Almost 20,000 more people died last year – the highest excess death rate since WWII

Almost 20,000 more people died in Australia last year than anticipated, with just more than half dying because of COVID-19 as the country recorded the highest number of excess deaths since World War II.

New data from the Actuaries Institute, published on Monday, estimates there was a 12 per cent spike in excess deaths in 2022, with COVID the reason for 10,300 extra deaths and a contributing factor in an additional 2900.

Deaths from heart disease, cerebrovascular disease and diabetes were also between 8 and 17 per cent higher than expected.Credit: Wayne Taylor

There were 6600 remaining excess deaths with no mention of COVID on the death certificate. Among those figures, ischaemic heart disease – which leads to heart attacks – and cancer were the biggest contributors, leading to 2020 and 970 excess deaths respectively.

The Institute’s COVID-19 mortality working group’s spokeswoman Karen Cutter said 20,000 additional deaths was a very significant number.

“It’s not normal to see that level of excess mortality in non-pandemic times. Normal fluctuations would be 1 or 2 per cent – to have 12 per cent excess mortality is a very large number ... You would have to go back to World War II to see these levels of excess mortality,” she said.

The 10 to 15 per cent rise in excess deaths was mirrored across all states and territories except for the Northern Territory, although the spike in Western Australia was delayed due to the state opening its borders in March.

There were excess deaths across all age groups – with a notable rise among females under 44 – but the number and rate were highest among over-65s, which was expected given that the risk of mortality from COVID-19 is steeper with age.

Deaths from respiratory diseases were 10 per cent lower than expected, despite influenza circulating in Australia again last year, but doctor-certified deaths from cancer and dementia rose 2 per cent.

Deaths from heart disease, cerebrovascular disease and diabetes were also between 8 and 17 per cent higher than expected.

Cutter said those three causes of death were also linked to COVID. “Studies show there’s elevated risk of those with COVID, and that’s where we’re seeing,” she said, adding that the spike in deaths from heart disease was significant.

She said periods of high COVID deaths had also corresponded with excess non-COVID deaths.

“Part of the explanation could be that people are going to hospital and not being able to access treatments because hospitals are full of COVID patients. At the peaks of COVID, ambulance and emergency department waiting times are high. We think that’s one factor in why there’s more non-COVID deaths coming through,” Cutter said.

“The other aspect of people not getting medical treatment could be they didn’t get the treatment they needed or the screening tests they should have in 2020 and 2021, so they’re having worse health outcomes that have taken a while to emerge.”

The analysis found that COVID-19, its long-term consequences, and its interaction with other health problems such as heart disease had the biggest impact on excess mortality figures last year, as did delays in emergency care.

Pressures on the health, hospital and aged care systems during the pandemic, which have led to ambulance ramping and bed block, meant some people did not get the timely help they required or avoided seeking care, and this hypothesis was supported by a rise in non-COVID deaths during COVID peaks.

There was a moderate effect from lower-than-expected deaths from respiratory diseases in previous years of the pandemic, which meant people who might have otherwise died earlier were now succumbing to their underlying illnesses.

There was also some evidence that delays in seeking routine care – for reasons including fear and lack of opportunity – led to missed chances to diagnose and treat non-COVID illnesses, which could be a factor in higher deaths from cancer, heart disease and diabetes.

The analysis found that the impact of pandemic-influenced lifestyle changes, for example drinking more or exercising less, was low, while the impact of vaccine-related deaths was negligible.

The Actuaries Institute chief executive Elayne Grace said the figures were “a stark reminder of the tremendous impact COVID-19 has had across Australia”.

“Although people have largely moved on with their lives beyond the lockdowns and border closures, the fact is that COVID-19 remains a key contributor to the majority of excess mortality,” she said.

The institute’s COVID-19 Mortality Working Group drew on data from the Australian Bureau of Statistics to make its calculations but it takes a different methodology than the bureau, which uses an average of previous years’ deaths to make its estimates.

The Actuaries Institute’s baseline level of expected deaths factors in demographic changes, including an ageing population, and therefore increases every year. It also discounts COVID, meaning its baseline estimates assume the absence of the pandemic. This means its figures for excess deaths are lower, but more accurate, than the ABS report.

Cut through the noise of federal politics with news, views and expert analysis from Jacqueline Maley. Subscribers can sign up to our weekly Inside Politics newsletter here.