Morbid Curiosity [Updated]

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Chief Medical Officer Dr Tony Holohan at a Covid-19 press briefing tonight

This evening.

Paul Cullen, of The Irish Times, asked Chief Medical Officer Dr Tony Holohan about the CSO’s mortality report published earlier today.

They had this exchange:

Paul Cullen: “The other thing I noticed, from reading through that report from the CSO. Obviously our peak of deaths occurred in April of this year.”

Tony Holohan: “Uh-hum.”

Cullen: “The peak of deaths in 2017 and 2018 occurred in January. They’re actually the same size, the whole three peaks. Would you draw any conclusions from that? In fact, the one in 2018 is slightly higher than the one this year.”

Holohan: “The one in?”

Cullen: “2018 is just marginally higher than the one…I mean there was a lockdown but…”

Holohan: “Pardon me?”

Cullen: “There was obviously a lockdown in April.”

Holohan: “Yeah, there’s always a peak in mortality in the winter time. We’re well used to seeing that. And it occurs in every, every developed country and we’ve seen these reports through the European mechanism which is the European Mortality Monitoring Mechanism, the Euromomo which I’m sure you’re well familiar with, and established the same sort of pattern. I haven’t had a chance today to study the CSO, I believe they just published that today and I simply haven’t had a chance to study the detail of that today so I’ll wait to study that before I comment on your specific question.”

Earlier:

The monthly recorded death notices for October 2019 to September 2020 compared with CSO mortality figures for the same period for the years 2014 to 2019

This afternoon.

On RTÉ Radio One’s News at One.

Central Statistics Office statistician John Flanagan spoke to Bryan Dobson about a report by the CSO, involving an analysis of death notices on RIP.ie, which shows that excess mortality for between March and September 2020 is estimated to be between 876 and 1,192 deaths.

Bryan Dobson: “When you say there has been, more, excess mortality in the order of 1,192, what are we talking about? What are you comparing it with?”

John Flanagan: “Good afternoon, Bryan, so excess mortality is a measure of the number of people who have died over and above the number we would have expected to die in the absence of the pandemic. So, for example, in 2020, we would have expected around 2,500 deaths but we observed 3,500.”

Dobson: “So in relation to Covid then, it’s quite clear that Covid has, or well, it’s certainly, it’s indicated by these figures that Covid has contributed to an increase in deaths since the pandemic began earlier this year?”

Flanagan: “Yes, absolutely. So essentially, in a sentence, what you could say is between 900 and 1,200 people are dead who would otherwise have been alive at the beginning of October 2020.”

Dobson: “But that is still below the official figure from the Department of Health for Covid-related deaths, I think which is in excess of 1,900. So how is that explained?”

Flanagan: “So in certain instances there have been some accelerated deaths, so but, if you were to take it on of people who have died of Covid-19 that there is a spectrum of people who are otherwise healthy and people who are gravely ill, so essentially we are seeing, we can state that the 1,800 is effectively capturing the number of people who have died of Covid-19.”

Dobson: “There’s also another pattern which you observed and that is that many of these excess deaths are concentrated in the earlier part of the period and I suppose when the pandemic was at its height and have, well, largely tailed off into the month of September?”

Flanagan: “That’s right, yeah. So we’ve seen the death rate, the numbers of deaths return to normal, as what we would have expected to see.”

Dobson: “So for the month of September, is there any excess mortality, any indication that Covid has caused additional deaths?”

Flanagan: “No, nothing really out of the ordinary.”

Dobson: “So what lessons then do you draw from this in relation to how the pandemic is being understood?”

Flanagan: “Well, you know, all we can really discuss on the basis of this analysis is what we’ve found based on death notices. I can’t, I’m not really sure if I’ve answered your question there Bryan.”

Dobson: “Right. Maybe that’s for others to give some consideration to.”

Flanagan: “I think so. I think so.”

Dobson: “OK, well, we’ll leave it there…”

Anyone?

Listen back in full here

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57 thoughts on “Morbid Curiosity [Updated]

  1. Cian

    Covid deaths in August: 14
    Covid deaths in September: 29
    Covid deaths in October: 109

    can you see a trend?

    1. Janet, dreams of a steamed clootie

      don’t worry, missed diagnoses of cancer and suicides will more than make up the numbers, just a matter of time

      1. Cian

        Janet, it’s not an either-or.
        If we didn’t go into lockdown, there is a good chance that the numbers of infections, hospitalisations, ICU-beds and deaths would continue to rise exponentially. As well as harming/killing people directly this would have overwhelmed the hospitals (with a knock-on of stopping all day-cases and non-essential operations and cancer treatment) and stopped screening services.

        1. Johnnythree

          ‘would continue to rise exponentially’… hmmm no, not really. It would taper and fall like all viruses. Jesus take a look at Sweden. No masks etc. No exponential there. What happened there?

          1. SOQ

            Sweden front loaded it’s deaths yes, but they are still well within the region of average annual mortality?

          2. E'Matty

            @ Cian – “Sweden has 10-12 times the deaths of it’s immediate neighbors.” Yet, it has almost exactly the same death rate as Ireland when the age profile of the nation is taken into account i.e. like for like. How is this?

            What are the actual stats involved:
            Population: Sweden (10.23 million) : Ireland (4.9 million) / Ratio 2.08:1
            Covid Deaths: Sweden (5,892) : Ireland (1,817) / Ratio 3.24:1
            % over 65 in population: Sweden (20% – 2.04 million ) : Ireland (13.32% – 652K) / Ratio 1.5: 1

            5892/2.04m : 0.28% – Sweden
            1817/652K: 0.27% – Ireland

            So, when one considers the actual population age profile and that the over 65s have borne the brunt of the deaths (90%+ of the deaths in both Ireland and Sweden), and compare the outcome for this age group in both populations, we find that it is almost identical, just 0.01% of a difference.

          3. Cian

            You can’t just compare countries because as you mentioned their age profile may differ. So could many other factors, climate, DNA, social norms, income, health, etc.

            So comparing Ireland with Sweden isn’t as fair as Sweden with it’s immediate neighbours.

            Why does Sweden have 10-12 the death rate of its (more similar) neighbours?
            Hint: perhaps it was lockdown?

          4. Micko

            Ummm

            Ireland is similar to Sweden’s neighbours in population size. In and around 5 million.

            Probably a better question to ask Cian – is what the F happened HERE?

            Why are our numbers so bloody high compared to Sweden’s neighbours?

            Why did we have so many nursing home deaths at the start and now?

        2. Janet, dreams of a steamed clootie

          I’m not suggesting there would have been none of these deaths otherwise, I would have preferred to see the hospital capabilities improved and the nursing homes given the tools to cope, it makes no sense this hasn’t been done

          1. Hank

            Exactly. The whole point of the first lockdown was to give them time to increase ICU capacity. They didn’t. A lockdown where a government doesn’t use the time to increase capacity is just a futile exercise with devastating social and economic effects. It makes zero sense. Focusing on protecting the most vulnerable while maintaining some form of normality for the rest would be a much more effective strategy.

          2. Cian

            What exactly do you mean by “hospital capabilities improved” and “the nursing homes given the tools to cope”? are they sound-bites like “protect the vulnerable”?

            Covid is highly infectious. The ways to manage it have a knock on of reducing capacity.
            In a hospital you need more space per person – ideally individual rooms. Unless the existing hospitals have lots of empty rooms (some may have empty wards that should be re-opened) then Covid forces you to reduce the capacity. A&E waiting rooms -> need to socially distance people -> reduced capacity. A&E itself -> need to socially distance patients (& staff) and sanitize between patients -> reduced numbers and slower throughput;

            Nursing homes:we need to increase available staff (in case some get sick)… so we need a big supply of staff that can be sent out to homes as needed! but we also need to avoid staff moving from home to home; so a big supply of staff isn’t a workable solution.

          3. Janet, dreams of a steamed clootie

            sure doing sweet f all was a much better approach,
            from my time at Beaumont I noticed large ” temporary ” day wards, perhaps these could have been converted to ICU ? If there’s a will there’s a way Cian.
            Even two extra staff per carehome would have helped perhaps one with the right training in PPE/ hygiene etc and not the underpaid undertrained ( 6 weeks course on line ) that are currently for the most part facing the crisis in care homes.

      1. Cian

        if excess deaths are 900-1200 and the covid deaths are 1900; then we could assume that about half the reported deaths are with Covid, and half are from Covid.

    1. d

      yeah good point, all stats get skewed. less heart attacks from being in the boozer all weekend.

      though road accidents is less than one person a day.

      and people stuck at home eating, not getting exercise, not getting their health checkup or GP appointment to look at that niggle that could be something more important.

      1. Daisy Chainsaw

        People can get GP appointments. I’ve been to my doctor and nurse in my local practice as recently as 2 weeks ago to get the flu jab. Since the first lockdown, I’ve seen both a private and public consultant, had an overnight in hospital after a minor procedure with 3 follow up appointments to check stitches and give me results.

        If doctors are refusing to see patients, then they need to change to a different doctor.

        1. SOQ

          Sweet Jesus- you have already stated that you have an compromised immune system- do you honestly think everyone gets the same priority as you?

          What about all those people who have not been diagnosed but have one or more of your conditions- what happens to them?

          1. Cian

            They get treated too.

            Unless the hospitals fill up with Covid cases, in which case they would need to stop treating the vulnerable people.

            The lockdown is to slow the spread, to ensure the hospitals stay open, to treat the vulnerable people.

  2. Johnnythree

    @Cian I hope you are not making a mistake. Sometimes you do, in your enthusiasm.
    Are the deaths you quote with or from Covid. Big Difference. I hope you read the interview with the guy from the CSO. He said there are no excess deaths. Some crack having a lockdown eh! Well done FG/FF/G

    1. Cian

      He said no excess deaths up to September (29 deaths). We’ll see about October.
      And if we didn’t go into Level 3/Level 5 there is a good chance that November would be been 300+

      if excess deaths are 900-1200 and the covid deaths are 1900; then we could assume that half the reported deaths are with Covid, and half are from Covid.

    2. Daisy Chainsaw

      If they died with covid instead of from covid are they any less dead and was covid any less of a factor?

      1. E'Matty

        “If they died with covid instead of from covid are they any less dead and was covid any less of a factor?” Yes. One can die with something and it play no role whatsoever in the death. For example, “he died WITH athletes foot”. Pretty sure the athletes foot wouldn’t be considered a primary factor in the death. To die FROM something implies the “something” played a primary role or was the dominant factor in the death. We don’t say you died with a heart attack. We would say you died of or from a heart attack.

        This is why we are told people already over the average life expectancy who have died from heart disease, chronic neourological diseases, chronic respiratory diseases, cancer and diabetes have died WITH Covid. They only had to be deeemed a Coivd patient by medical staff, or test positive for the viurs. No symptoms even have to be present for the latter. Why are they not saying people have died from Covid? It’s a very clever use of words and it is quite telling just how many people cannot discern the clear difference in meaning between the two choices of description.

        1. Daisy Chainsaw

          Then maybe you can tell me how many died from flu or with flu over the last few years as a comparison.

  3. Johnnythree

    @Cian
    Always mildly amused by your posts.

    ****’We’ll see about October**** – We will indeed, what with dropping cases in-the past few weeks I doubt it will be significant.

    ***And if we didn’t go into Level 3/Level 5 there is a good chance that November would be been 300+**** – Eh unlikely. You saw the graphs with cases dropping off before Lockdown took effect I am sure? L3 just with social distancing would have done it so Don’t go all Sam McConkey on me now.

    ******if excess deaths are 900-1200 and the covid deaths are 1900; then we could assume that half the reported deaths are with Covid, and half are from Covid ******- Yikes!!!! Presume much?? I like the way you built seasonality, age, demographics etc into that. And 50/50% Wow neatly done.
    Take a look at data for Flu and come back to me on the deaths from/ with covid chat.

    1. Cian

      There were 109 “covid” deaths in October – enough to be noticeable in excess deaths.

      I dunno, perhaps level 3 would have been sufficient… but perhaps not. the numbers were still rising across the whole country.

      I think the 50:50 is valid. I’ve shown why. You give a better breakdown.

      What do you mean “Take a look at data for Flu”? in what way has that to do with covid deaths? Do you mean how deaths are proportioned from/with the flu each year?

      1. Johnnythree

        The 109 covid deaths are in October may not be enough to cause excess figures due to the interplay between Covid and Flu. Its really simple. Excess deaths are not just from covid they could be from flu or any number of causes as long as there is no time lag in reporting.

        What do you mean ‘ I dunno’?? You reported it as fact a few posts above.

        You have not shown why the 50/50 breakdown is valid. Not at all. You assumed so go again and show it or remove it because right now its just a sentence of nonsense.

        The data for flu is important – I’m sorry to have to be the one to point this out to you in November when you have spent a lot of time since March on here talking about Covid. The flu deaths are particularly low to date – in fact as of today-

        ””There was no evidence of influenza viruses circulating in the community in Ireland during week 43 2020
        (week ending 25/10/2020) or during weeks 40-43 2020. Limited influenza testing at this time should be considered when interpreting these data. Rhinovirus and enterovirus detections continue to be detected during October 2020*

        So, in peak flu season there is no flu being discovered or recorded nationally and low deaths from/ with (take your pick) covid then where are the deaths?
        Are they all dead? Under their beds? Dying slowly? Emigrated?
        Maybe ‘covid’ as a reported death is taking place of the flu as a reported death which is on average 200 -500 deaths a year in Ireland. So flu and covid are very much an interplay. odd that there are no flu deaths but covid deaths don’t you think?

        **Source:https://www.hpsc.ie/a-z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20202021season/

        1. Cian

          It’s not peak flu season! It is the very start of flu season. Peak flu season is December-JanuaryFebruary.

          From your link “Of 458 non-sentinel specimens tested by the NVRL between weeks 40-43 2020, no confirmed influenza or RSV positive detections were reported. “. They are testing for flu… but none found.

          If you look at week 43 (this week) from last year you’ll see similar:.. very little flu; 1 hospitalization, 0 deaths.
          https://www.hpsc.ie/a-z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/previousinfluenzaseasonssurveillancereports/20192020season/Influenza_Surveillance_Report_Week%2043%202019_20191031_v1.0.pdf

          It would be odd to see flu deaths in October.
          The 109 covid deaths are not masking 109 flu deaths.

          1. E'Matty

            HSPC data reveals that 95% of individuals who died with confirmed Covid-19 infections so far also suffered from known underlying health conditions. The most common underlying condition was Chronic Heart Disease, followed by Chronic Neurological diseases including Alzheimer’s, Parkinson’s disease, and Multiple Sclerosis. These were followed by Chronic Respiratory Disease, Hypertension, Cancer/malignancy, and Diabetes. As we move into the Autumn and the temperature drops and the climate becomes damper, we see every year a rise in elderly deaths. The question will be whether there is an excess mortality rate in October and the scale of any such excess.

      1. millie

        I’ve stopped reading all the covid threads here bisted. Not worth your while.

        The arguments are the same day in, day out, regardless of what side of the debate you fall on. It’s tiresome and not even healthy to dwell on such a topic, indeed any topic, so relentlessly to be honest.

          1. Nigel

            I only read Cian’s comments at this point. He gets dog’s abuse for it, seems the least I could do

        1. realPolithicks

          I stopped reading them months ago millie, its an utter waste of time with the same arguments from the same people everyday.

          1. SOQ

            No offence but if you think that people are not dying because of lockdowns then you really need to dislodge your head from your backside.

          2. bisted

            …again…the irony is…and I really don’t want to sound glib about this…shouldn’t those people who die from lockdown related causes be counted as Covid related?

          3. SOQ

            busted- shouldn’t those people who die from lockdown related causes be counted as Covid related?

            At best- you really don’t understand what this irrational unscientific madness is doing to people’s lives- or more likely- you just don’t care.

  4. Mick

    While you are all getting flustered around “with” or “from” Covid, take a look at the US to witness what happens when a government drops the balls on a pandemic. Do we really have to explain again that its all about “potential” and that thankfully lockdowns are used to stop the spread of this nasty virus?

  5. f_lawless

    The sheer insolence of Paul Cullen: to momentarily cast doubt over Emperor Holohan’s choice of attire. Luckily for him he quickly reigned himself in by acknowledging Holohan’s lockdown magick

  6. Johnnythree

    @Cian – sorry late reply. You make good points. But the excess deaths in September didn’t happen and October looks like it will not be significant either. There is no flu prevalent and we have a pandemic which mostly affects over 65’s so where are the significant excess deaths. We are in Level 5 Lockdown. For what?
    Imagine if there was no PCR test – would we be looking at Covid in the rear view mirror?

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