Unexpected excess mortality among the elderly

Through Maurice, I received a question from a reader. She had the Lareb article and wondered if she was the only one who had noticed the excess mortality among the elderly (she mentioned 75-79 in particular). Reason to take a closer look at that. When comparing the excess mortality figures from CBS with the Covid mortality as reported on the RIVM corona dashboard, striking things indeed emerged.

First the Covid mortality of the RIVM. The line is marked with red to make it more visible in the other graph. This is the average across all age groups.

Then a graph from Statistics Netherlands: the excess mortality per age group. The light areas are margins of uncertainty. The light-coloured lines represent the expected mortality. The dark-coloured lines show the measured mortality.

From top to bottom: 80+, 65-80 years, 0-65 years.

We overlay both graphs. Where Covid mortality was (almost) 0, that zero line has been set at expected mortality. Because the red line concerns all ages, it does not quite match the highlighted ages, but enough to get an impression. Then some striking differences emerge, indicated by background colors.

Excess mortality since March

Waar het vooral om gaat heb ik aangegeven met de grijze rechthoek. Vooral in de leeftijdsgroep van 65-80 jaar is er iets opvallends. Daar is in maart een oversterfte ingezet die in elk geval tot augustus voortduurt. Dat is geen Covid want de rode Covid-lijn blijft daar vlak - logisch ook want die groep is dan grotendeels dubbel gevaccineerd. Waar zijn die mensen dan aan gestorven? Het kunnen niet de ongevaccineerden (door Covid) zijn want dan was de rode lijn mee omhoog gegaan. In de groep 80+ jaar is er minder bijzonders in die periode: de lijnen slingeren nog een beetje om elkaar heen. Er is nu wel al enkele weken oversterfte (en Covid loopt ook iets op) maar wie weet zakt dat weer. Zo niet, dan zouden ze zo'n drie maanden achterlopen op de 65-80-jarigen met een langdurige oversterfte.

If you look at the over-65s (you have to look closely), you will see the same thing: there, too, the blue excess mortality line will remain above the expected values and above Covid mortality from the end of March. It puts in there later than at 65-80. It was not Covid in this group either, and there is no flu. Where does this mortality come from?

The numbers at 0-65 are actually too small to be able to say anything about it on the basis of this graph. A numerical study is necessary to take a closer look at these groups and to count how many people have died. Does someone throw themselves up? Or could the designated authorities come up with a conclusive story?

I am very curious about what data analyses will yield and what causes of death will be mentioned. In the previous post I already gave a push.

More information

Links van de gele kolom (mei-aug) zien we een periode van ondersterfte vooral in 80+. Dat is logisch na zo'n piek en met een lage prevalentie van het virus.

In the yellow column itself we see the heat wave peak, which clearly affected the oldies the most. The red Covid line remains fairly flat there. You could say: proof that other causes of death are not attributed to Covid. In short: the differences are quite easy to interpret and the trends are similar.

In het groene vierkantje valt op dat de covidsterfte enkele weken ruim boven de totale sterfte heeft gezeten. Nu lopen de lijnen wel vaker niet helemaal synchroon maar dit is toch best substantieel: de hele maand november lijken er beduidend minder mensen doodgegaan dan er Covid-patiënten zijn overleden. Dat kan natuurlijk niet - of toch? Een registratiefout?

Not only in the Netherlands

Maurice draws my attention to the fact that there are similar graphs from Spain (Madrid to be precise) that zoom in on the last few weeks among the over-75s. The 65-74 year-olds give a less intense but similar picture, in the 0-64 group it is even less.

We have also heard alarming noises from Israel before. Something seems to be going on. Now it may be that we as beer mat calculators miss the mark. But if we can explain this, why hasn't VWS, rivm or Lareb already explained how they think it is? This has been going on for weeks. Is it the deadlier Delta variant? It does not seem so deadly in other countries.

Of course, it is also suggested here and there that it could be side effects of the vaccination and a worsened response to variants or ADE, an overly severe response in vaccinated people (a study on ADE is in peer review). The issue of vaccine-trained variants (immune escape) also continues to come up, if we ask Geert VandenBossche. However, the latter two are unlikely because then the red Covid line would probably not have remained flat. Someone else suggested that this could be the result of delayed care, which was a problem especially in the Netherlands because of the substandard care capacity.

To end cautiously (pseudo)scientifically: there seems to be reason to recommend further research. Before it has been scientifically proven that there is no relationship between vaccinations and excess mortality, it may be an option to consider whether a vaccination pause would be appropriate. But that will probably not benefit the willingness to vaccinate.