AS THE NUMBER of people who have died in Ireland with Covid-19 continues to grow, some misleading posts on social media have claimed that deaths overall have not been impacted by the pandemic.
The number of people in Ireland who have died with Covid-19 has now reached 2,149.
Some claims on social media have suggested that the total number of people who have died in the country this year has not changed compared to previous years.
One post from an Irish Facebook page said that “deaths in the first eight months of the year are in line with other years”.
The post has been seen over 17,000 times since it was first shared on 10 December.
However, official sources have estimated that during the first three to six months of the pandemic alone, around 1,000 more people died in Ireland this year compared to what would have been expected if Covid-19 had not emerged.
Excess mortality
The Central Statistics Office (CSO) has estimated excess mortality for the period from March to September alone to be between 876 and 1,192.
Similarly, the Health and Information Quality Authority (HIQA) has estimated that between 11 March to 16 June, there were 13% more deaths in Ireland than there would have been without the pandemic.
Excess mortality refers to deaths “over and above what would be expected under normal circumstances”.
To analyse excess mortality during Covid-19, the CSO used data from the website RIP.ie, which publishes death notices from around the country, to monitor deaths close to the time they occurred.
The CSO compared mortality figures on a monthly basis from October 2019 to September 2020 with figures from 2014 to 2019.
In a statement accompanying its findings, the CSO said that “while there are observable seasonal peaks, there is significant variance year on year”.
“However, a clear increase can be seen in the level of death notices observed in April of this year which contrasts with observed dips in mortality levels in April of all previous years,” the CSO said.
“A total of 3,503 death notices were recorded in April, which is over 900 higher than the next highest number of deaths recorded in April in any of the previous five years (2,594 in April 2018).”
“The number of death notices decreased in May and June (to 2,639 and 2,205 respectively) and has begun to rise slowly between July and September 2020 in line with the trends seen in previous years.”
The estimation assumes that in the absence of Covid-19 deaths, mortality in Ireland would have followed a pattern similar to previous years.
However, the CSO notes that adjustments could be required to control for factors such as changes in the number of influenza (flu) deaths because of reduced social interaction.
In July, the Health Information and Quality Authority (HIQA) published a report of excess deaths from 11 March to 16 June.
HIQA estimated that there was a 13% increase in deaths during the period compared to what would have been expected otherwise based on previous trends.
Dr Conor Teljeur, HIQA’s chief scientist, said that “based on an analysis of the death notices reported on RIP.ie since 2010, there is clear evidence of excess deaths occurring since the first reported death due to Covid-19 in Ireland”.
“There were about 1,100 to 1,200 more deaths than we would expect based on historical patterns; a 13% increase between 11 March to 16 June,” Dr Teljeur said.
The report says that the reported number of Covid-19 deaths – which was 1,709 at the time in mid-June – was higher than the number of excess deaths estimated by HIQA, which it said could be due to the inclusion of some people who were infected with Covid-19 but whose death had also been due to other factors.
However, at the time of the report’s publication, Dr Teljeur told RTÉ’s News at One that the official death toll “may be a slight overestimate, but it is likely to be an accurate estimate“.
“Excess mortality is trying to contrast the number of deaths that were observed with the number that were expected. And as some of these people were expected to have died during that period, then they don’t count towards the excess mortality,” Dr Teljeur said.
“But the reality is, they did die because of Covid-19, and it therefore contributes to the overall mortality and we need to count that correctly.”
HIQA noted that it was possible that mortality “may have decreased for certain causes of death” during Covid-19, but that it was not possible to examine that using the data from RIP.ie.
It said that Covid-19 “may have accelerated time of death in frail and vulnerable individuals over the peak period”.
“The excess mortality observed at the peak is now being followed by a period of decreased mortality as date of death for individuals who would ordinarily have died during this time occurred earlier than expected by a matter of weeks or months.”
According to figures released from the CSO on 27 November, in the second quarter of 2020, the total number of deaths increased by 14.1% compared to the same quarter in 2019.
Deaths rose from 7,519 in the second quarter of 2019 to 8,582 in the second quarter of 2020, during which time there were 1,227 deaths due to Covid-19.
Over 22,400 deaths that occurred between January and October have been registered as of the middle of November.
The total number of deaths on a quarterly basis is available for each year from the CSO.
On 24 November, the CSO released analysis of data from 1 January to 31 October, and estimated that 2,500 to 3,500 deaths still needed to be registered from that period.
At that time, 22,416 deaths that occurred during the first ten months of the year had been registered with the General Registrar’s Office.
When the CSO is notified of deaths by the GRO, the CSO assigns an underlying cause of death to each case to use in its data.
The underlying cause of death “refers to the disease or injury that initiated the train of morbid events leading directly to death or the circumstances of the accident or violence that produced the injury”.
The CSO follows the World Health Organisation’s (WHO) International Statistical Classification of Diseases and Related Health Problems (ICD-10) classification for assigning an underlying cause of death.
For the purpose of its records, the CSO defines a Covid-19 death as “a death resulting from a clinically compatible illness in a probable or confirmed Covid-19 case, unless there is a clear alternative cause of death that cannot be related to Covid-19 (e.g. trauma). There should be no period of complete recovery between the illness and death.”
Covid-19 was the fourth most common underlying cause of death identified in the CSO’s analysis of registered deaths up to the end of October.
Cancer was the most frequent underlying cause of death, followed by circulatory system diseases, respiratory system diseases, and Covid-19.
Other underlying causes included mental and behavioural disorders; diseases of the nervous system; diseases of the digestive system; endocrine, nutritional and metabolic diseases; diseases of genitourinary system (reproductive and urinary systems); and external causes of injury and poisoning.
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