If you believe everything you read in the mainstream media, a lot of people are reportedly dying of COVID. On Tuesday, official reports claimed 104 COVID-related deaths, the day before there were 28 deaths attributed to COVID. Last week, it was claimed that 400 people died of COVID. But are the statistics telling the whole story?
While the case fatality rate of Omicron is extremely low globally at under 0.20% (the infection fatality rate is believed to be perhaps as low as 0.01% — as many people don’t test themselves, or don’t report a positive test, or are completely asymptomatic), the reported death rate in Australia is strangely high by global standards. According to reported data, 16% of all deaths in Australia last week were due to COVID.
Something here just doesn’t add up: how can Australia be both one of the most vaccinated countries on earth and also have one of the world’s highest COVID death rates?
The stated fatality rate is also inconsistent with the number of people entering ICU wards with COVID. In NSW, which is reporting around 18 deaths per day, there are only 66 people in ICU and only 14 on ventilators (this number continues to fall). In Victoria, which is reporting around 14 deaths per day, there are only 36 people in ICU and 10 on mechanical ventilators.
In short, the data simply doesn’t add up.
To try to resolve this inconsistency I spoke with one of Australia’s leading respiratory specialists, who has spent the past two years working on COVID wards to understand how so many people are dying from COVID, when ICU wards around the country remain devoid of COVID patients.
According to one of Australia’s most accomplished COVID specialists, ICU admissions remain low because reported COVID deaths relate largely to people who are very old (above 80) and, in most cases, already very ill. In fact, these patients are so unwell doctors are making the decision to not place them in ICU; most have multiple comorbidities and in many cases their COVID infection is incidental (patients are tested when admitted). While COVID may, in some cases, reduce the remaining life expectancy of some of these patients, typically these patients had only a few months to live with a very poor expected quality of life.
This data is analogous with reports from Los Angeles, where the chief medical officer of Los Angeles County Medical Centre, Dr Brad Spellberg, noted “90% of the time it is not due to COVID. Only 10% of our COVID positive admissions are due to COVID. Virtually none of them go to ICU, and when they do go to the ICU it is not for pneumonia. They are not intubated; we haven’t seen any of those since February.”
Comparing the Australian data to the global data completes the story. Around the world 153,000 people die each day, according to the last comprehensive study conducted in 2017, with around 1800 reported COVID deaths — around 1.1% of all deaths.
In Australia, approximately 450 people die every day, but last week official reports claim that there were 72 COVID deaths per day — that’s 16% of all deaths in Australia being attributed to COVID.
The concern here is that Australia appears to be grossly overstating the lethality of COVID by not properly distinguishing between those who die directly from COVID, as opposed to those who have COVID when they pass away.
To restate: if the official data is to be believed, in highly vaccinated Australia 16% of all deaths are because of COVID, compared to 1.1% everywhere else.
There are two versions of the truth but only one is correct: either Australia is massively overstating COVID deaths or every other country is understating them. Based on ICU data, it appears that the rest of the world has got it right.
Adam, you cited ‘reported data’ on Covid death rates, yet didn’t cite your source. Thus, everything that follows looks like a straw man, holding your own grindable axe.
In any case there are several issues with your reasoning.
Firstly it’s problematic for any country to report Covid death rates in real time, since that requires an accurate real-time read on cause of death (a death can easily have inobvious causes or multiple causes) and an accurate read on case rates (no country has an accurate real-time read on Omicron cases at the moment, due to testing overwhelm.)
However, one of the best long-term reads we have on Covid-caused death rates at the moment is through The Economist’s Excess Deaths model, which subtracts from total national deaths those death rates from other causes projected from previous years.
In Australia and NZ, excess deaths actually went negative in 2020 and 2021 as we were saving lives under lockdown due to lack of flu and road deaths. Thus even our Covid deaths didn’t eat all the lives we saved.
However, after the three whole Omicron waves we’ve seen in 2022 (and we’re now in a fourth), our excess deaths are positive this year, and NZ’s are now nudging positive too.
Excess deaths from Jan-Mar 2022 were around 5,426, while reported Covid deaths for the same period were only 3,669. So we’re likely under-reporting deaths to Covid and one reason for this might be that not all of those deaths occur in hospital (we lose a lot of patients in Aged Care, and many of those may have terminal underlying conditions where their inevitable mortality is only brought forward by a Covid infection.)
The second issue is getting a clear read on case-rate. We had a good read on it prior to 2022, but this year PCR testing rapidly got overwhelmed by Omicron. Epidemiologists routinely estimate that our real cases are two to three times confirmed cases, but anyone who divides death rates by confirmed cases will likely get a higher death rate than supplied by global studies. (As you didn’t cite your source, it’s not possible to confirm how that figure was reported.)
Across the same Jan-Mar period this year, we had a monster 3.9 million confirmed cases. Even if we accepted the higher Excess Death count of 5,426 that would produce a death rate of 0.13%, but if the true case rate is two or three times higher, that death rate would of course be two or three times lower.
Lastly, when we are in a peak of infections, the death count actually climbs — usually peaking two to four weeks after the infection peaks.
All this is well understood by anyone who researches it.
You don’t, and consequently your ‘commentary’ represents ignorant chatter. This has been demonstrated repeatedly, Adam. To be clear: reporting on your own ignorance is not news to anyone but you.
Adam, you need to either educate yourself to the necessary level and reported from balanced insight, or else recuse yourself from Covid health commentary. Anything else is unprofessional, misleading, disrespectful of Crikey’s masthead, its values, and its paying readers.
Ruv, thanks again for your comments – truely appreciated.
This is an outstanding comment Ruv. You should write an article!
Alongside the excess deaths model, is there a model for years of life lost? I heard several medical commentators stating that this would be a useful metric.
E.g. if I, a healthy 43yr old, caught covid tomorrow and died, that’s approx 42 years lost (assuming the expectation is I would normally live until 85)
Johan asked: is there a model for years of life lost?
Yes there is, Johan — it’s of interest both at the national and the international levels. However it has to be updated and reconciled periodically rather than in real time and there are two broad metrics, namely:
For the latter, the general equation is DALY = YLD + YLL, where YLD is Years of Living with Disability.
There’s some political opinion about what metrics to use when, but both are useful for health and economic analyses. Because Covid frequently induces disability we’ll likely need both; however it may be premature to understand how Covid plays with DALYs since we’re still being surprised by long-term Covid effects on health (e.g. myocarditis, neurological deterioration and a range of potential other horror conditions, with various prospects of recovery.)
The Australian Institute of Health and Welfare is probably the best source for YLLs and DALYs in Australia, though you can bet that insurers and financial institutions will be tracking it too. AIHW’s last report from 10-Sep-21 only covers to Apr/May of that year so we’re missing much of our Delta and all our Omicron case data. However from those data, AIHW estimates that each Covid death costs an average 8-9 years of life lost. (I believe that will also change as the death demographics change.)
Meanwhile, OzSAGE (a multidisciplinary, Covid-focused Australian Science group) estimates that 89.8% of deaths in the first calendar quarter of 2022 were from Covid, not with Covid, so Covid is tracking to clobber heart disease as our #1 killer this year (see also: Mr Schwab and Ms Schultz should not be commentary on this matter until they are prepared to research thoroughly and check their speculation with experts.)
At the same time, a March paper from the University of Manchester this year calculates that to August-21, the US had lost about 8.5 million life-years; England and Wales 1.6 million. (Obviously Australia’s data at that time didn’t figure, but this year’s surely will.)
Meanwhile a November 2021 paper in the British Medical Journal suggests that four-fifths of the OECD lost life expectancy in 2020, in the range 1.2 – 1.6 years per capita depending on country.
Toward the start of 2023 I’d hope to see these numbers updated again to cover trending pre-vax and post-vax campaigns through 2022, and to include Australia which like New Zealand is now in ‘case catch-up’ thanks largely to Omicron.
For now, I think the evidence is that by keeping Wuhan through Delta locked down as best we could and getting vaxed and boosted before Omicron hit us, we’ve saved vast numbers of lives — and quality of life. By contrast, our 2022 deaths are tracking to be horror figures against the national experience, yet not against world experience.
It’s hard hard to tell a simple, single story for Covid epidemiology, but the stories recently told in Crikey’s pages have been unworthy of publishing.
Brilliant answer to my Q Ruv.
You really should write an article or two.
Thanks for taking the time to respond with such an informative and cogent answer to the question
Thank you for your comment, Johan.
(I’ve been tracking the data and commenting on it in private distribution since March 2020.)
Crikey’s continuing attempts to downplay the impact of COVID are making me seriously reconsider my subscription. I expect it from those outlets funded by the business lobby who regard us as mere cattle fodder to feed their wealth generating activities, but to keep finding it here is dissapointing.
How about considering some other possible explanations for the disparity between high vaccination rates and our massive death toll from covid this year (11,300 deaths and counting) – such as that the vaccine is not proving effective against the latest variants for example, and the massive rate of infection (the latest is that up to 50% of Australians have been infected) due to government refusal to implement effective control methods (viz promotion and mandating of N95 masks, good ventilation and air purification) for example?
There are some particularly disingenuous arguments in this article, such as the ICU numbers are lower than consistent with the death rate. The failure to treat our elderly (consistent with our general neglect and abuse of them in nursing homes) is certainly a contributing factor, but the bigger one is surely that the disease is one that attacks multiple organs, causing clots, cardiac events and many other manifestations that don’t necessarily get caught in time to go to hospital let alone lead to ICU treatment.
The sheer callousness of the ‘dying with covid rather than of’ and wouldn’t have lasted much longer anyway/had poor quality of life reflects value judgments imposed on the old, sick, living with disabilities that just make me deeply angry at how far our society has moved away from basic morality.
And of course the reality is that far from overestimating the death rate, the likelihood is that the number substantially undercount the death rate, since we now know that covid weakens the immune system and leads to an increased likelihood of death or serious illness for at least six months after infection.
My personal experience with Covid after two boosters was a simple runny nose. No vaccine is 100% effective, though I doubt that my experience would be the same had I not been fulled vaxed
Fully vaccinated – aged over 70. Had heart tests etc early this year and all OK – no need for any medications. Got covid couple weeks ago. – mild with headaches and difficulty sleeping. 4 or 5 days post free covid ambulance required to hosp with heart problems! More tests coming only in Nov (!)
I’m going to pass away (quickly I hope) from long covid, although don’t think I’m part of any study.
Sorry to hear that – if it is not too stressful, could you please provide progress reports?
It would balance this appalling dreck.
I hope you get better soon.
One of my best mates had heart issues earlier this year, or at least he felt something was wrong with his heart – but the tests kept coming up negative.
Then two months ago he had a myocardial infarction, and required angioplasty to remove 3 blockages. His troponin levels were off the chart. Why they weren’t elevated at earlier tests is unknown.
Hope whatever issues you’re experiencing are found and resolved quickly
Can we please stop sharing our personal experiences as though they confirm something epidemiologically?
I know of more than 30 unvaccinated people who caught Covid and only had mild symptoms. What does that mean? Absolutely nothing, in isolation.
For some, Covid hits like a brick, regardless of vaccination status.
Fine. I have friends who are fully vaxxed and who have had a much worse experience. I’m not sure what you think your experience proves. Yes, it’s really important to be vaxxed. But people are still having to take time off work and that is multiplying across the community and it is causing really big problems. It’s not about how sick you get. It’s about how infectious it is.
I wonder if the “Get out of editorial standards free” card that is issued to board members of Crikey’s parent company comes laminated?
Or is a trip to officeworks necessary?
Don’t forget, Adam has skin in this conflict of interest. Luxury Escapes must have taken a hammering during the time of travel restrictions.
Great, the ghoul is back. Being provably wrong about everything all the time is no barrier to a Crikey sinecure, it seems.
I’m sharing this with my neighbour. He and most of his family suffered from Covid earlier this year, with mild to moderate severity. They’re lovely people, but are also hard-core Catholic – to the point where they were essentially kicked out of their local church.
Needless to say, they’re avid anti-vaxxers.
Incidentally, he’s a Science and Maths specialist secondary teacher in the Cath. Ed. system. (I should say, he *was* in that system.)