Analysis by Keith Rankin.
These two charts show the recent upsurge in reported Covid19 cases in the two larger countries with the most cases. (See my recent January league charts for where these countries fit in relation to others.) Both Denmark and Israel recently peaked with over 7,500 daily cases per million people; equivalent to a daily count in New Zealand of nearly 40,000.
Denmark received publicity on the TV1 (TVNZ) news yesterday on account of its recent removal of all anti-covid mandates; and Denmark has been arguably the strictest of the Scandinavian countries. The hospitals in Copenhagen were shown as being completely underrun with covid patients.
Israel actually peaked at 9,500 daily cases per million people (compared with New Zealand’s recently announced 90 cases per million). Israel is a country in which many people have been vaccinated four times, and in which people are very mobile and resist mandates that last for more than a week or two.
Both countries provide reliable and timely statistical information.
Charts rescaled to better show important detail. Denmark.
In its first wave, Denmark’s excess deaths initially closely follow its covid-recorded deaths; they then fall to negative as government public health mandates take effect.
In September 2020, we see excess deaths rise with cases; this means that the next wave of cases was discovered when very sick people were admitted to hospitals. In other words, government mandates were ended when the first wave ended, and by August 2020 people were living normally. New mandates were introduced, but covid got away in late October, and stayed around until late January. As in March 2020, excess deaths closely matched recorded deaths in December 2020. Strong anti-covid measures then brought excess deaths way down, as people stayed home.
The alpha strain of covid hit Denmark especially in May 2021, and then the delta strain hit in July, about when Denmark first announced that covid should, for practical purposes, be regarded as over. (At the end of April, Denmark had 96% alpha; delta replaced alpha largely in the first week of July.)
At the beginning of July 2021, half of Denmark’s people had been covid-vaccinated; most of these double-vaccinated. Delta struck again in October, somewhat by surprise. It was killing mainly unvaccinated people, but – especially its later strike – also some whose vaccination immunity had waned substantially.
While official covid deaths in the delta waves substantially understated excess deaths during July to November, we can conclude that these excess deaths are mainly covid deaths because of the correlation of excess deaths with reported cases. We infer that most of these deaths, not recorded as covid deaths, were not in hospitals.
Denmark’s delta epidemic accelerated in November 2021. Many earlier deaths were not recorded as covid deaths until the week before Christmas.
Then after Christmas, covid fatalities suddenly stopped. Excess deaths continued to fall through January; and this fall was not due to a substantial increase in anti-covid government mandates. Rather, the fall in excess deaths coincided with the arrival of omicron in mid-December. The data suggests that omicron was nature’s own anti-delta solution.
So, despite recorded covid deaths continuing to increase, actual covid deaths plunged. The difference – as Danish epidemiologist Professor Lone Simonsen noticed – is that while increasing numbers of people died with covid in January 2022, almost nobody now is dying of omicron covid.
In Israel the correlation between covid reported cases, covid recorded deaths, and excess deaths is very strong. As we might expect the apparent case fatality ratio is high in the first wave, when community testing for covid was not fully established.
In the January 2021 covid peak, excess deaths timed closely with recorded deaths; though people staying at home kept excess deaths to a minimum.
The July 2021 delta cave came as a surprise, with the rise in excess deaths closely matching cases; this means that the wave was first observed by testing people who had been hospitalised due to initially undiagnosed covid infections. Once understood, this wave precipitated the first program in the world of covid booster vaccinations. The problem of waning vaccination efficacy long-preceded the arrival of omicron. Israel had been a pioneer Pfizer vaccinating country, so was the first to be exposed to the problem – already known to be true for common cold coronaviruses – of immunity short-livedness.
Israel is particularly interesting in that the current, now waning, omicron wave is very clearly distinct from its preceding delta wave. As with Denmark, recorded covid deaths – deaths with covid – have increased with a clear and expected lag with respect to case numbers. The key finding, however, is that, again like Denmark, excess deaths have moved in the opposite direction – downwards.
That’s great news. From Denmark we get a sense of omicron ending delta; and from both countries we get falling deaths in a month with record cases though few mandates.
Both countries may well show steady numbers of excess deaths as 2022 progresses; these, if they happen, most likely will be post-covid (rather than long-covid) deaths. They will be rightfully classed as from covid, though not necessarily of covid. Many will be deaths attributable to the pandemic in its wider context.
New Zealand and the Pacific
If omicron covid peaks in New Zealand in March 2022, it is likely to progress much as it is progressing in Queensland at present. New Zealand can expect significant – though not necessarily large – numbers of excess deaths because the population has substantially-less overall immunity than had the populations of Israel and Denmark.
This problem of ‘immunity deficit’ is likely to be even worse in the Pacific Island nations – eg Kiribati and Tonga, which are now experiencing omicron covid waves. Nevertheless, we in the South Pacific can prepare ourselves as best we can, not be afraid, and hope that we get omicron when we are best able deal with it. Better to get exposed with a small than a large viral load. More antibodies and fewer virons – individual virus particles – mean that our precious lungs can remain safe.
Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.