deaths, mostly among a small minority of older people with a multitude of comorbidities: the 3% of the sample that had at least four risk factors. Among everyone else, a group that included elderly people with one or two chronic conditions, there were just eight deaths among more than 1.2 million people, so their risk of dying was about one in 150,000.

Those are roughly the same odds that in the course of a year you will die in a fire, or that you’ll perish by falling down stairs. Going anywhere near automobiles is a bigger risk: you’re three times more likely during a given year to be killed while riding in a car, and also three times more likely to be a pedestrian casualty. The 150,000-to-one odds of a Covid death are even longer than the odds over your lifetime of dying in an earthquake or being killed by lightning.

John goes on to note that “studies have shown that natural immunity is much stronger and longer-lasting than vaccine immunity”, and while the threat of Covid is greater for unvaccinated adults, the case for vaccine mandates is obsolete “now that it’s clear that vaccination doesn’t prevent reinfection and transmission”.

Worth reading in full.

2021 Less Deadly Than 2015, ONS Data Show

Many lockdown sceptics have recently been sharing statistics from the ONS showing that just 17,371 people died of Covid in England and Wales up to the end of September 2021 where COVID-19 was the only cause of death recorded on the death certificate. This compares to 148,536 official Covid deaths in the same period (also for England and Wales, as are the estimates below) where COVID-19 was mentioned as a cause of death somewhere on the death certificate. Separately, the Government dashboard reported 126,384 deaths recorded as occurring within 28 days of a positive Covid test in the same period, while the ONS reported 117,247 excess deaths.

A more recent response to a Freedom of Information request in January gives a figure of just 6,183 deaths, again where COVID-19 was the only cause mentioned on the death certificate, this time up to December 31st 2021. The reason for the difference in these two figures is likely to relate to the definition used – the first figure (17,371) came from a dataset on pre-existing conditions that has been published throughout the pandemic (so didn’t actually need an FOI request to provide the data) and the definition is stated in the dataset. The definition and source of the second figure (6,183) is not stated.

Either way, the figures are an order of magnitude lower than official Covid deaths – for example, 17,371 is just 12% of the official ONS tally of Covid deaths of 148,536 – and some sceptics have inferred from this that up to 90% of the official Covid deaths are not really Covid deaths, or at least were likely to have happened around that time anyway, and thus that the pandemic death toll has been hugely overstated.

November’s Age-Standardised Mortality Rate Was 8% Higher Than the Five-Year Average

The ONS announced last week that there were 48,180 deaths registered in England in November, which is almost 5,000 more than in October, and 15.6% more than the five-year average.

November therefore saw a non-trivial rise in deaths. Interestingly, much of the increase seems to be accounted for by non-Covid causes. A comparison between last month’s breakdown by leading cause of death, and this month’s breakdown, is shown in the figure below.

The comparison is confusing because, for some reason, the ONS decided to reverse the colour scheme between the two reports. On the left-hand chart dark blue corresponds to the month itself (October), whereas on the right-hand chart it corresponds to the five-year average.

In any case, if you look carefully, you will see that the age-standardised mortality rates for all the leading causes of death (including Covid) rose from October to November. For example, the age-standardised mortality rate from Dementia and Alzheimer’s disease increased by more than 20% from 102 to 122 per 100,000.

Note: the charts should be interpreted with caution, as determining cause of death is not always straightforward.

November’s overall age-standardised mortality rate was 7.7% higher than the five-year average. This is a greater disparity than last month, when the two figures were approximately equal. Though it is less than that seen in September, when the age-standardised mortality rate was 11.2% higher than the five-year average.

Here’s my updated chart of excess mortality in England since January of 2020. Notice that November’s bump was smaller than September’s.

In terms of cumulative mortality to date, 2021 is now looking slightly worse than 2018. However, it is not yet as bad as 2015. In other words, the first eleven months of 2015 – a year with no pandemic – were more deadly than the first eleven months of 2021. And of course, 2021 is still looking better than last year.

November’s non-Covid excess mortality may reflect the delayed impact of lockdown. However, the overall figure of 7.7% indicates that mortality isn’t that much higher than you’d expect this time of year.

October’s Age-Standardised Mortality Rate Was Equal to the Five-Year Average

The ONS announced last week that there were 43,435 deaths registered in England in October, which is about 1,000 less than in September, and 7.1% more than the five-year average.

This is a marked change from last month, when total deaths were 19.4% above the five-year average. Looking at the breakdown by leading cause of death, it is also quite different from September’s:

Last month, several non-Covid causes of death were above their five-year averages, notably dementia and Alzheimer’s, as well as ischemic heart disease. In October, by contrast, all non-Covid causes other than “Symptoms signs and ill-defined conditions” are below their five-year averages.

This suggests that my concerns about the delayed impact of lockdown on mortality may have been misplaced. In other words: last month’s elevated rates of death from non-Covid causes may have been a blip, rather than the start of trend toward rising mortality.

October’s overall age-standardised mortality rate was approximately equal to the five-year average – 0.1% lower, in fact. Again, this is a marked change from last month, when the age-standardised mortality rate was 11.2% higher than the five-year average.

Since age-adjusted excess mortality is the best gauge of how mortality is changing, the fact that October’s value is about equal to the five-year average indicates that any impact of lockdown on mortality must be relatively small. Here’s my updated chart of excess mortality in England since January of 2020:

Various newspapers have reported a large excess of non-Covid deaths in England over the past four months. However, these claims appear to be based on absolute excess deaths, rather than age-adjusted excess mortality.

In October, there were more than 2,000 non-Covid deaths in excess of the five-year average. Yet as I already mentioned, age-adjusted excess mortality was approximately zero – and that includes the Covid deaths. This means that the most of the ‘excess’ non-Covid deaths we’ve seen recently are due to population ageing over the last two years.

All in all, October’s figures are more encouraging than September’s, giving no indication that mortality is unusually high. Let’s just hope it stays that way.

Sweden Has Had *Negative* Excess Mortality Since the Start of 2020

We all remember what happened last year when Sweden’s unflappable state epidemiologist Anders Tegnell announced there wouldn’t be a lockdown. His “trust-based” approach was roundly denounced – not only in the media, but also by some ‘experts’.

As Johan Anderberg notes, Sweden’s pandemic strategy was variously described as “deadly folly” (Guardian), “a disaster” (Time magazine) and “the world’s cautionary tale” (New York Times).

Since the end of the first wave, however, Sweden has been gradually creeping down the list of countries by official Covid death rate. As of 16th October, it was ranked 52nd – well below the European average.

Yet this actually understates how well Sweden has done. As I and others have consistently argued, number of Covid deaths per million is not the best measure of the pandemic’s impact on mortality. Far better is age-adjusted excess mortality.

Thanks to an ONS report published on Thursday, we now have age-adjusted excess mortality numbers for most of the countries in Europe, covering the entire period from January 2020 to June 2021.

As an aside, the report clearly states: “The best way of comparing the mortality impact of the coronavirus (COVID-19) pandemic internationally is by looking at all-cause mortality compared with the five-year average.”

So what do the new numbers show? Sweden has had negative excess mortality. In other words, the level of mortality between January 2020 and June 2021 was lower than the five-year average. If this isn’t a vindication of Anders Tegnell’s approach, I don’t know what is.

The table below (taken from the ONS report) shows age-adjusted excess mortality from 3rd January 2020 to 18th June 2021. As you can see, Sweden is 8th from bottom, with a value of –2.3%.

Interestingly, the bottom six are all small, geographically peripheral countries (three islands, plus Denmark, Norway and Finland). This suggests that geography and border controls were key, and that lockdowns – in the absence of effective border controls – didn’t make much difference.

The top seven are all in Eastern Europe, which again suggests that some geographic factor is at work. What may account for high excess mortality in these countries is the fact that all of them missed the first wave, and hence had even bigger epidemics in the winter. Official Covid death rates are shown below:

If true, this would constitute strong evidence against the House of Commons’ report, which concluded that Britain should have tried to suppress the first wave. As I’ve noted before, this approach always carried the risk of creating an even bigger epidemic in the winter.  

In any event, Anders Tegnell can give himself a well-deserved pat on the back. His country kept civil liberties largely intact, and ended up with one of Europe’s lowest death tolls. Well done, professor.

UK Life Expectancy in 2020 Was Still at 2010 Levels and Over 80, OECD Report Shows

A new report from the OECD has shown that the pandemic took life expectancy in the UK in 2020 back to 2010 levels. Life expectancy at birth dropped by one year from 81.4 to 80.4, a level last seen in 2009. In 2008 it was even lower at 79.8.

This has largely been reported as something shocking – “Pandemic wipes out decade of progress on improving life expectancy”, declares the Telegraph – but in fact what it really shows is how limited the impact of the pandemic has been.

Despite all the daily reports of deaths, the running total of over 165,000 Covid deaths, and the repeated lockdowns imposed to protect a health service ever on the brink of collapse, the country has experienced a mortality rate no worse than 2009. I don’t know about you, but I can remember 2009. I don’t recall any lockdowns and panicking, or coerced experimental medicine, or bodies piling up in the morgues. Yet it was a worse year for deaths than the great pandemic year of 2020. Let that sink in.

Why are we destroying people’s lives and livelihoods and dismantling our freedoms to avoid going back to 2009 levels of mortality? Are we that obsessed with extending life at all costs that we regard it as intolerable to return to mortality levels last seen around the time the current party of Government came to power?