Germany’s Deadliest Weeks since World War Two? – Spiralling Deaths in Germany

The four weeks ending 8 January 2023 have seen easily the most deaths in Germany of any four‑week period since 2015. The worst week was the week ending Christmas Day, with 28,481 deaths. While it’s hard to compare with pre-1990 years, due to the East Germany question, it may well be that this week last December had a greater percentage of excess deaths than any other week since the last world war.

Baseline weekly deaths for 2022 would have been just over 17,000; a baseline of 68,700 for four weeks, as shown in Table 1.  Therefore, winter illnesses have raised peak deaths at the end of 2022 to 65 percent above what they would have been in a normal non-winter week.

While the December 2022 statistic is remarkable, it seems that most Germans themselves are not aware of this. Many people suffering individual tragedies will typically not be aware if their ‘micro’ tragedy is part of a much bigger ‘macro’ tragedy. This DW story (23 Jan 2023) The impossible task of calculating global pandemic deaths, only looks at 2020 and 2021, and gives no commentary on the Germany chart included. The best I can find on DW discussing the health situation in Germany last December is: Winter illnesses burden Germany’s intensive care units, 17 Dec 2022.

What is remarkable is that this latest winter toll comes very soon after three other periods of high peak mortality in 2022, listed in Table 1 as ‘autumn wave’, ‘summer wave’, and ‘omicron wave’. So, from the Grim Reaper’s point of view, the ‘low-hanging-fruit’ should already have passed.

These recent mortality waves compare unfavourably with the three ‘classic’ Covid19 death waves, each of which had weekly peaks in 2020. By ‘classic’ I mean the original ‘Wuhan’ coronavirus strain, before ‘variants’ and ‘vaccinations’ became a thing in 2021.

It is also noteworthy how high some of the pre-covid death peaks were. The influenza ‘pandemic’ of late 2016 to early 2018 was particularly pronounced. (I use single-quote-marks, because this actual pandemic was never granted pandemic-status by the World Health Organisation.) Germany’s two peaks for this influenza pandemic were in February 2017 and March 2018. We also note a particularly bad season of epidemic influenza in early 2015.

Refer to my Death Spikes and Covid Dissonance? Examples of Germany and Denmark for charts recently published, comparing Germany’s excess deaths with those of its neighbour, Denmark. The December 2022 mortality peak is reproduced to some extent in most (but not some eastern) European Union countries, and in the United Kingdom and United States. However, Germany’s year-of-death in 2022 is probably the most dramatic. (One other country which appears to have an equally problematic mortality, maybe worse, in 2022 is South Korea. I wait in hope for the eventual publication of South Korea’s complete dataset.)

Chart 1 below shows ‘excess deaths’ – as distinct from total deaths – for Germany, by age group.

Chart 1

Germany’s demographics are unusual (but maybe not unusually unusual) on account of World War Two. The oldest Germans – shown in red – were all born before that war. The German post-war baby-boomers are shown in green. Germany shows disturbingly high rates of pandemic death for its baby-boomers, from 2021. (It should be noted that Covid19 deaths tended to peak from November to January, whereas epidemic influenza death tended to peak in February or March. Thus the big reductions in excess deaths each February and March are mainly due to high death-norms set by pre-covid influenzas.

Countries regarded as having pursued the best anti-Covid19 public health policies in 2020 have not had a good 2022. Germany is one of those countries. South Korea, Japan, Taiwan, Thailand, Singapore and China are others. So are Australia and New Zealand. Once having acknowledged the 2022 death statistics for what they are, terrible, the question is whether the problems of 2022 in these countries will extend into 2023. While my hunch is that new vaccinations could make a difference, in 2023 at least, I am concerned that societies have already passed a demographic turning point and that life expectancies are already declining from their peaks, and may continue to decline for decades.

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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.

The chart above is quite alarming, and not only because of Germany’s high death toll. It’s the difference between reported Covid19 deaths and excess deaths, in the context where four waves of excess deaths in Germany in 2022 are clearly ‘epidemic’ in nature. And we see the same death waves in Germany’s northern neighbour, Denmark.

Both countries are assiduous in releasing their demographic data on deaths; most countries are not. And both countries had a reputation for having among the best sets of public health data re the Covid19 pandemic. Yet while public health data may be released with much media fanfare, demographic data usually is not. While certain public health data might be classed as ‘black verse’ poetry, and hence of interest to mainstream media, the more prosaic data sourced from ‘births, deaths and marriages’ tends to be overlooked.

In both countries, easily the worst month for epidemic deaths this decade has been December 2022. Yes, 2022, not 2020. In both countries, the people would seem to be largely unaware of this collective death experience. (Awareness would largely be confined to people’s own families.)

The widely endorsed supposition is that the pandemic is over; a concept that may mean different things to different people. To an epidemiologist, an ended pandemic may be followed by a new era with a new normal of permanently higher death rates. To the lay public, or to the pollyanna-ish finance industry which never stops telling us that we are all going to live longer, an ended pandemic means a return to something like pre-covid normality.

I watch DW (Deutsche Welle) world news semi-regularly, and I have heard nothing about the December death spike in Germany. The few stories on DW that I have found in a search today are these:

Winter illnesses burden Germany’s intensive care units, 17 Dec 2022.

Top German virologist says COVID-19 pandemic is over, 26 Dec 2022.

Germany’s new COVID debate [about removing Covid19 restrictions], 29 Dec 2022.

Are Germany’s hospitals in critical condition?, 5 Jan 2023.

WHO discusses end of COVID-19 emergency status [mainly a reference to China], 27 Jan 2023

So, as in New Zealand, there’s acknowledgement of overstretched hospitals and seasonal illnesses. There’s little suggestion that the main culprit is another covid wave, and we certainly have no indication that Covid19 has recently become more virulent.

We should also note that excess deaths in Europe have looked quite dramatic, since 2020, each December. This is because ‘normal’ influenza outbreak deaths – in the 2010s at least – tended to peak in February, not December. The big falloff in excess deaths from January 2023 is to some extent due to death numbers needing to be higher to be classed as ‘excess’.

Both countries started to downplay their reporting of Covid19 deaths from mid-2021; with the exception of Denmark during the first ‘Omicron wave’ of early 2022. We can see that, in February and March 2022, many people in Denmark died of or with Covid19, while significantly fewer people died of other causes. (This substitution of death-causes was much less true for Germany.)

But the situation in Denmark reversed in December 2022, with many more excess deaths than reported Covid19 deaths. Indeed, in Denmark there were five death waves in 2022, and all (except perhaps the relatively small June death wave) correlating with reported Covid deaths (but see the Denmark chart below); expect that the peaks in reported deaths have been increasingly lagging the actual death peaks. The Denmark data in this chart definitely points to all of these death peaks as being associated with recurring waves of Covid19.

We certainly see the same lags in the German data, although the reported death waves are less pronounced. Generally the ‘peaky’ nature of the data suggests that these populations have been facing repeated outbreaks of respiratory viruses; outbreaks for which their immunity levels have been decreasingly able to cope. While waning immunity appears to be the main problem – a problem long known in relation to human coronaviruses – and that waning immunity here likely relates in particular to vaccination immunity, it is also possible that each wave of infection creates new morbidities in the most vulnerable people. So, a combination of waning immunity – covid immunity and general immunity – combined with new comorbidities is leading to progressively higher death tolls. We also note that December in particular is a month characterised by much social ‘mixing and mingling’; conditions ripe for coronaviruses transitioning from epidemic to endemic.

These two charts, for each country separately, also include ‘case’ information. Again, while underreporting is also an increasing feature of case data, this is data that underpins the timing of Covid19 outbreaks (as distinct from non-covid respiratory viruses). Nevertheless, case data may also lag actual deaths, as people are slow to test for covid, and report, until they are fully aware that a new outbreak is taking place.

When we look at Germany, we can clearly see the correlation of case data (in blue) with excess deaths (in red). When there were new covid variants, as in March 2021, August 2021, and January 2022, we can see the uptick in reported cases leading the uptick in deaths. Otherwise, we tend to see the uptick in deaths coming first, with case reporting lagging ever-further behind. December 2022 was particularly striking, with an eventual upsurge in cases suggesting that a significant number of people who died in the death spike were indeed infected with the coronavirus. In Denmark the pattern of excess deaths correlating with reported cases of Covid19 is, if anything, even stronger.

If we think of Covid19 as a three-year pandemic, we can see that in both countries the second half of the pandemic was worse than the first half, regardless of the official cause of death attributed to each casualty.

A death is a death is a death. To dying persons, and their families, it matters little if a death is directly or indirectly caused by Covid19. An indirect death may be due to a loss of general immunity, or to any other factor linked either to the biology of the virus, to fear-induced behaviour changes arising from the attention given to the virus when it was a big story, or to the government mandates ‘to keep us safe’ but which may have (to some extent) substituted one risk for another.

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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.

On 7 March 2023 I published a summary table of death tallies in a wide range of countries, comparing 2019‑2022 with 2015‑2018. (Covid19 Pandemic-era Facts: Irrefutable, Inconvenient, Important, Evening Report.)

I let the data stand on its own, largely without interpretation. The most important findings to explain are the reasons why Sweden weathered the Covid19 pandemic so well, and why East Asian countries fared so poorly. These facts run counter to the mainstream narrative; a narrative which has presumed that the truth is the precise opposite of what the recently available data shows. East Asian countries relied very heavily on government mandates and the compulsory wearing of facemasks for extended time periods. Sweden, on the other hand, came to be known for adopting one of the least interventionist public health policies during this early-2020s’ pandemic.

This is the main issue that needs to be explained. The demographic data, of course throws up other issues as well – including the high death tolls in the USA and the remainder of the Americas, and the lower toll in Eastern Europe than might have been expected given earlier health data. Demographic imbalances may be contributing to countries’ different experiences; imbalances relating to diverse and changing birth rates and economic migration, in addition to life expectancy issues.

Interpretation

To answer a question such as the main query posed here, we need data, at least one hypothesis, and at least one counterfactual. We also need a contestable academic environment, whereby multiple interpretations can be freely posited and reasonably argued.

We have an important set of data in my report in Evening Report.

The hypothesis that I posit is that pandemic-related mortality in general has been lowest in societies which have good balances with respect to pathogenic exposure and hygiene, that imbalances lead to reduced levels of general immunity and/or raised levels of morbidity, and that societies with high levels of general morbidity will have more excess deaths during an event such as a pandemic; indeed, during any catastrophic event.

It is possible to have too little (as well as too much) exposure to environmental pathogens. In these situations, there are two types of risk – which statisticians, prosaically, call Type 1 and Type 2 – and the reduction of one type of risk in itself raises the other type of risk. The recently oft-said phrase ‘an abundance of caution’ is an example of attempts to reduce Type 1 risk.

In teaching statistics, it is commonplace to use a criminal courtroom setting to explain these risks. A ‘risk-averse’ approach (ie an ‘abundance of caution approach’) is to acquit an accused person if there is any doubt whatsoever about the person’s guilt of the crime in question. The expression ‘beyond reasonable doubt’ expresses balance; the expression ‘beyond all doubt’ expresses an abundance of caution.

It is easy to see that, minimising the risk of an innocent person being convicted also increases the risk of a guilty person not being convicted (and thereby being ‘free’ to commit further crimes); this is the ‘Type 2’ risk. Reduced risk to the defendant means an enhanced risk to society.  ‘An abundance of caution’ simultaneously means ‘a scarcity of caution’; more caution with respect to pathogen exposure means less caution re general immunity deficiency. (The quality of the evidence – eg the data – minimises both types of risk; it also minimises the quality of interpretative reasoning in relation to that evidence.) In pandemics, a good practical compromise is to adopt ‘Type 1’ caution for a brief period of acute danger associated with an unknown threat, and to as soon as possible to revert to a normal ‘balanced caution’ approach.

The most straightforward counterfactuals are purely demographic. And comparative. This is why we need much better, and more comprehensive, demographic information. Demography is the statistical analysis of births, deaths, and migrations. The most important demographic variable is a person’s ‘age’. While race/ethnicity/ancestry, sex/gender, and (to a lesser extent) religion are also demographic attributes, ‘age’ is more important to understanding outcomes (noting that the most important demographic ‘outcome’ is death). Age is the most important predictor of a person’s likelihood of dying; after that, it is socio-economic and lifestyle attributes such as income, housing, education, happiness (leading a meaningful life) and access to healthcare services which determine the likelihood of both mature and premature death.

In the context of Covid19 pandemic mortality, the counterfactual is what levels of mortality would have occurred had there been no Covid19 and hence no pandemic. The usual ways to establish such a pandemic counterfactual is to evaluate and project normal patterns of mortality in the previous few years; if necessary making comparative-country adjustments for any abnormal events in those prior years. And then to use those normal data to predict an ‘alternative present’; in essence, this process of forecasting the immediate past is a valuable use of forecasting techniques.

The next process is, if possible, to compare your (affected) place (eg country) with some other place (or places) which were unaffected (or lesser affected) by the phenomenon you are seeking to evaluate. Some countries are better comparators than others. While Australia – with its many cultural and economic similarities –  is the most widely used comparator for New Zealand, Scandinavian countries are also widely used.

With a pandemic, no country is unaffected. But countries pursuing different public health policies become useful comparators; they help to answer the question as to what would have happened had one country followed another country’s policy. Thus, Sweden’s experience can be built into a counterfactual for New Zealand, because Sweden’s policies were different in both substance and in style. Australia is less useful because its pandemic public policies were very similar to New Zealand’s.

So, a simple counterfactual for New Zealand would be to project 2015‑2018 mortality data into the 2019‑2022 period. The documented excess of deaths compared to that counterfactual represents an estimate of New Zealand’s ‘quantity of life’ pandemic outcome. Then, repeating the exercise for Sweden yields a comparable quantity of life outcome for that country. The country with the smaller percentage excess of deaths probably pursued the better set of policies, noting that two quite different policy approaches could yield similar outcomes.

A well-reasoned counterfactual is an essential part of any interpretation of historical facts. In a scientific process, for which the reasoned use of counterfactuals is an example, a counterfactual is commonly called a ‘control’. It was widely noted (eg in the book The Herd) in 2020 and 2021 that Sweden potentially contributed substantially to the scientific understanding of the Covid19 pandemic, by providing demographers and epidemiologists with a control. So far, however, I have seen little evidence that Sweden’s value as a control – as an important policy counterfactual – has been well-utilised.

The quality of demographic information throughout the world is rather poor. While New Zealand is better than most countries, getting good information about the ages of the population (and where people of different ages live) is difficult. Indeed, until a few years ago, demographic information about immigrants and emigrants was collected somewhat casually as an accessory to tourist data. (Indeed, re yesterday’s ‘compulsory’ population census, the government’s target was only ninety percent compliance; meaning it is regarded as acceptable to ignore the 500,000 ‘harder to reach’ people in this country.) Travellers were assessed as immigrants – rather than visitors – based on their stated intentions on arrival, and not on the actual outcomes of their travel. Many of the people who die in New Zealand are not born in New Zealand, and vice versa.

This makes it hard to create good projections of what mortality in any country, let alone the world, would have been from 2020 in the absence of the Covid19 pandemic. Nevertheless, indications are that, in the absence of the pandemic, New Zealand would have had a higher increase in mortality (maybe a four percent increase from 2015‑2018 to 2019‑2022) than most other countries in the world would have had. This finding relates in particular to New Zealand’s particular pattern of aging, noting some substantial variations in birth rates in the years from 1930 to 1960; and, also variations in the age distribution of older foreign-born New Zealanders.

There are other indications, based on the use of the United States as a comparator country, that some of the increases in morbidity occurring in the USA before 2020 were also occurring in New Zealand; for example, reasons around income inequality, housing, and mental health. The pandemic in USA was substantially more severe than in Sweden, with New Zealand falling in between.

Evaluation of the Hypothesis

In New Zealand, an excessive emphasis on hygiene – including the mandated wearing of facemasks in many public settings – most likely contributed to a loss of general immunity to infectious diseases. New Zealand, by in large, followed the East Asian public health policy model.

This loss of general immunity was countered by a comprehensive, though belated, Covid19 vaccination programme. Vaccination immunity almost certainly contributed to low excess mortality in the period from October 2021 to March 2022. But specific immunity (whether arising from infection or vaccination) to coronavirus diseases – which include around ten percent of ‘common colds’ – and influenzas has always been known to be short-lasting. So general immunity that arises from lifestyle factors remains an important protector of life; general immunity is enhanced by balanced diets (avoiding excesses of foods that create morbidity, such as alcohol, sugar, some fats, and salt) and some ongoing exposure to a range of less-dangerous pathogens.

People living in West European urban environments probably have had closer than most other people to ideal levels of balanced nutrition and general immunity. So these countries have generally had the least pandemic mortality, and (if my hypothesis is correct) probably have the best outlook for the next few years with respect to deaths arising from respiratory infections. People living in Eastern Europe, especially in the European Union, seem to have regained high levels of general immunity, though they bore a high cost in 2021; and membership of the European Union gives them lifestyle options not available in many other countries.

My hypothesis, if correct, suggests that excess deaths will continue in East Asia for another year or so, due to compromised general immunity arising from excessive hygiene. And, in the Americas, increased morbidity seems to be a growing socio-economic problem, making those populations particularly vulnerable to respiratory pandemics. Both of these regions will experience increased levels of morbidity arising from the after-effects of Covid19 infections.

Africa and South Asia are hard to evaluate due to lack of data. But, for Africa at least, indications are that Covid19 excess deaths have been less than in the Americas, and maybe even comparable to Western Europe. Lifestyle morbidity remains less in Africa as a whole than in the Americas. And general immunity levels in Africa have always been high; it is a continent widely associated with ongoing pathogenic exposures. The critical factor for Africa in the coming years will be nutrition. South Asia most likely the same, though with complications arising from substantial air and water pollution.

New Zealand and Australia? Harder to predict, based on my hypothesis, because both countries contain elements of the East Asian, American and Western European experiences. I just hope that New Zealanders are able to get their pre-winter boosters in time. There is every reason to anticipate a dangerous new outbreak of Covid19 in the early winter, much as occurred in Western Europe in the three months to mid-January 2023.

To get to the truth we need reasoned argument, scientific argument. The pandemic has touched on our lives sufficiently to deserve mainstream media attention be given to contestable analysis of its impact; and to question politicised narratives of the form ‘the science says this’ when in fact science is a contestable and argumentative process.

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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.

The most important question about the Covid19 pandemic of the early 2020s is ‘how many people died?’. (The second-most important question relates to the impact of the pandemic on people’s ‘quality of life’.) The data here, available since last week, is the starting point for an answer to the first question. This data is as close as can be got to ‘pure facts’, ‘body counts’ in which no expert interpretation plays a role. (This contrasts with ’cause-of-death’ data which requires a doctor’s opinion.) This is raw data. Raw data is true.

There is not really such thing as a ‘global pandemic’, because a pandemic is, by definition, a global event. In a pandemic, individual countries may be understood as ‘administrative regions’. National differences of mortality during a pandemic will be a mix of fortune, prior circumstances, and quality of administration. Re ‘quality of administration’, ‘body counts’ – while most important – do not represent the whole story. We note here my second-most important question, above.

The data above will never be a global total, no matter how long we wait for laggard countries to report. Some countries simply don’t register deaths; these countries are mainly in South Asia and Africa. Some other countries do not share their death tallies with the rest of the world.

The data above is irrefutable, in that it is a simple count of deaths, covering two periods each of four years (209 weeks for those countries which report on a weekly basis). This contrasts with ‘official’ Covid19 death tallies which depend, in each administrative jurisdiction, on some interpretation of what counts as a Covid19 death. ‘Total deaths’ data does not distinguish direct from indirect pandemic deaths.

For most countries, regardless of covid, there would have been an increase in deaths in the most recent ‘quadrennium’ (four-year period) vis-à-vis its predecessor. The major single cause of such covid-unrelated increased deaths is changes in the numbers of ‘elderly’ people, with the precise age of ‘elderly’ being higher in some countries (say Denmark) compared to others (say Lithuania). A country with a high proportion of elderly people need not have a higher percentage increase in deaths from one period to another; however, in these times, most countries are experiencing faster annual increases in their elderly populations than in their younger people.

One complication here is that World War Two ended in 1945, meaning that in 2020, a person born in 1945 turned 75 in 2020. While we are very sure that most countries had higher birth rates after 1945 than before, we are less sure about which countries had the biggest post-war ‘baby booms’.

One question that may be asked is ‘why include 2019 with the other pandemic years?’, given that the pandemic started in 2020. There are two reasons. First, as we have eight years of data conveniently tabulated by ourwordindata.org, the simplest procedure is to compare one quadrennium against the other. The second reason is that death rates in one year may ‘inversely’ impact on the following year’s data. Countries which have above-average levels of epidemic influenza in the year-or-so before a pandemic are likely to have reduced deaths in the first year of that pandemic, because many of the people most vulnerable to infectious diseases have already died. Likewise, re the present pandemic, a benign influenza year in 2019 (such as in Sweden) would of itself postpone deaths until 2020.

Table 1 is not a ‘league table’ of administrative competence, jurisdiction by jurisdiction. Nevertheless, the data shows broad categories of national experiences, and interesting variations (and non-variations) between countries regarded as like. It is a factual unnuanced measure of the different experiences of the Covid19 pandemic in different countries.

Some data highlights:

Scandinavia

As with many social indicators, Scandinavian countries had the lowest amounts of ‘increased death’ arising from the covid pandemic. Within that Nordic group, Sweden is a clear ‘winner’. This is particularly interesting because Sweden gained much publicity in 2020 for its contrary approach to public health administration during the pandemic. Sweden’s state epidemiologist, Anders Tegnell, famously said that Covid19 was a “marathon, not a sprint”. The marathon is now over, and Sweden has at least taken ‘line honours’.

However we should note that Sweden’s second-worst month (for excess deaths) for the whole pandemic was December 2022. (Its worst month was April 2020.) This significant though largely unnoticed fact is also true for other Western European countries. For some the 2022-2023 festive season was the worst three weeks for the entire pandemic. So, we may be looking at Covid19 as an ‘ultra-marathon’ rather than a marathon; if so, we still have years to wait before we can conclusively evaluate the demographic consequences of this pandemic.

The countries which ‘did best’ in the pandemic were those able to confine most of their covid-diagnosed deaths to people who, had they not died of Covid19, very likely would have died from other causes during the pandemic quadrennium.

Western Europe

Countries in Western Europe outside of Scandinavia had increased deaths mainly in the six‑percent to ten‑percent range, with Belgium and Netherlands both just outside of that range (though on either side of it). Interestingly, in the first wave of Covid19, Belgium had many more recorded covid deaths (per capita) than Netherlands. But it was Netherlands which ended up with an ‘above 10 percent’ increase. Netherlands had a bad pandemic.

The United Kingdom came very much in the middle of the Western European ‘pack’.

Two other ‘western’ countries to note are Canada and Israel. Both have increased deaths higher than the European Union and United Kingdom countries.

Australasia

Australia and New Zealand have increased deaths very similar to Western European levels.  ‘Officially’, both have reported fewer covid deaths per capita than do these European countries. This may be due in part to unusually large increases in the elderly populations of Australia and New Zealand; if so, many of these recent additional deaths will be neither directly nor indirectly due to Covid19.

Eastern Europe and East Asia

Both these groups of countries have, for the most part, increased deaths in the ten‑ to twenty‑percent range. This, for East Asia at least, may be a big surprise to the many people who believed that East Asia set the exemplar for best public health policy during the pandemic.

In East Asia, South Korea is a country of particular concern. South Korea has not released weekly death tallies since July 2022; it used to be a reliable reporter of such data. Subsequent Covid19 case data from South Korea suggests that it has experienced two recent waves of Covid19.

Another country for which the Table 1 data may be understated is Hong Kong. December 2022 was known to be China’s worst month, and this showed in the alarming excess death toll for Macao (Hong Kong’s close neighbour) for that month. So the recent Hong Kong data may be substantially revised, or we may see a much bigger toll for Hong Kong in January 2023. (We should note that, in the United Kingdom, there are signs that many people who die in the end of any December have their deaths counted in the following January. Different administrative practices can may weekly data hard to compare across countries.)

For Eastern Europe, I have generally restricted this table to countries in the European Union, though I have included Serbia, showing that its experience is comparable to its European Union neighbours. Eastern Europe did particularly badly in the ‘official’ Covid19 death tallies, in large part due to their high proportions of elderly people. Eastern Europe is a major source of economic migrants. (And, with lower life expectancies than in Western Europe, the threshold age that defines ‘elderly’ in these countries is lower. We may note, as a matter of interest, that the typical life expectancy in Eastern Europe is comparable to New Zealand’s ‘Pasifika’ population.)

An interesting group of Eastern European outliers are the Baltic countries: Lithuania, Latvia, and Estonia. While these recorded high numbers of Covid19 deaths relative to their total populations, the percentage increase in deaths is not so large. This is due to their high but unchanging prevalence of older people. Indeed, their populations probably got slightly younger in 2020 and 2021, as previous high levels of youth emigration will have been stemmed by Covid19 public health controls within the European Union.

South America and the United States

The typical increase in deaths for South American countries is between twenty and forty percent, with Uruguay, Chile and Brazil looking best for those countries with available data. (Argentina is extremely slow at releasing its total death tallies.) Uruguay is easily best.

The high Covid19 mortality of the United States is very apparent in this simple tally of deaths. Indeed USA probably compares better with South America than it does with its European allies. The demography of the United States is like that of New Zealand in some respects, but like South America and Mexico in other respects. Western European (and Australasian) populations have life expectancies above 80. The USA and most South American countries do not. While Covid19 was a disaster for the United States, it may not be that the different public health responses within USA made much difference. It may be that certain known comorbidities – such as diabetes, drug dependency, mental unwellness – are more present in American than in European populations.

Further Interpretation

I have here confined my interpretation of the data to the points which would be best understood by a professional statistician. Further interpretation takes us into the realm of scientific speculation. The science – the testing of plausible explanatory hypotheses with adequate datasets – needs to be done.

The first question begged by the data presented here is why Sweden in particular (and Europe in general) have come out of the pandemic rather well (so far! the ultra-marathon is far from over). The second question is why East Asia has come out so poorly, despite early indications to the contrary.

Sweden coming out of the pandemic marathon so well, and East Asia so problematically, is the inconvenient counter-narrative which happens to be the truth – the poorly understood truth – of the matter.

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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.

Quantity of Life

With mortality data now available for many countries to the end of 2022 (and, for a few countries, for a month into 2023), we are now able to properly assess the demographic cost of the Covid19 pandemic. There is a proviso, in that for a number of countries, December 2022 experienced substantial covid-related mortality, suggesting that the demographic consequences will last into 2023 and probably 2024. The demographic cost includes mortality indirectly caused by both the disease itself and unintended consequences of the public health measures taken to contain the covid coronavirus.

It is important to note that there is an additional impact – the socio-economic impact – arising from the pandemic; a disruptive impact on the living, adverse on balance, that cannot be measured by death tolls, though which may be reflected if life expectancies beyond 2023 fall below previous projections. This is a ‘quality of life’ rather than a ‘quantity of life’ consequence of the public health events of 2020 and 2020.

We also need to note that, with eight years of data shown, we can compare the death tally for the second four years’ [2019‑22] directly with the first four years [2015‑18] (both representing ‘quadrennial’ periods of 209 weeks). It is appropriate that 2019 is included with the subsequent pandemic years, because events in 2019 may contribute to 2020 death numbers; in particular, if 2019 had lower than usual seasonal illnesses, then many people who would normally have died in the winter of 2019 would have died in of 2020 or 2021 instead.) We note that, for the pre-covid years in the 2010s’ decade, the winter death peaks (typically late winter in the northern hemisphere) mainly relate to influenza, with a more general seasonal mortality effect triggered by ‘common colds’ and the like.

(And one piece of technical information. The weekly death tolls charted have been ‘smoothed’ to reduce the effects of random variation. Thus, the peak numbers for Australia and New Zealand – in July 2022 – each represent a weighted average of the deaths for that actual week and the deaths for the weeks immediately before and after. It means that the actual numbers of deaths in the peak weeks were higher than shown.)

Australia and New Zealand

I start with Australia, which in the past I have been unable to chart very well because the Australian authorities are unnecessarily slow to release mortality data, and when they do it’s typically up to ten weeks of data at a time. We note, with reference to the New Zealand chart, that Australia’s population is slightly more than five times more than New Zealand’s, and has a similar age structure.

A baseline mortality toll for Australia in the early 2020s would be 3,000 deaths per week; it is shown by the black ‘predict 2020’ plot on the chart. The pattern of increasing deaths from 2015 to 2019 is mainly due to population increase; particularly, increased numbers of people aged over 70. (Baseline pre-pandemic weekly mortality for New Zealand is about 600.)

The scale of these charts is (approximately) with the top number (eg 5,000 for Australia) being double the bottom number (eg 2,500). In the first year of the pandemic, 2020, Australia’s weekly death tallies were much like what would have been expected in a non-covid year, but with lower winter deaths. That 2020 experience reflects the public health restrictions which were imposed, with the international travel restrictions probably being most important.

The demographic cost – in deaths – really begins in Australia in April 2021, and clearly persists to the end of (and most likely beyond) 2022. (A look at my previous set of chartssuggests that, based on northern hemisphere experiences of late 2022, mid-2023 – winter – could be particularly bad in the southern hemisphere; although taking advantage of the seasonal time-lag to get suitable vaccination programs in place may help the ‘lucky south’.)

New Zealand data reveal a broadly similar pattern to Australia, though the 2020 shortfall of deaths was more accentuated, and the more general appearance of excess deaths began seven moths later than in Australia, in November 2021. New Zealand, having a much smaller population than Australia, shows more exaggerated peaks and troughs; and generally more ‘random noise’, more random variability, from week to week.

Australia’s pre-covid estimated life expectancy (source: IMF database) was 83.4, with a median population age of 37.9. For New Zealand, the comparable numbers were 82.3 and 37.9; so, both countries have very similar demographics.

I have calculated the increase in quadrennial (ie four-yearly) total deaths for 2019‑22 compared to 2015‑18. For Australia, with December 2022 data still missing, it’s an estimated 7.9% increase in deaths. For New Zealand it’s 8.2%, slightly higher. For both countries, 2022 is the year that most contributed to the 2019-22 excess deaths’ toll. In addition to Covid19, increases in these countries’ populations of elderly will have contributed to higher mortality this decade.

Finland and Sweden

Finland has just a few hundred thousand more people than New Zealand. Its 2019 estimated life expectancy was lower than Australia’s and New Zealand’s, at 81.9. And its median age, at 42.8, suggests that Finland should have a significantly higher base rate of deaths per week. Indeed, the chart shows a base weekly tally of about 950, substantially higher than New Zealand’s 600.

Finland was the most restrictive of the Nordic countries, with respect to public health management of Covid19. It’s pattern of weekly deaths looks very similar to New Zealand’s, with New Zealand having a six-month (seasonal) lag. This means that the extent that Finland’s deaths are above baseline from July 2022 seems likely to be a good predictor for New Zealand in the first half of 2023.

Finland had 7.2% more deaths in 2019‑22, compared to the previous four years. The main explanation for its lower mortality increase (than Australasia) is likely to be due to a lower rate of increase in the size of its elderly population.

Sweden has close to double New Zealand’s population, and had almost the same pre-covid life expectancy as Australia and New Zealand (82.8). Its median age was 41.0; lower than Finland’s, probably due to both more immigration (especially refugees) and (given Finland’s membership of the Eurozone) less emigration than Finland to places like Berlin and Brussels. As Sweden’s chart shows, Sweden’s pre-covid baseline mortality was about 1,600 deaths per week, equivalent to 800 in New Zealand; again, higher due to Sweden having relatively more older people than Australia or New Zealand.

Unlike the other countries mentioned so far, Sweden had almost all its pandemic excess mortality in the year commencing March 2020. One important reason for this was Sweden’s unexpectedly low mortality in the year-and-a-half prior (especially in the winters of 2018/19 and 2019/20) to Covid19, meaning that many of the covid deaths of the frail elderly in Sweden in 2020 were people who, based on statistical expectation, would normally have died before the pandemic struck. The other main reason for Sweden’s high early toll was its classically liberal public health policy approach.

2021 in Sweden looks very much like a normal pre-covid year in Sweden. In the second half of 2022, all west European countries had significantly elevated mortality, mainly it would seem associated with renewed Covid19 outbreaks. Comparing Finland and Sweden, both had December mortality peaks about 50% above baseline weekly death tallies. But Finland clearly had much worse autumns than Sweden, in both 2021 and 2022.

In an important sense, many people died in Finland in 2021 and 2022 who would have died in 2020 were it not for the public health mandates then operating in Finland but not Sweden.

There’s more to it than that though. Sweden’s increase in deaths for 2019‑22 compared to the previous four years was just 2.2% compared to Finland’s 7.2%. It looks as though Sweden’s population had a significantly higher level of general immunity in 2021 and 2022 than did Finland’s. Finland experienced a greater overall demographic cost from the pandemic – presumably in large part because of its different policy choices – than did Sweden.

Both of these Nordic countries (and the other Nordic countries too) had a lower increase in deaths than did Australia and New Zealand. But the Australasian countries probably had bigger increases in the elderly populations (defining ‘elderly’ as over 70); nevertheless, Australia and New Zealand most definitely should not be congratulating themselves on having ‘done better in the Covid19 pandemic’ than Sweden.

Greece

Greece is a European Union country with essentially the same population size as Sweden. It has the same pre-pandemic estimated life expectancy as the other countries charted so far (82.2), but has a significantly older population structure (pre-covid median age of 45.3), almost certainly due to a substantial depopulation of young adults in the wake of the Eurozone crisis which peaked in 2012. So we expect baseline weekly deaths to be substantially higher in Greece than in Sweden. Indeed, that is so. Pre-pandemic baseline weekly deaths in Greece stand at 2,200 compared to 1,600 in Sweden. (We note that much of this depopulation of young adults from Greece will have occurred before 2015, so we have no reason to believe that there has been a significant change in the age structure of Greece that would contribute to the pandemic-era death experience. Hence, the dominant reason for increased deaths in Greece will be Covid19.)

The chart for Greece shows no impact arising from Covid19 until October 2020. While this will be due to restrictive public health measures in the first half of 2020, it may also be due to high levels of influenza that seem to have been generally the case in southeast Europe in February 2020. This will mean that more vulnerable older Greeks will have died just before the pandemic, rather than in its early phase. And it means that Greeks will have had higher levels of general immunity in those early months.

The second European wave of Covid19, in late 2020, substantially impacted Greece, as it did all other European countries. In general, it had a disproportionate impact on vulnerable Eastern Europeans, with less natural immunity than their western co-Europeans. Greece had 11.1% more deaths in 2019‑22 compared to 2015‑18.

We see that Greece has had an unusually high level of summer epidemic death, almost certainly due to its status as a tourist destination. In 2021 Greece was a substantial victim during the ‘Delta’ outbreak; based on comparative analysis this toll was due mainly to compromised immunity (including inadequate vaccination) and not to any specifically deadly features of the ‘Delta’ variant of the Covid19 coronavirus. We see Greece with the same 50%-above-baseline mortality in December 2022 as other European countries. Southern hemisphere countries can expect this sort of peak around June 2023, though preventable by mass vaccination this April.

Chile

Chile is of interest as an alternative southern hemisphere country. It has almost exactly four times New Zealand’s population. It has a pre-pandemic baseline death rate of 1,900 which would be equivalent to 475 in New Zealand; that is, well below New Zealand’s baseline weekly death tally of 600. While this is due to Chile’s lower pre-pandemic median age (35.4 compared to Australasia’s 37.9), it also reflects Chile’s high – for the Americas – pre-pandemic life expectancy estimate of 80.2.

We see that Chile was largely successful at keeping Covid19 at bay until May 2020. But it was always more challenging in a country with land borders to three other countries, with the Peruvian and Bolivian border most significant at that stage. And clearly the international airport in Santiago was not as well sealed as those in Australasia. Unlike Australia and New Zealand, Chile was hit hard in the first half of 2021, and had a much bigger (‘Omicron’ variant) peak mortality in early 2022. Other than that, its experience in late 2021 and late 2022 was similar to Australia’s. Overall, Chile saw a 20.1% increase in mortality in 2019‑22 compared to 2015‑18, accentuated by its surprisingly low pre-pandemic base. Low pandemic mortality for South America, but high for the world as a whole. Undoubtedly Chile has also had a substantial increase in its older population, though maybe not as marked as in those countries whose birth rates were most affected by World War II.

United States

The United States is like a mix of Australia and Chile. It had a pre-pandemic estimated life expectancy of 78.9, well below both Chile and Australia; indeed a ‘third world’ life-expectancy. The median age pre-covid was 38.3, very similar to Australia and New Zealand; so having a similar age structure to the Australasian countries.

USA has a population 66 times that of New Zealand. It’s base pre-pandemic weekly mortality of 52,000 is equivalent to a high 790 for New Zealand, much higher than New Zealand’s actual 600 baseline. Given the similar age structures of United States and New Zealand, this has to be due to a generally higher pre-pandemic risk of death from all causes in the United States.

Overall, the chart for USA is comparable with the chart for Chile. Deaths in the United States increased by 16.8% over the two periods; like Chile but without the low base that might have inflated this statistic for Chile. Covid19 was clearly a big disaster for the United States, though I suspect that high levels of comorbidity – including obesity, diabetes, drug misuse, mental unwellness – contributed more than public policy. Indeed, USA had a younger profile of Covid19 mortality than most other countries.

United Kingdom

Finally, we look at the United Kingdom, with a baseline pre-pandemic death tally of 10,500 per week. That translates to 775 in New Zealand. The United Kingdom had a median age of 40.8 pre-pandemic, similar to Sweden. And a life expectancy of 81.3, similar to Finland. This older population structure largely explains Britain’s higher (than Australasia and Chile) level of baseline mortality.

Mortality patterns in the United Kingdom were most like that of Sweden, except generally higher, and significantly worse in 2021. We should also notice Britain’s huge peak in January 2023, probably partly due to Britain’s unique way of reporting death statistics. (Many late December deaths are recorded in the following year; this seems to be true for each year.)

Overall, the United Kingdom’s increase in deaths for 2019‑22 over 2015‑18 was 7.9%, same as Australia and less than New Zealand. However, we cannot claim that the demographic impact in the United Kingdom, so far, is less than in New Zealand. In the absence of the Covid19 pandemic, New Zealand’s deaths would have increased by more. This is because New Zealand’s increase in the number of people aged over 70 is more pronounced than is Britain’s. It may also be due to a worrying rate of increase in New Zealand of sub-70 non-covid mortality; that is, of mortality of people aged under 70 with American-style comorbidities. We note this already, in that the average age of people in New Zealand who die with Covid19 is significantly younger than the average age of those who die of Covid19.

Brief Conclusion

Sweden, with its more classically liberal public health approach, has had easily the lowest pandemic and post-pandemic mortality increases so far.

Data from other countries suggests that factors around general immunity and comorbidity are the major determinants of pandemic mortality; that is, neither infection rates nor viral mutation rates. And we should note that Covid19 vaccinations also probably improve general immunity, and not just immunity to the covid virus.

Re Australia and New Zealand, the lessons are two: the severe Covid19 winter of 2022/23 in (especially western) Europe will likely be replicated in Australia, New Zealand and Chile if mass revaccination does not take place this April. And that these southern countries may have unaddressed comorbidity problems, not unlike the problem in clear sight in the United States; in New Zealand this problem is by no means confined to people of Māori and Pasifika ethnicity.

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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.

The Niue government has confirmed the country is experiencing covid-19 community transmission for the first time since the virus was recorded at the border in March.

“We don’t have additional resources to be finding sources of infection, previously we haven’t done that before.

“This is the first time we have had community transmission in Niue,” Acting Secretary of Government Gaylene Tasmania said.

Out of the seven cases recorded in the reporting period to November 28 local time, four were listed as covid-19 community transmission.

On November 29, 12 new cases were recorded taking the total number of active cases to 33 and the total number of cases since covid-19 arrived at the border in March 2022 to 136.

Community transmission means a case has not been linked to any other infections, Tasmania said.

“We are unable to link it back and we stopped linking it back because we need to look at containing the spread,” she said.

New Zealand-based public health specialist Sir Collin Tukuitonga said this marked a new chapter in Niue’s covid-19 response,

“You can have a community case that is not from a community transmission, this is a case that is in the community connected to the border but this person is now in the community, that is not community transmission,” Sir Collin said.

What is ‘community transmission’?
There has been confusion around what community transmission means with the term being used by the public.

“You have got to be careful, for public health people like myself, we have a very strict definition of what constitutes a community transmission,” Sir Collin said.

Any case that starts in the community and can’t be linked to the border is called a case of community transmission, according to Auckland University.

“A case comes through the border, negative tests and therefore goes into the community but nobody knows they have covid-19 because they are asymptomatic and they test negative but they are carrying the virus with them.

“So that individual could go home and be with family and be the source of infection,” Sir Collin gives an example of how community transmission can occur.

Tasmania said at the moment Niue residents could assume that there were people in the community that were positive that had not yet been identified.

“People are just picking it up just by being around the community,” Tasmania said.

The cases deemed community transmission were not been able to be linked back to any of the positive cases or any of the close contacts, she said.

New phase for Niue covid-19 health response
As of Tuesday, 29 November, the government covid-19 website is set to change and will not report “community cases” just “active cases”, Tasmania said.

“It is not an unusual response,” Sir Collin said.

He said New Zealand “gave up”, or placed less emphasis on contact tracing when the covid-19 numbers became high and the system was stretched.

“They have accepted the fact that there will be cases. Why would you persevere with all of that if you have changed your focus,” he said.

“Like us they’ll probably see a blip like increasing cases you are seeing here [in New Zealand] but given the high vax status I expect the peak to be lower and not as many sick people.”

No request has been made to New Zealand for support but Tasmania said there were options if needed.

This article is republished under a community partnership agreement with RNZ. 

Article by AsiaPacificReport.nz

A few weeks ago this article from Stuff (24 Sep) was drawn to my attention: The shocking stats that prove Covid19 does not kill equally. While I have some problems with the article’s interpretation of the data, by and large the article itself was reasonable. Less so the headline, which is different in the online version of the story. (The print version omits the sensationalist word ‘shocking’. I wonder if there is a general pattern to present online versions of stories in a more sensationalist manner?)

In fact, there’s nothing surprising about the Covid19 statistics indicating more Māori and Pasifika deaths. The charts in the article, however, perpetrate the erroneous interpretation in the headline, that Covid19 is in some evil sense discriminatory. (In particular the chart that shows death rates of people aged over 90.) The facts are that, among population subgroups, Covid19 mortality reflects differences in general mortality.

With respect to recent data (ie since the beginning of August), just two Pasifika people have died of Covid19 (as the ‘underlying cause); one in their 70s, and one aged under 60 (though 20 others have died ‘with’ Covid19). Ten Māori have died of Covid19 in that recent time period (32 others ‘with’ covid), only one of whom was over 90. In that same time period, 176 people of ‘European or other’ ethnicity died of Covid19, 56 of whom were aged over 90.

While the article was about the whole pandemic, not just its recent phase, it remains no more useful to focus on deaths of Pasifika aged over 90 than it does to focus on Pakeha aged over 100. Regardless of Covid19, the probability that a New Zealander of Pacific Island descent will reach the age of 90 is similar to the probability that a Pakeha New Zealander will reach 100.

Life Expectancy by Ethnicity

Ethnicity statistics in Aotearoa New Zealand should always be treated with caution. For example, a person with just one Māori great-grandparent would typically be classified as Māori, regardless of the ethnicities of the other seven great-grandparents. (This suggests that the mortality and morbidity statistics are even worse for people whose predominant ethnicity is Māori, especially for people who are perceived as Māori [either due to their name or to their appearance].)

If we try to compare socio-economic ‘apples’ with socio-economic ‘apples’, we have almost no data which can give the true picture. My suspicion is that a dapper Māori man such as Scotty Morrison has a similar life expectancy as his Pakeha equivalents. And my suspicion is that a Pakeha solo-mum with three children in emergency housing has a similar life expectancy as a Māori solo-mum in the same situation. Generally, we are very light on evidence that Māori and Pasifika people have lower life expectancies than their Pakeha neighbours.

The problem is that, in proportion to their sub-population totals, relatively more Māori and Pasifika are in impoverished or facing other stressful life circumstances. The telling Covid19 statistics are shown in the table below. The median ages of death for the different ethnicities, estimated from Ministry of Health covid mortality data, are:

We may regard the final row of the above table as valid estimates for life expectancy for each sub-population. It’s not a pretty picture for Māori. What it says is that Māori have significantly more health comorbidities than other ethnic groups. In particular, this represents the socio-economic circumstances that many Māori face; this reflects significant inequality among Aotearoans in general, and also within the Māori sub-population. It reflects the substantial problem in New Zealand of rural poverty. It reflects historical circumstances faced by indigenous peoples throughout the ‘new world’. Some of that is due to biological circumstances which go back into deep history. These include being at the wrong end of the immunity gradients for most diseases during the globalisation phases of world history; and it reflects – for example – an evolutionary context which, among other things, makes Māori (and Pasifika) people comparatively intolerant to alcohol and sugar. (In Eurasia, tolerance to alcohol was a biological adaptation to the problem of water-born diseases. In England a culture developed, especially among men, of drinking ‘small beer’ instead of water. In other places, wine and other fermented drinks were partial substitutes for water.)

The above ‘life-expectancy’ table (especially the second row) also suggests that people with substantial comorbidities are more likely to get Covid19 as well as being more likely to die of Covid19.

Getting back to the interpretation of the Stuff article, because life expectancy for Māori and Pasifika is so much lower than for Pakeha, it means that we should be comparing covid mortality rates for Māori/Pasifika in their 60s with Pakeha in their 70s, comparing Māori/Pasifika in their 70s with Pakeha in their 80s, and Māori/Pasifika in their 80s with Pakeha in their 90s. A randomly chosen Māori person of a particular age, in essence, is as likely to die (from any cause) within twelve months as a similarly chosen Pakeha person ten years older.

While discrimination is certainly part of the ‘historical circumstance’ problem many Māori face, Covid19 doesn’t add to that problem; it simply reflects it. (And we should note that historical discrimination is more nuanced than intellectually-lazy words like ‘colonisation’ or ‘imperialism’ convey. Subsequent to the era of industrial capitalism which began at scale around 200 years ago, life expectancies have increased, with the life expectancies of ‘white’ people (and latterly East Asian people) increasing the most. While non-imperial historical counterfactuals might have had a smaller life-expectancy gap between Polynesian peoples and (say) Anglo-Celtic peoples, it is unlikely any such counterfactuals could have achieved a higher life expectancy for Māori than Māori have now.

Co-mortality and critical states

The final issue of importance to note is that ’cause of death’ is not a simple discrete matter. In an important sense, probably most deaths are due to ‘old age’, but few other than the Queen of England have the privilege of having ‘old age’ listed as their sole cause of death.

The reality is that most deaths have more than one ‘clinical’ cause, and environmental events such as pandemics can kill in non-clinical as well as clinical ways. (Poor quality, under-resourced, or inaccessible health services count here.) In the fable of ‘the straw breaking the camel’s back’, ‘straw’ would never be listed as the sole cause of that camel’s subsequent death. The camel was in a critical state before the straw added, fatally, to its burden.

It’s interesting that ‘comorbidity’ is listed as a word in the dictionary, but ‘comortality’ is not.

Co-mortality is the reason why an ‘excess deaths’ approach is the best indicator of the scale of epidemic deaths. The sadness is that demography is the poor cousin of social science. Much core demographic data – births by sex, deaths by age/sex and place of birth, arrival/departures by age/sex and place of birth – is hard to find in even the rich world. In many countries it remains largely absent. Population censuses are required to make up for poor record-keeping; but too often they are under-resourced, and the value of the core demographic information is under-understood. In New Zealand we remain substantially ignorant about intra-national population movements.

Almost all the Covid19 deaths tallied – whether ‘with covid’, of ‘covid’, or ‘as a consequence of covid’ – are in fact co-mortal deaths. Very few people have died of Covid19 without some other vulnerability being present.

What matters most is an understanding of critical states. Typically, when things go wrong there are multiple causes. Today we use the increasingly popular (and indeed overused) phrase ‘perfect storm’ to indicate the problem. A person is in a critical state when just one additional factor will kill them. (High blood-pressure is one oft-cited factor that can contribute to a person being in a critical state.)

Surprisingly, a person in a critical state may to all intents and purposes be healthy. One person may be much more vulnerable than another to a particular fatal illness, but not obviously so. One seemingly small trigger event may have a fatal impact on that person, but may have no impact on the other person. For a person in a critical state, a trigger event may be sufficient to cause death. (Or, as in ‘chronic fatigue syndrome’ which incorporates ‘long covid’, a trigger event can initiate a long period of chronic unwellness for some people but not others.) An otherwise healthy individual with, say, the Huntingdon’s gene may in fact be in a critical state; one small trigger may unleash the uncurable disease.

‘Old age’ is a critical state; a state which some people – and some peoples – reach earlier than others.

Systems may or may not be in a critical state. (The name ‘critical state’ comes from the nuclear sciences.) A highly stressed population is likely to be in a critical state; especially a population having to constantly negotiate with unsympathetic bureaucracies, permanently raising the levels of cortisol in the bloodstream. A homeless person will likely be in a critical state, meaning that a trigger such as a covid infection could have elevated consequences.

If Māori are more likely to be homeless, or have no socially-approved source of income, then Māori are more likely to die in a pandemic. And die at younger ages.

Is Covid19 a trigger that’s causing human existence to unravel? I suspect that a keyword search on the word ‘existential’ would show a big uptick this decade. Growth capitalism, the way we practice it, is a system that places most people in a near-critical state. (If a critical state is when one more aggravation is fatal, then a near-critical state is when two more aggravations are fatal.) There are signs that this comparatively mild infectious disease has triggered a turning point in global history, and that’s partly because the climate system was already in a critical state.

While Covid19 has been a disease of the rich, and spread mainly by the rich, it is a disease that has revealed the widespread comorbidities – critical states and near-critical states – which our economically vulnerable populations experience. So while the (often oblivious) privileged sub-populations spread covid more while suffering less – not unlike the environmental consequences of careless human behaviour – it is the sub-populations in critical and near-critical states who die the most.

Our systemic problems are our systems in critical states; superficially they may have looked healthy before 2020. Since then, for those willing to see, Covid19 has become the highlighter, not the central problem. If we are homo sapiens – wise ‘men’ – we will look to solutions which destress our systems. What we should not do is aggravate our systemic problems by converting near-critical systems into critical systems; into systems that can become ‘perfect storms’, destroyable by mere straws.

Is Covid19 returning?

My recent statistical analyses suggest ‘yes’. See my Tourist Europe again: Covid19 Waves compared (Evening Report, 17 October 2022). Spain has just had its worst round of Covid19 deaths since April 2020. Covid’s arriving now, in those full aircraft coming here. October is peak season for people flying from Europe to New Zealand. And of course, covid is circulating domestically, and is known to resurge as immunity wanes. It is far too soon to think that Covid19 has become just a winter problem.

If New Zealand’s ability to cope in 2020 and 2021 was weak, and required drastic emergency measures then, New Zealand’s ability to cope this summer may be even weaker. Aotearoa New Zealand is now facing a ‘cost-of-living crisis’, in an economy with severe labour shortages. The New Zealand economy is in a critical state; it is ‘supply inelastic’, meaning it has no surge capacity to respond to a new imported crisis.

Policy is now focussed on creating a recession, the only way today’s policymakers believe they can respond to recent increases in the price level. (Refer to these RNZ stories: Domestic inflation rise ‘a shocker’ – economists; Analysis: Inflation rate higher than expected; Unemployment next challenge for economy – experts.)

New Zealand as a whole was not in a critical state in February 2020. It’s closer to being in such a state today. Marginalised sub-populations will be affected most from any trigger events this decade. Many, but by no means all, vulnerable New Zealanders are of Māori or Pasifika ethnicity.

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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.

Here we see charts of the same ten western tourist countries of Europe (refer to my Travel Warning: Excess Summer Deaths in Europe, 5 Oct 2022). It is important to note from the outset that ‘reported death’ figures have become increasingly unreliable. And reported cases are now unreliable indicators of the size of a covid outbreak; they do indicate the timing of covid waves, however, albeit with increasing time lags relative to the date of infection. The most reliable data is ‘excess deaths’. (Indeed Michael Baker has recently taken to citing this measure; see NZ Herald 16 October Covid19 Omicron outbreak; Another Wave.)

The Mediterranean tourist countries most popular with English-speaking visitors are shown first. All charts are to the same scale. We start with Greece this time.

Greece is one country that, using reported covid data, did not seem to be impacted much until the very end of 2020. However excess deaths in 2020 do suggest that there was a summer wave of Covid19; in addition, Greece was suffering excess deaths from influenza in the beginning months of the covid pandemic. The chart for Greece is quite dramatic-looking in 2022, with a significant death-wave in July (almost certainly continuing into August). We note that, re cases, July is worse than August; this represents the peak of American tourism into Greece, with intra-European vacations peaking in August.

Moving west to Italy, we see again the substantial covid death wave in July 2022. And we see, more clearly than Greece, the most recent (autumn) wave. This may be the wave of greatest impact, worldwide. Moving on to Spain, we see that the July death wave there is Spain’s highest covid death-wave since March 2020. And, by looking at reported cases, this July wave of excess deaths is clearly attributable to Covid19. (Note that 1,000 daily deaths per 100 million people is the same as 10 daily deaths per million; equivalent to 50 daily deaths in New Zealand. Indeed some of these deaths may be New Zealand tourists in Spain.)

Finally for South Europe, in the far southwest we see that Portugal had a bigger autumn wave of Covid19 (May) than elsewhere, while also catching the July wave early. Its July 2022 peak is as big as (or bigger than) its three 2020 peaks.

Looking at West Europe’s ‘big three’, the UK has had smaller summer peaks than the Mediterranean countries, probably because the ratio of visitors to residents is much lower than in (say) Greece and Italy. But we do see a clear rise in cases in June, meaning that the actual rise in cases will have been in May, when the summer tourism season in Britain gets underway. And excess daily deaths have averaged three in a million since May, equivalent in New Zealand to 2,700 pandemic deaths over a six-month period. We also note that these deaths occur in a context where many of the most vulnerable people had died in earlier covid waves.

France represents the high point of the immunity gradient, where many cases translate to relatively few domestic deaths; but where visitors can expect to be especially vulnerable. We see clear covid death peaks in April (when the French tourist season is well under way) and again in July, the peak month for English-speaking tourists. And, like Italy, we see that the latest wave is well underway.

Germany has seen a bigger covid death wave in the later summer; and we note that reported cases in Germany precede deaths, which is what happens in a country with an efficient reporting system. The latest wave of cases is prominent in Germany; deaths will come this month and next, not unlike 2021.

Now the mountain tourist areas, attractive in summer to people who like to walk (and to travel about by train) rather than to swim and sunbathe. Austria shows a pattern very similar to Germany, with a very marked October wave of cases. Austria, like Germany, was a leader in the autumn wave of 2021. Switzerland shows the same patterns as Austria, though with less amplitude. Norway is the most muted of these destinations. Yet its excess deaths are higher relative to reported cases than most of the other countries shown here. Reliable once for its excellent record-keeping, Norway seems to have lost interest in Covid19. My sense is that their autumn deaths will be much as they were in 2021. For Norwegians, October and November 2021 represented their biggest death-wave of the pandemic.

It is important to note that October is a peak month for air travel from Europe and North America to Aotearoa New Zealand. As I have previously noted (see Covid Waves in Europe, Lesson for New Zealand 26 July, and Covid Demography: New Zealand in context of North and West Europe 19 August), New Zealand can expect a late spring or summer covid wave. New Zealand, which has no regular summer seasonal pattern of high deaths, may well in a few months see its highest peak of excess deaths for the whole of the pandemic. Indeed, as has been announced by New Zealand’s Ministry of Health today (RNZ), Covid19 is waxing once again.

As has been the case in 2022 so far (but not in 2020 and 2021) New Zealand’s covid deaths most likely will be nameless and faceless statistics. Out of sight – as reporters, politicians and public servants take their holidays – and out of mind.

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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.

Covid Excess Deaths: East Asia in context – These charts show excess pandemic mortality so far for a wide range of countries, geographically themed. The charts are structured to emphasise deaths in 2022 and 2021, and to facilitate comparative analysis between regions. (General mortality data is lacking for Africa and South Asia.)

The first chart shows Australasia and East Asia, with Scandinavia providing context. (While Malaysia and Indonesia are missing because of a lack of supplied data, indications are that Malaysia’s excess death profile might be an average of those of Philippines and Thailand. Indonesia is more speculative, though estimates from The Economist and WHO suggest that Indonesia has suffered worse than the United States, maybe worse than Brazil, and certainly – unlike USA and Brazil – with the vast majority of its deaths in the 12 months to June 2022.)

From New Zealand’s point of view, the 2022 ‘performance’ is comparable with Australia and most of Scandinavia; New Zealand was much better in 2021 though. The worst performers in these regions over the last 12 months have been much of East Asia, Finland and Norway. Japan is most like New Zealand, with its worst half-year to date being the most recent one, suggesting that much of Japan’s and New Zealand’s eventual covid stories are yet to be told.

Philippines needs a special mention. It’s a country with a substantial demographic and labour force connection to New Zealand; it’s also comparable in terms of the severity of its top-down anti-covid public health mandates. On Al Jazeera News today, one item indicated that Philippines has been in shutdown for two years, featuring a succession of lockdowns which are just now ending. (See links to Al Jazeera stories at the end of this commentary.) Of most significance was that children there are only now returning to school after a two-year closure; and that the costs of this lost education may prove to be huge.

We should also note that the 2,300 excess deaths per million in the last 18 months in Philippines is in a country with a young population, making Philippines’ experience somewhat different to that of East Europe. (For East Europe, see final chart below; one similarity though is that both Philippines and East Europe are exporters of young labour.)

This next chart, to the same scale as the first one, allows for comparisons to be made with West Europe and North America. Greece is the country here which is most like Philippines in the earlier chart, having a substantial majority of its deaths in 2021 and 2022 following an apparently successful 2020. Greece is also a country that New Zealanders connect with, yet is almost never mentioned by New Zealand’s epidemiologists.

Germany, Austria, and Netherlands are not too flash either, having more than half of their excess deaths in 2021 and 2022. Spain, France and the United Kingdom have done significantly better than these from 2021, having done worse in 2020.

The next chart, on an extended scale, shows the Americas (with South Africa). Canada shows a ‘performance’ comparable with Ireland and Scandinavia. United States looks much like Latin America. Three countries which did pretty well in 2020 did poorly in 2021 and 2022: Uruguay, Paraguay, and Cuba. (Cuba’s actual numbers for 2022 are highly speculative.) In many ways these ‘Latin’ countries are like Philippines, in culture, demography, socioeconomic circumstance, and in economic proximity to the United States. Though only Cuba has been like Philippines epidemiologically, with the majority of its deaths being in late 2021. Both countries actively fought-off the virus for a long time, only ‘surrendering’ to it after a year-and-a-half (or so).

The final chart, on an extra-extended scale, shows the underacknowledged epicentre of the covid pandemic, East Europe. In all countries in East Europe, we see that the first wave of the pandemic (February to July 2020) was fended-off successfully, I understand through government mandates. The crisis came late in 2020 as the perpetuation of these mandates became untenable. East European populations were substantially less able to cope, owing to both economic and immunological weakness, than were West European populations.

On both sides of Europe, covid’s initial hit was during a shoulder season, neither winter nor summer. East Europe has the look of a region with a substantial general-immunity deficit in the autumn of 2020. Most countries in the region now appear to have restored general-immunity, but at great cost. For the most recent period (shown in black), February to July 2022, New Zealand falls between Hungary and Romania. Some countries in this region have lower recent excess mortality rates than New Zealand; this was especially true in July.

East Europe has an unusual demography, dominated by older people, as the region bleeds its younger population to West Europe. East Europe was already in dire straits before Covid19 hit. Indeed, it has been becoming the Dixieland of the European Union. We ignore East Europe’s stresses at our peril; those stresses are the crucible of world wars.

(A note about Russia and Ukraine. Russia’s reported deaths have dropped dramatically since it invaded Ukraine; before this year, Russia’s aggregate mortality data could be trusted. And Ukraine’s last reported aggregate of monthly deaths was in January.)

*******

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.

Al Jazeera news links:

https://www.aljazeera.com/news/2022/8/22/philippine-schools-reopen-after-one-of-worlds-longest-shutdowns

https://www.aljazeera.com/news/2021/8/21/philippines-eases-lockdown-amid-record-covid-19-infections

The Marshall Islands is a live demonstration that the omicron BA.5 variant is the most contagious covid variant yet to appear.

In the first five days of the outbreak in the Marshall Islands, more than 10 percent of the population in Majuro, the capital, has tested positive, reports the Ministry of Health and Human Services.

From initial confirmation of a handful of positive cases in the community on August 8, the number of positive cases skyrocketed to the one-day total of 1064 testing positive on Saturday, August 13, at the three community-based “alternative care sites” established to test and treat local residents.

This brings Majuro’s total in the wake of the outbreak to more than 2000 cases in a population estimated at 20,000. There were nine early hospitalisations, with most reported to be recovered by Sunday.

President David Kabua on Friday signed a proclamation of a “State of Health Disaster,” which outlines duties of all ministries and government agencies to respond.

It also gives the government the power to access emergency funding for the response to the initial outbreak.

Health authorities reported two deaths in the first week — both men. The first was a 23-year-old man, the second a 69-year-old.

Both pronounced dead
They were both pronounced dead on arrival at Majuro Hospital’s emergency room, Health officials said. Their vaccine status was not announced.

Majuro experienced a chaotic first couple of days as alternative care sites (ACS) were rolled out at two local schools and at an outdoor sports court, with thousands of islanders crowding in to get tested.

By Friday the influx of hundreds of volunteers to support the Ministry of Health and Human Service in managing the flow of people led to improvements in the service.

“What we are seeing at these sites is what we expected, the ACS sites are getting better and more organised as we go along,” said Health Secretary Jack Niedenthal Sunday.

“Much of the chaos is beginning to die down, though it is still there for sure, but this will continue to get better.”

Spread was not contained to Majuro Atoll, the capital. Within a day of the initial confirmation of positive cases in the Majuro community last Monday, the first case was identified on Ebeye, the densely populated community next door to the US Army’s Reagan Test Site at Kwajalein Atoll.

In addition, several isolated outer atolls at week’s end were reporting multiple residents with covid-like symptoms.

All remote island flights suspended
All flights on Air Marshall Islands and all government ships to remote islands were suspended August 9 in an effort to contain the spread. But travellers from the previous week to remote islands unwittingly caused the spread.

August 12, a special Air Marshall Islands flight took a health team to Wotje Atoll, confirming multiple positive cases, training the local health aide to conduct further testing, and leaving a supply of PaxLovid and other therapeutic medicines for islanders, according to health officials.

RMI COVID-19 Update eo in an 08-12-2022. pic.twitter.com/lsjjXfWVin

— V7AB Radio Marshall Islands (@v7abradio) August 11, 2022

Health teams were attempting to visit other remote islands for similar follow up Sunday, but all AMI pilots reportedly tested positive, putting flights in limbo.

Although the government did not require a lockdown, most churches cancelled in-person services Sunday and the one main road in the capital atoll was unusually quiet as people appeared to be staying home.

Restaurants also saw the number of customers decline dramatically, although most continued to see ongoing demand for takeout meals.

“We at the Ministry of Health and Human Services are very proud of the response that has come in from all corners of our country to help us deal with the health crisis,” said Niedenthal.

The ministry struggled in the initial phase of the outbreak with more than 200 of its staff, including many doctors and nurses, testing positive for covid — many exposed before they knew it was circulating in the community.

Covid-free success
Until last week the Marshall Islands had successfully employed some of the world’s strictest quarantine rules for people entering the North Pacific nation. This had kept it covid-free for the first two-and-a-half-years of the covid pandemic.

A reduction of quarantine time in recent weeks, coupled with unprecedented numbers of people coming in through the managed quarantine process is suspected to be the cause of the outbreak.

The government had earlier announced it was going to eliminate the managed quarantine requirement and open the borders on the October 1.

“As expected, the outbreak continues to gain strength,” Niedenthal said on Sunday.

“We had over 1000 cases in Majuro yesterday, almost double from the previous day. About 75 percent of the people we test are positive, which is an incredibly high positivity rate.”

Outbreak escalating
Last week, as the outbreak was escalating, Majuro traditional leaders sent a letter to President Kabua calling for the borders to be closed and opposing the announcement that medical teams arriving this week would not be required to quarantine.

The medical surge support teams are from the US Centers for Disease Control and other agencies. Niedenthal emphasised the importance for delivering services to the public by these medical professionals.

He described these as “boots on the ground medical support professionals” and said they would be tested on arrival and then sent right into the field to support ongoing services by local Health authorities.

“As a country we have moved from prevention to mitigation because we are now fighting this disease,” he said.

“The days of quarantine upon arrival are now over. I know some people are nervous about this, but we at the Ministry of Health are not and we are the ones on the frontline,” Niedenthal said.

“Please respect these public health decisions. We knew this would have to be a fast shift in strategy that would trouble some people because we had been working so hard (and) successfully to prevent the disease from coming into the Marshall Islands.”

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The Marshall Islands lost its covid-free status yesterday when tests confirmed six positive cases in the capital, the first known community transmission since the pandemic started in early 2020.

It was not immediately clear the source of the covid-19 spread as Marshall Islands borders have been closed since March 2020 and rules currently require 10 days of government-managed quarantine prior to release.

The six people who tested positive Monday had “no travel history, no contact with anyone who was in quarantine,” said Health Secretary Jack Niedenthal.

The government moved quickly last night to announce a halt to the start of the new school year with all island schools scheduled to open this week.

President David Kabua delivered a brief 90-second statement to the nation via an online live stream in which he announced that the Ministry of Health and Human Services had confirmed six people positive in the capital of Majuro.

The President’s short speech was the first official notice of news that in the fashion of a small island had spread several hours prior to his speech.

“I advise people to remain calm and follow the protocols to prevent covid,” Kabua said.

Wearing facemasks advice
President Kabua advised the country to follow established protocols of wearing facemasks when in public. Kabua wore a facemask while delivering his speech.

Notices on social media went viral in the minutes and hours after people learned of the first-ever covid community spread in this isolated north Pacific nation.

Although there were no rules except for school closure announced by government, within minutes of the official confirmation of the cases, a national basketball tournament game was halted mid-way through the contest Monday night, and some restaurants began shutting their doors.

The Office of the Chief Secretary said that the start of the new school year, which opened yesterday at some public schools and was scheduled to open later this week in private schools, would now be postponed for two months.

While businesses and government offices can continue as usual, hospital services will be modified and masks will be required in public for the next two months, said a statement issued by the government.

The government also announced a halt to travel by plane or ship to remote outer islands in hopes of restricting spread of covid to islands that have only rudimentary medical care services available.

“The most important lesson learned from Palau’s experience with a wave of covid starting in January is to protect the hospital during the initial stages of a covid outbreak,” said Niedenthal.

Protecting patients
“This is to protect both the patients already in hospital from being infected by incoming covid patients and, of equal importance, minimising the exposure of hospital staff so they can remain functional and on the job.”

The Ministry of Health and Human Services moved quickly last night to set up previously planned “test and treat” facilities in designated locations in the community.

Niedenthal said the number one lesson learned from watching other nations respond to their covid waves was the priority of “protecting the hospital”.

The goal, he said, is to have people use community test and treat facilities where health officials will perform tests and determine treatment needed.

The entire Marshall Islands has a population estimated at only 42,000 scattered on dozens of atolls and single islands. The two urban centers of Majuro and Ebeye, however, contain three-quarters of the population and many people live in overcrowded conditions ripe for the spread of covid.

Laboratory tests of people who were positive for covid while in managed quarantine last month showed they were all BA.5 variant. And ministry officials said they were proceeding on the basis that BA.5 is what they are seeing.

One local resident said that he was aware of a church member who was confirmed with covid yesterday.

“That means spreading already since yesterday was a busy day at church,” said the person.

Giff Johnson is editor of the Marshall islands Journal and the RNZ Pacific correspondent in Majuro. This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

A couple of weeks ago I received a number of articles mainly about Covid19 deaths in the United States. (See below.) As I have noted in the past, it is important to address the reported facts, rather than to ignore them.

As they stand, these articles are being used to question the safety of Covid19 vaccinations. It seems more likely to me that, while real, these deaths are linked to the pandemic in other ways. A comparative analysis is useful.

Here I post five charts of Covid19 deaths by age. The first two are the USA and France.

Certainly, the United States shows significant numbers of young pandemic-linked deaths. But we need to understand that pre-covid life-expectancy in the United States was about five years less than France. The United States has had lots of pre-covid comorbidities, and probably many more comorbidities arising from its experiences during the pandemic.

France, which had as much covid and at least as many vaccinations per capita as the United States, shows a quite different pattern of death from the USA; much less death of younger people.

We may also look at the United Kingdom, Spain and Israel.

The United Kingdom shows an unusual similarity of excess pandemic deaths by age, except that the latest wave it is clearly more like the very first wave, with people over 75 most affected.

While Spain shows a more chronic death pattern for the younger age group than United Kingdom, its chart otherwise looks much like that British chart. And Israel clearly shows the younger age group as having fewer excess deaths relative to expected deaths.

(But note also this similar chart for Italy. It does point to significant younger Covid19 deaths there, especially in 2021.)

So, of all these countries, it is mainly the USA – the only one with a life expectancy at birth below 80 – which shows the younger age group prominently impacted. Re vaccinations, we know that it was Israel and United Kingdom that particularly led the way.

So yes, pandemic deaths of younger people have been a particular problem in some countries, especially the USA. But it also looks as if we need to look more widely for the reasons; and not to scapegoat the vaccines which – I am confidently sure – have saved many lives, young and old.

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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.

https://www.wsws.org/en/articles/2022/02/24/life-f24.html

https://www.thecentersquare.com/indiana/indiana-life-insurance-ceo-says-deaths-are-up-40-among-people-ages-18-64/article_71473b12-6b1e-11ec-8641-5b2c06725e2c.html

https://www.lifesitenews.com/blogs/insurance-company-raises-alarm-over-unprecedented-spike-in-deaths-and-they-dont-seem-to-be-from-covid/

https://www.thepostemail.com/2022/06/20/the-latest-tragedy-sudden-adult-death-syndrome/

New Zealand has had the worst reported mortality rate for Covid19 in the world for the last two weeks, according to the international data. And by a significant margin. But you wouldn’t know it from the media. ‘Underwhelming’ is an overstatement. The best I could find was this from Reuters nearly two weeks ago. New Zealand COVID death rate at record levels, 22 July 2022.

From worldometer weekly trends, the comparable number to the 151 given by Reutersis 271, that’s 54 deaths per million people in the week to 1 August 2022. The top five countries (all attending the Commonwealth Games) are:

• New Zealand, 54 deaths per million
• Barbados, 33 deaths per million
• Isle of Man, 35 deaths per million
• (New Zealand revised, 33 deaths per million)
• Bermuda, 32 deaths per million
• Australia, 27 deaths per million

These are the data published on Monday 1 August. This screenshot shows the same table on Friday 22 July.

We should note that all these countries other than New Zealand and Australia have populations less than 300,000 people. (Barbados’s population is 5.75% of New Zealand’s.) For very small countries, just one death has a big impact on the death rate. Unlike these little countries, New Zealand has been in the ‘top ten’ in the world for published covid deaths continuously, for several months.)

For a few days, the people at Worldometer struggled to work out New Zealand’s new reporting system. But they eventually decided that the original measure – deaths within 28 days of a positive test for Covid19 – was both the most comparable with other countries, and the most indicative as a measure of when the deaths occurred.

(The statistic above for ‘New Zealand revised’ is the new number favoured by the Ministry of Health. It’s not shown on Worldometer, and shown here only for comparison. This number – people who would not have died had they not had Covid19 – includes a few people who tested positive more than 28 days before their deaths.)

For the last few months, New Zealand has consistently had double Australia’s weekly Covid19 death rate. Both countries saw substantial increases in Covid19 deaths last month.

Why is this news not being reported by the traditional mainstream media? It’s more than the combined total of deaths in the 2011 Christchurch earthquake and the 2019 Christchurch Mosque tragedy. They were news.

A quick snapshot of other information, not easily accessible, about those who died with Covid19 in the last week:

• 86% of the deaths with covid in the last week were neither Māori, nor Pacific, nor Asian. Thus, mostly Pakeha.
• 83% of the deaths were people aged over 70 (ie all eligible – in principle though maybe not in practice – for four vaccination shots).
• 79% had had vaccination ‘boosters’ (though, for the vast majority of these, their immunity will have waned to minimal levels)

Good news for me on the personal front. I got my second vaccine booster yesterday, and without the intervention of petty bureaucracy to prevent me from doing so. (Refer: Answers Please? Tribulations af Getting a Covid19 Vaccine ‘2nd Booster’.) I’ll never know whether the first pharmacy simply had a wrong interpretation of the rules, or whether the Ministry of Health computer system was tweaked on Friday to fix the petty anomaly that I mentioned.)

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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.

Respiratory Virus Hospitalisations in Counties-Manukau, as reported by Stuff

The chart above splits the patients in Middlemore Hospital into the different categories of Severe Acute Respiratory Illness. The vast majority are what in the past we have called ‘common colds’. There is no indication that any of these ‘colds’ are due to human coronaviruses other than the Covid-Omicron. Indeed, as well as ridding us of Covid-Delta and its ancestor variants of the original SARS-Cov2 virus, Covid-Omicron may well have sealed the fate of the human coronaviruses which previously caused about 15% of all ‘colds’.

We do not know what percentage of covid hospitalisations end up becoming deaths. (My guess is that about half of covid deaths occurred in people’s homes, including age-care facilities.)

It is likely that the deaths associated with the 93% of SARI hospitalisations which were not covid are a relatively low number compared to covid deaths, mainly because a large proportion of these other cases will be children. But it is appropriate to remind ourselves that, in normal times, about ten percent of all winter deaths are attributable to ‘common colds’, and that this figure will be higher this year, maybe 20% of all winter deaths.

Recent Changes to the Reporting of Covid19 Deaths

The recent changes have been very confusing to media trying to report these. But I will summarise the three main measures, using data from Tuesday 26 July until today.

• Deaths of people who became Covid19 cases within 28 days of their death: 154
• Deaths of people for whom Covid19 was the principal cause: 90
• Deaths of where Covid19 was the principal or a contributory cause: 130

The last of these has become the favoured measure of the Ministry of Health. It is important to note, however, that because of times required to verify that Covid was the underlying or a contributory cause of death, this last favoured measure is not as up-to-date as the first (previously favoured) measure.

To impute weekly deaths (and allowing for lower weekend reporting) we should scale-up these four-day totals by 50%: giving 231, 135, and 195.

Then, to convert them into weekly deaths per million in the population, we must divide by five. That gives, for each measure:

• 46 per million
• 27 per million
• 39 per million

These last three numbers should be seen in the context of this Worldometer screenshot (22 July 2022) which showed New Zealand last week as the country with the world’s highest Covid19 death rate.

Based on the above calculation, New Zealand’s current comparable rate of Covid19 mortality is 46 per million (up from the 34 per million shown in the screenshot). And even if we use the much more conservative measure above (27 per million), that’s still the same as the number given for Malta, and well above the high numbers for Taiwan and Australia.

And we know that significant numbers of people are also dying from the other SARI viruses. SARI deaths would appear to be being substantially downplayed by the Ministry of Health.

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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.

The covid-19 pandemic has already generated its own mythology. In Britain, they talk of the “myth of the blitz” – the idea of a society that pulled together in the Second World War to withstand the bombs dropped by the Luftwaffe with pluck, bravery and humour.

In Australia, our covid-19 myth is about a cohesive and caring society that patiently endured lockdowns, border closures and other ordeals. Like many myths, ours has some foundation in reality.

It might be a poor thing when considered alongside wartime Britain’s wartime sacrifices, and you have to ignore the empty toilet paper shelves in the local supermarket, but it still has its own force. It might be especially potent in Melbourne, where the restrictions were most severe and prolonged.

The covid-19 myth is now presenting its puzzles to true believers. If you imagined we all pulled together for the common good, and because we have the good sense to look after our own health, you are likely to find it strange that we are now apparently prepared to tolerate dozens of deaths in a day.

Australia’s total covid death toll is now above 11,000 – New Zealand’s has topped 2000.

More than tolerate: there has been a preparedness to pretend nothing out of the ordinary is happening.

All of this seems a far cry from those days when we hung on the daily premiers’ media conferences and experienced horror as the number of new infections rose above a few dozen a day, a few hundred, and then a thousand or so. Have our senses been blunted, our consciences tamed?

A product of power
Public discourse is never neutral. It is always a product of power. Some people are good at making their voices heard and ensuring their interests are looked after.

Others are in a weak position to frame the terms of debate or to have media or government take their concerns seriously.

The elderly — especially the elderly in aged-care facilities — have carried a much larger burden of sacrifice than most of us during 2020 and 2021. They often endured isolation, loneliness and anxiety.

They were the most vulnerable to losing their lives — because of the nature of the virus itself, but also due to regulatory failure and, in a few places, gross mismanagement.

Aged Care Minister Anika Wells has provided @abcnews with new details on COVID cases in residential aged care homes:

983 current outbreaks
6000+ residents infected
3250 staff are positive

ADF support for aged care homes will be continued until the end of September.

— Henry Belot (@Henry_Belot) July 24, 2022

Casual and gig economy workers, too, struggle to have their voices heard. On his short journey to an about-face over the question of paid pandemic leave, Prime Minister Anthony Albanese at first said the payment was unnecessary because employers were allowing their staff to work from home.

Yet the conditions of those in poorly paid and insecure work have been repeatedly identified as a problem for them as well as for the wider community, because they are unable easily to isolate.

Up to his point, however, our democracy has spoken: we want our pizzas delivered and we want to be able to head for the pub and the restaurant. And we are prepared to accept a number of casualties along the way to have lives that bear some resemblance to those of the pre-covid era.

The “we” in this statement is doing a lot of heavy lifting. There is a fierce debate going on about whether governments — and by extension, the rest of us — are doing enough to counter the spread of the virus.

Political leadership matters
Political leadership matters enormously in these things.

In the years following the Second World War, Australia’s roads became places of carnage, as car ownership increased and provision for road safety was exposed as inadequate. It peaked around 1970, with almost 3800 deaths — more than 30 for every 100,000 people.

Road fatalities touched the lives of many Australians. If not for the death of my father’s first wife in a vehicle accident on New Year’s Day in 1954, I would not be around to write this article today.

In the 1960s and 1970s, the coming of mandatory seatbelt wearing and random breath-testing helped bring the numbers down. Manufacturers made their cars safer.

Public campaigns urged drivers to slow down and stay sober. These were decisions aimed at avoiding avoidable deaths, despite the curtailment of freedom involved.

A British seat belt advertisement from the 1970s.

These decisions were also in the Australian utilitarian tradition of government, “whose duty it is to provide the greatest happiness for the greatest number” – as the historian W.K. Hancock famously explained in 1930.

The citizen claimed not “natural rights”, but rights received “from the State and through the State”. Governments made decisions about how their authority could be deployed to preserve the common good and protect individuals — from themselves as well as from others.

Pragmatic position
Governments have during the present surge so far been willing to take what they regard as a pragmatic position that the number of infections and fatalities is acceptable to “the greatest number”, so long as “the greatest number” can continue to go about something like their normal lives.

But this utilitarian political culture also has its dark side. It has been revealed persistently throughout the history of this country — and long before anyone had heard of covid-19 — as poorly equipped to look after the most vulnerable.

The casualties of the current policy are those who have consistently had their voices muted and their interests set aside during this pandemic — and often before it, as well.

These are difficult matters for governments that would much prefer to get on with something other than boring old pandemic management. The issue is entangled in electoral politics — we have just had a federal contest in which major party leaders studiously ignored the issue, and the nation’s two most populous states are to hold elections in the next few months.

Governments also realise that restrictions and mandates will meet civil disobedience.

But covid cannot be wished away. At a minimum, governments need to show they are serious about it to the extent of spending serious money on a campaign of public information and advice on issues like mask-wearing and staying home when ill.

They usually manage to find a sufficient stash of public money ahead of each election when they want to tell us what a beaut job they’ve been doing. They might now consider whether something similar might help to save lives.

Dr Frank Bongiorno is professor of history, ANU College of Arts and Social Sciences, Australian National University.  This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz