Niamh Griffin: How the OECD calculated excess covid deaths in Ireland and around the world

Ireland — along with New Zealand, Iceland, and Norway — had the lowest levels of excess deaths during the peak years of the covid-19 pandemic

The OECD report says countries such as Ireland with successful vaccination programmes had lower levels of deaths directly linked to covid-19 — but notes the disruption of healthcare systems wreaked by the pandemic. Picture: Dan Linehan

A study by the OECD indicates no excess deaths in Ireland during the pandemic, based on a number of factors. There is a lot to unpick in those findings.

How many people died from covid-19?

In Ireland up to early January this year, some 9,466 covid-19 deaths were reported to the Health Protection Surveillance Centre (HPSC).

Globally, during each of the three years from 2020 to 2022, the OECD counted around 2m additional deaths compared to the five-year pre-pandemic average.

Its analysis, OECD Health Working Paper No 163, found an estimated peak of almost 13.5m deaths recorded across the 38 OECD countries in 2021.

What does ‘excess deaths’ mean?

The OECD paper, written at a remove from the realities of overcrowded intensive care units and nursing homes tragedies, focuses on a specific way of analysing patterns in deaths.

Excess deaths include the total number of deaths registered — weekly, monthly or annually — compared to the number that might have been normally expected across all age groups.

The OECD analysis places Ireland among four countries with the lowest levels of excess deaths during the years examined, along with New Zealand, Iceland, and Norway.

Mexico had the highest number of excess deaths during this period, followed by Colombia, Bulgaria, and the USA.

What factors did the OECD take into account?

The authors acknowledge countries saw periods when deaths rose quickly.

They said weekly analysis shows “a much greater degree of variance” and that this led to “acute pressures on health systems, which may not be apparent from examining average annual mortality rates.”

In Ireland, the month of January 2021 is one such devastating time people will not soon forget.

During just one week, some 440 people died with covid-19, and deaths stayed at over 300 weekly for four weeks heading into early February, HPSC data shows.

The OECD team factored in rapid demographic change, highlighting particularly an increase in older people.

There was an 8% rise in the overall population in Ireland between 2016 and 2022, as well as a 22% increase in the number of over-65s.

This increase among older people is particularly noticeable as it is more than double that seen across the OECD.

In a statement on the OECD paper, the Department of Health said: “Adjusting mortality rates to take account of these changes has shown that Ireland did not record excess mortality during 2020-2022. In fact, Ireland had a lower than expected death rate.”

The OECD paper also states that, during the pandemic, there were lower numbers of deaths from violence, accidents, and other infectious diseases which people would usually be exposed to over those years.

However, as public concern in recent days has shown following the Department of Health’s comments, the paper also reflects the complexities involved in analysing mortality rates.

The team found the number of deaths directly linked to covid-19 dropped in countries where vaccination programmes were successful.

At the same time, they said: “The pandemic also disrupted healthcare systems, making it harder for people to access medical care at times.”

They suggested this may have contributed to an increase in deaths from other illnesses.

In Ireland, oncologists have separately warned the pandemic’s impact on cancer rates may not be understood for another decade.

Is this the only study on pandemic deaths in Ireland?

Research by Maynooth University and the University of Limerick found “excess mortality for the covid-19 period is almost 40% higher than that recorded for the ‘severe’ flu season of 2017/18.”

They measured this using notices on the funeral website Rip.ie but also noted fewer notices at other times during those years.

In April 2022, health regulator Hiqa said: “There were an estimated 2,019 excess deaths in Ireland between 2 March, 2020 and 28 November, 2021.”

They found two lengthy periods where deaths increased in early 2020 and early 2021, saying also “between mid- and late 2021, the excess mortality in Ireland was observed to be amongst the lowest in Europe.”

Will these findings form part of an inquiry in Ireland?

Taoiseach Leo Varadkar has said: “The inquiry will certainly be up and running in 2024.”

Terms of reference set out its scope and these are expected to be before the Cabinet shortly.

However, The Irish Patients’ Association has called for further analysis of the deaths as part of preparation for this inquiry.

“We think that the OECD needs to further explain its calculations, in the interests of the families who have been affected by those deaths,” a spokesperson said.

“We need to know more about what that indicator is telling us. Then, importantly, analysis of mortality in Ireland should be done prior to any public inquiry, with a root focus on why we’re doing this to ensure it doesn’t happen to other people.”