HealthAnalysis

Covid-19 pandemic review’s puzzling finding of no excess deaths in Ireland has a simple explanation

Time may now have arrived to start long-promised assessment of actions taken during coronavirus years

Lost Lace, a public art installation, commemorates the lives lost to Covid-19 in Ireland. Photograph: Alan Betson

Paul Cullen's face
Paul Cullen
Tue Jan 2 2024 - 20:30

The finding in an international study that Ireland recorded no excess deaths during the core Covid-19 pandemic years might seem puzzling to some.

Research published by the Organisation for Economic Co-operation and Development (OECD) shows Ireland was one of only nine OECD states to avoid excess deaths in the 2020-2022 period. The State registered the fourth lowest rate, behind New Zealand, Iceland and Norway.

The notion that proportionately fewer than expected people died in Ireland during the pandemic might seem counter-intuitive to anyone who remembers those dark days, especially families bereaved by Covid-related deaths.

The first thing to note about the preliminary OECD study is that it is written by uninterested experts working for the Paris-based organisation

Indeed, subsequent studies, many of them based on the rising number of death notices published online, identified a large number of excess deaths during this period. Researchers at Maynooth University found excess mortality in 2020 was almost 40 per cent higher than during the severe flu winter of 2017-18. A study by the Heath Information and Quality Authority (Hiqa) found there were more than 2,000 excess deaths during the spring and early summer of 2020 and the winter of 2021, the worst periods of the pandemic.

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So which take is right? Or could they both be correct?

The first thing to note about the preliminary OECD study is that it is written by uninterested experts working for the Paris-based organisation. There is no attempt to sugar-coat the devastation wreaked by the pandemic in the report, the main finding of which is that an additional 2 million deaths were registered across the OECD in each of the years between 2020 and 2022 when compared to the average number of deaths during the five years leading up to the pandemic.

In 2021, the number of registered deaths across the OECD was 19 per cent higher compared to average pre-pandemic levels.

Ireland’s total population increased by 8% between the 2016 and 2022 censuses, while the number of people aged 65 and over increased by a remarkable 22% during that period

The big difference between this study and others is that it takes account of changes in the population structure of countries in the period under review. Western countries are ageing and Ireland is getting older faster than almost anywhere else.

Ireland’s total population increased by 8 per cent between the 2016 and 2022 censuses, while the number of people aged 65 and over increased by a remarkable 22 per cent during that period. This is more than double the 10 per cent increase in EU countries.

When account was taken of this change in population structure, Ireland was found not to have recorded an increase in excess deaths over the three years.

Excess deaths refer to the number of fatalities from all causes during a period, above what would normally be expected. It is regarded as one of the best ways to measure the impact of, say, a pandemic, as it catches deaths from all causes.

However, this does not mean there were no variations in the death rate at different points between 2020 and 2022. In Ireland, the adjusted rate appears to have gone up in 2020, down in 2021 and up again in 2022.

If online reaction is the barometer of public opinion, there would appear to be a high degree of scepticism about the Government’s assertion that Ireland had a good pandemic, relative to other countries

As the Hiqa study noted, the worst periods of the pandemic were associated with spikes in deaths. In other parts of Europe, but not Ireland, heatwaves in the summer of 2022 led to a surge in deaths.

Minister for Health Stephen Donnelly and his officials were, understandably, quick to welcome the OECD’s findings and attribute them to the public health measures taken during the pandemic, notably the widely supported Covid-19 vaccine programme.

If online reaction is the barometer of public opinion, there would appear to be a high degree of scepticism about the Government’s assertion that Ireland had a good pandemic, relative to other countries.

The only way of properly answering the questions about Ireland’s performance during these years may be to start the long-promised review of the actions taken during the pandemic.

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