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.

While some women at the University of the South Pacific’s 14 campuses found working from home enjoyable during the covid-19 pandemic, others felt isolated, had overwhelming mental challenges and some experienced domestic violence, a Pacific survey has found.

Titled “University Women Remote Work Challenges”, the survey was funded by the Council of Pacific Education (COPE) and was supported by the Association of the University of the South Pacific staff (AUSPS)

The research report, released last month, was conducted by Dr Hilary Smith (an honorary affiliate researcher at the Australian National University and Massey University) for the women’s wing of AUSPS.

“This survey confirms that many of our university women had support from their family networks while on Work From Home, but others were left feeling very isolated,” said Rosalie Fatiaki, chair of the AUSPS women’s wing.

“Women with young children had a lot to juggle, and those who rely on the internet for work had particular frustrations — some had to wait until after midnight to get a strong enough signal,” she said.

Around 30 percent of respondents reported having developed covid-19 during the Work From Home periods, and 57 percent had lost a family member or close friend to covid-19 as well as co-morbidities.

In the survey there was also evidence of the “shadow pandemic” of domestic abuse and although the reported levels were low, it was likely the real incidence was much higher, said Dr Smith.

‘Feelings of shame’
“That was because of the feelings of shame (reporting domestic violence). In the Pacific Islands families and communities tend to be very close-knit groupings,” Dr Smith said.

Only two of the 14 USP campuses in 12 Pacific countries avoided any covid-19 closures between 2020 and 2022 — the shortest closure was two days in Tokelau and the longest at the three Fijian campuses of Laucala, Lautoka and Labasa lasting 161 days.

There had been no cases on the Tuvalu campus until the second quarter of this year.

“For women who had older children they said they enjoyed the time with their families,” Dr Smith said.

“And it was more difficult for those with young families,” she said.

She stressed the importance of being careful with the survey in relation to domestic violence.

“With this kind of survey, we had to be a little bit careful. We can’t say we got evidence of how much there is because it is a very tricky thing to survey and especially in this kind of survey,” Dr Smith said.

‘Sensitive issue’
“And because it is a sensitive issue and people tend not to identify and it is something that people tend to be ashamed about pretty much.

“The survey was totally confidential, and we set it up so no one would who the respondents were.

“It was impossible to find out through the ANU programme we used.

“But the fact people did give some evidence then I think that we know that it is actually quite significant, and we assumed that the prevalence was quite higher.”

She said that she was not saying there were more incidents, but from media reports, particularly in Fiji, she had suspicions that it was higher than reported in the survey.

“We were responding to the fact that there were other news reports in Fiji we referenced, and there has been the other report by the UN (United Nations) women about it,” she said.

The report “Measuring the Shadow Pandemic – violence against women during Covid-19” was released by the UN in December 2021 and the Violence Against Women Rapid Gender Assessments (VAW RGA) were implemented in 13 countries spanning all regions — Albania, Bangladesh, Cameroon, Colombia, Côte d’Ivoire, Jordan, Kenya, Kyrgyzstan, Morocco, Nigeria, Paraguay, Thailand and Ukraine.

There was general support of national statistical offices (NSOs) or national women’s groups and funding from the policy and Melinda Gates Foundation, which found an incidence of 40 percent of reported domestic violence.

‘There in Pacific”
“So, we weren’t saying that it was more than in other countries, but we were saying it was there in the Pacific.

“It could be more, or it could be less but because the evidence had been already highlighted in Fiji, we were just picking up on that.”

AUSPS had specifically asked for it to be followed up because of “widespread murmuring” that domestic violence was occurring.

“My colleagues at USP had indicated they wanted to follow it up because they had heard that it was an issue for some women,” Dr Smith said.

In her recommendations she had suggested counselling for women and a safe space on campus, but she was unsure if it would be acted on.

Limited counselling
There was limited counselling available already and some had suggested that it should be done through religious denominations, she said.

She said internationally people had struggled with mental health issues during the pandemic, so it was common to all communities.

“There was a relatively high incidence in Fiji, and we reported the findings from the survey,” Dr Smith said.

Among the recommendations for support during isolation was the setting up of a helpline and regular calls from senior personnel and support staff.

She said even if this pandemic had passed there were other events like natural disasters, politics, and wars to be mindful of.

“Human-made or nature-made or the prevalence of other pandemics, we are basically saying the university should be prepared,” Dr Smith said.

Article by AsiaPacificReport.nz