Faltering immune systems?

In spite of the political statements, excess mortality is becoming more and more pronounced. We have now reached the stage where the RIVM is pulling out all the stops to keep the figures out of the spotlight. The baseline has been adjusted sharply upwards by calculating the in a different way (See: Excess mortality: from CBS to RIVM). The incomplete figures for the last week are also shown and then the conclusion is drawn from: "Not increased". In the meantime, England has also in this way the calculation method has been adjusted.

But there is much more than comparing the actual mortality with something you expect based on a model. By expecting more mortality, you can indeed say later: this is what we expected, so we no longer consider it excess mortality. What cannot be ignored, however, is the greatly changed pattern in mortality. I'll show you.

Seasonal effect

For as long as the RIVM has been keeping track of mortality figures, we have seen a seasonal effect in these figures. More people die in winter than in summer. In winter, our immune system is less able to cope with the viruses that constantly attack us than in summer. This effect is greater among older people than among young people. The RIVM keeps it at 19% difference between summer and winter for 80+, for 0-65 years at 4% as can be deduced from the Figures on the website. On average for all ages, that difference is 16%.

If we look at a year without flu, we see this pattern most clearly, for example in the 2018/2019 season:

The blue line is the actual mortality rate for all ages. The light blue band is the bandwidth, calculated according to the RIVM method. The thin line in the middle of this band is the average value expected for each week of the year. The breadth is determined solely on the basis of the statistical uncertainty in the figures. If the weekly value is outside this interval, it can be said that with 99% certainty it is not based on chance and so there is excess mortality in that week (or under-mortality if the value sticks out at the lower end). Indeed, we see that almost all weekly values are within the interval.

Because the Dutch population is getting older and the composition of the population is also constantly shifting (the aging population and the "baby boom"), this blue band slowly shifts upwards over years, about 0.5% per year.

The flu of 2018

In 2018, there was a flu wave.

From January to April, about 5800 people died from this flu. In May, we see the under-mortality, characteristic of a respiratory disease. For many people, the flu has brought the moment of death forward by a few months. In the end, it turns out that the flu has caused a net mortality of around 35% of the flu itself.

The first corona wave

Corona only came at the end of the flu season, the last week of February (corona first had to come all the way from China).

The combination of a new virus, the end of the flu season, and the fear that engulfed us and kept us at home made for a shorter, fiercer wave compared to the flu. But other than that, it has all the numerical characteristics that a respiratory virus has. The excess mortality was also fully explained by mortality due to corona itself.

The number of deaths from corona was slightly higher than during the flu wave: around 8500. But here too, we see the same under-mortality occurring in the months following the death wave itself.

So far, nothing special, but the big difference is that the media (under the direction of the WHO) have devoted a lot of publicity to this and thus influenced our behavior. Lockdowns brought public life to a standstill, traditional methods of treatment were banned under penalty of legal prosecution.

The second wave

Already in the autumn of 2020, the second wave (or rather it was three waves) began, preceded by extra mortality as a result of a heat wave in August. The first autumn wave was in fact the continuation of the first wave, which was interrupted by the shutdown of social life and the arrival of spring.

A second autumn wave occurred at the end of November, caused by the extra contagiousness due to the Seasonal effect. In January 2021, there was the "British variant" which caused an additional 18% of contagiousness and gave the epidemic the long undulating pattern. These three waves merged into one broad wave.

So far, corona perfectly followed the laws of nature that are also used in flu: the build-up of immunity ensures the predictable slowing down of an epidemic. It fully explains the course during these 5 months. It was a period that was further characterized by a multitude of Measures, the efficacy of which was highly questionable. Koopmans explained the lack of a visible effect as "The Prevention Paradox", about which I published in the article "The paradox of the measures". The government has even tried to restrict social life via the QR code. We wrote the article about this "The Fata Morgana of the 2G efficiency", which revealed a serious error in the calculations of TU Delft. The proposal was subsequently rejected by the House of Representatives.

From March onwards, however, we have already seen an important difference with the first wave: there is no under-mortality. The excess mortality persisted and from that moment on can no longer be explained as a result of corona itself.

The Delta season

In the fall of 2021, a new wave emerged, which is called Delta Wave after the discovery of a new variant of the corona virus: the Delta variant.

Here, however, there is something curious to see. The excess mortality started well before the Delta variant itself appeared. Anton Theunissen was the first to point it out in the article Unexpected excess mortality among the elderly and Why all the summer deaths?

We also see here that the excess mortality was three times as large as the mortality from corona itself (the red line) and that is remarkable. A wave of deaths at the beginning of autumn is very striking, our immune system has apparently faltered here. Despite the fact that less than a third consisted of corona, this wave was attributed to the Delta variant. Most of this excess mortality must therefore be explained by other viruses, for which there was apparently insufficient resistance. Unexplained excess mortality.

Apart from a few weeks in which mortality fell slightly below the expected value, there was no under-mortality after that.

The sequel

After the Delta variant, the Omicron variants appeared in 2022, which were much less pathogenic, as was also seen in the mortality rates from corona.

Corona mortality disappeared, but excess mortality remained. In an article, this Excess mortality modelled. It is officially "unexplained excess mortality" and the government would like to keep it that way, the elephant in the room should not be named.

In the original model, excess mortality was approached in the long term as a phenomenon that was evenly distributed throughout the year. In the meantime, the picture is beginning to emerge that excess mortality manifests itself as a wave pattern, exactly the same as the waves in the bandwidth. In the graph this is indicated by the black dashed line "Forecast". No excess mortality during the summer months, but there is excess mortality in the winter months. In the 2023/24 season, the seasonal influence has increased from 16% to 37% (compare with the first graph 2018/2019). So on February 1, 2024, 37% more people died than on July 1, 2023. This behavior suggests that our immune system faltered, each year more than the year before.

The total number of deaths expected for the 2023/24 season (i.e. the black dashed line) will then be 173,000, which is almost 14,000 more than expected.

What possible causes do we know?

• Deferred care. The government's most popular explanation was "Deferred Care". In addition to the fact that this explanation is still not supported by figures, this possibility is not possible, because otherwise we would have had to see something different. You can expect effective care to postpone the moment of death by, say, a year. If this care is not provided, the moment of death will no longer be postponed, but will take place a year earlier. As a result, there were more deaths in 2020, but fewer in 2021. To a lesser extent, this will also apply to the following years. But from 2021 onwards, we will see excess mortality and not under-mortality due to deferred care. These numbers serve as examples, but other numbers won't change the picture.
• Under-registration. Determining the correct cause of death is always difficult and sometimes arbitrary. But a certain fact is the number of deaths themselves. The number of deaths from corona is now so low that it will be negligible compared to excess mortality and therefore no explanation for excess mortality.
• Something to do with corona. That would be a strange cause. Until April 2021, there was no indication that a corona infection would have a longer-term effect. After all, the unexplained excess mortality only started in mid-2021!
• Accidental fall. This possibility was recently suggested by Minister Dijkstra as an important cause. Here, too, it seems unlikely that since 2021 people will fall off kitchen steps or trip over curbstones, especially in the winter months. However, it may be that "accidental fall" has the role of the "canary in the coal mine". Since mid-2021, many "sudden deaths" have been reported. If the actual cause of death is not investigated, it could indeed be an "accidental fall".
• The elephant in the room. This is the only remaining cause, but it should not be named and investigated.

What does RIVM do?

The persistent excess mortality is very uncomfortable for the government. It indicates failing policy and everything is now being done to write this excess mortality out of the books. This current chart illustrates this approach:

Since 2024, it has RIVM has taken over the reporting of excess mortality of Statistics Netherlands (CBS). Two important changes have been made:

• The baseline has been increased by almost 10%, resulting in administrative under-mortality in the summer months. This then compensates for the excess mortality in the winter months and so on balance there is virtually no excess mortality left.
• The mortality figures of the last few weeks are always incomplete and will be supplemented in the following weeks. As a result, the last week regularly falls within the bandwidth, until additional additions are made. By drawing conclusions from this last week, the verdict of the RIVM is sometimes week after week: "Not increased".

The ONS in England has now also adopted this approach: Estimating excess deaths in the UK, methodology changes: February 2024. So there seems to be some kind of coordination in rewriting history.

Conclusions

Now that corona has virtually disappeared and is no more than one of the viruses circulating, excess mortality continues. Until April 2021, the course of excess mortality could almost entirely be explained by deaths from corona. This is followed by an erratic course, of which the impression now arises that this erratic course also has a clear seasonal pattern. It will more than double the number of seasonal deaths by 2024. A conservative estimate shows that excess mortality in the 2023/24 season will amount to 14,000, slightly more than in the year 2023 itself.