Be warned, this is going to be a long article, because it’s an important article. If you’re looking for a breezy two minute read, this one ain’t going to be for you. We’ll still try to make it as quick as possible, though.
There might be no more important question after all, in the context of the Covid-19 pandemic, for historians, than the simple question of how many people did it kill. The black death, in the four years from 1347 to 1351, is reckoned to have killed somewhere between 75 million, and 200 million, people. The Spanish flu, in the aftermath of world war one, is credited with fifty million deaths. Coronavirus, worldwide, so far, is credited with 3.01m deaths.
It might be tempting to look at those figures and immediately conclude that Covid is much less serious than the black death, or the Spanish flu. And indeed, that assessment might be correct. But to jump to that assessment, you have to forget that medicine today is not what it was in 1347, or even what it was in 1918. It’s unlikely, given what we know about Coronavirus, that it would ever reach the level of the black death, but we have to allow for the probability that without modern medicine, and hospitals, and our advanced knowledge of immunology, deaths might be in the tens of millions, globally.
But what about Ireland? How many people have died, and how many people were saved by lockdowns, or medicine, or Government policy? That question is a matter of great importance, both as a historic fact, and a tool to assess whether Government policy – the longest, most restrictive lockdown in the western world – worked, or was necessary.
The official Irish Covid death toll, recorded by the Government and reported internationally, stands, at the time of writing, at 4,847. But did 4,847 people really die of Covid? Did some of them die “with” Covid, for example? How many of them died of covid, but just a few weeks short of when they would have died anyway?
What we can say, given what we know about how the Government logs Covid deaths, is that 4,847 is probably the highest possible estimate of Covid deaths. It includes, after all, almost every death where Covid was considered a factor. Given the widespread testing in our hospitals, its hard to imagine that many people died of Covid, but had their death recorded as something else. It’s certainly arguable that fewer people than 4,847 lost their lives to the pandemic. But it would be hard to argue that more people than that died of the disease.
There has been some controversy in recent days about an RTÉ Prime Time report which pegged the number of “excess” deaths in Ireland from March last year to March this year at 3,200:
One question that's repeatedly been asked is whether those who died with Covid-19 necessarily died due to it.
— RTÉ Prime Time (@RTE_PrimeTime) April 20, 2021
If you go to that tweet, you’ll find that most of the replies are hostile, and accuse RTÉ of getting it wrong. Indeed, my own initial reaction yesterday was that they had gotten it badly wrong. Why? Because they assess deaths from March to March, rather than from January to December. That includes two “peaks” of the virus, but doesn’t catch the fact that overall, according to the CSO, Ireland had slightly fewer deaths than in an average year in 2020. But, to be fair to RTÉ, my own initial reaction was unfairly harsh, because it’s more complicated than that. And it’s important to explain what they did, and how they arrived at the number they did.
First, what is an “excess death”? Put simply, it’s the number of people who died in a given year above the average number of people we would expect to die every year. So if the average number of deaths in Ireland every year is 20,000, and 25,000 people died in 2020, we would say there were “5,000 excess deaths”.
It’s not a perfect measure, though, because an average is not a fixed number: The average of 2, 3, 4, 6, and 10 is… 5. To arrive at an average, in other words, you can – in extreme examples – include some figures that are actually double the average. There is not a fixed number of deaths every year, and average variations will mean that every year has either more deaths, or fewer deaths, than the average.
So, what RTÉ did, in conjunction with their researchers, was to try to refine the averages to be more precise. They looked at data from 2014 to 2019 for every single day of the year, and came up with an average number of deaths per day. They said, for example, that on June 20th, the average number of deaths for 2014-19 was X, but on June 20th 2020, the number of deaths was Y. If Y was bigger than X, they subtracted X from Y and got a number of excess deaths. If X was bigger than Y – meaning there were fewer deaths in 2020 than on that day in the previous five years, they took those deaths off the total. Every single day then had it’s individual plus or minus figure for deaths.
When they did that for every day of the year, they arrived at a figure of +3,200 – meaning that there were that many excess deaths recorded in the period compared to the average of the previous five years.
It is worth noting a couple of things about this: First, and most importantly, 3,200 is over 1,600 fewer deaths than recorded by the Government.
Second, it is a very imperfect measurement, though that is not necessarily the fault of RTÉ. All measurements are somewhat imperfect, for a number of reasons. They used RIP.ie data, for example, which records death notices. Sometimes these notices are duplicated (an undertaker might post a death twice, for Dublin, and Kerry, if a person lived in both counties). RTÉ did take account of this, with an estimate, but we don’t know whether they guessed right or wrong. Second, many undertakers in Donegal do not use RIP.ie, which means that deaths in that county will be under-recorded in Donegal using the RIP.ie system, meaning there’s a likelihood it could skew the RTÉ estimate a bit low. RTÉ were aware of that problem, but took the numbers at face value anyway.
Third, and most importantly, the RTÉ assessment tells us very little about what some people call “accelerated deaths”. These are people who, not to put too fine a point on it, were likely to die at some stage this year anyway, but who ended up dying during the virus surge in January.
Indeed, the CSO figures for last year show a big spike in deaths (over a thousand extra deaths) in April of 2020, but then a drop off compared to the average in every other month. One way to read this is that a lot of the people who died in April might otherwise have lived until May, or June, or November, and died a little bit early with Covid. They still died prematurely, make no mistake, but the amount of life lost may have been only weeks or months, rather than decades, in those cases. But in RTÉ’s defence, calculating that figure is an educated guess many of us might make, rather than anything totally certain.
If you want to criticise RTÉ, you might say that their number comes with a very big margin for error. Not quite as big as the 75m-2oom range for the black death, but certainly it could easily be a thousand deaths lower, or higher, perfectly plausibly.
That said, RTÉ’s figures are certainly likely to be much more accurate than the official state figures. As the state Coroner for Mayo said, about those official figures:
Mayo coroner and solicitor Patrick O’Connor believes the recorded death figures for the illness “do not have a scientific basis”.
As of last Thursday, a total of 4,820 deaths related to Covid-19 have been recorded in Ireland.
But cases where Covid is recorded as the principal cause of death when a person is already terminally ill raise questions about the accuracy of the method of recording, said Mr O’Connor, who is public information officer for the Coroners Society of Ireland.
“In reality, a lot of people have terminal cancer or multiple other serious co-morbidities. People can die from Covid and or with Covid. I think numbers that are recorded as Covid deaths may be inaccurate and do not have a scientific basis,” Mr O’Connor said.
In that context, 3,200 deaths seems a much more realistic figure than 4,800, or so, doesn’t it?
But wait, there’s more. Because there is one problem with both the RTÉ data, and the NPHET data, and that problem is one we will call “two thousand and seventeen”.
Covid dissident (that’s a compliment, by the way, not an insult) Ivor Cummins, whose commentary on the lockdown views has attracted a lot of attention, has been banging the “2017” drum for some time now. And what is his case?
Well, it’s that the Covid excess mortality over the course of the pandemic looks an awful lot like the excess mortality we saw in Ireland in 2017, when there was a bad outbreak of influenza, resulting in about three thousand excess deaths. Like RTÉ, he uses RIP.ie figures, though unlike RTÉ he looks at one year encompassing a single flu season (October through September), instead of March to March:
You can go watch Ivor’s full video, explaining the chart above, here. Give it a watch, if this is a subject that interests you.
Those figures show that there just isn’t a big difference between Covid, and the last flu year. So is he right?
Well, he has a very good point, which is why we are mentioning it here, but one fair quibble you might have with his argument is that the period he studied – October to September, for one full year – does not encompass the full scope of the pandemic. You might quibble with the dates RTÉ chose with their approach, but there are arguments for and against both approaches to doing this. The quibble with RTÉ is that their study includes the two peaks of Covid, in separate years, which makes the figure higher than if they had studied one full year with just one seasonal peak. The quibble with Cummins’ approach is that it leaves out – for now – the second half of the pandemic, which means that we’re not getting the full picture of the pandemic, just yet. What he’s doing is perfectly fair and correct, but it gives us a picture of one year, not two. Cummins does say, though, that in his figures to date, the second half of the pandemic is not on course to be any worse than a normal year, either.
Still, over the two years, it’s reasonable to assume that Covid will have killed more people than a single season of flu, and how you count these numbers does make a difference to the number you arrive at.
But how many more will have died with covid, compared to the flu? Not a whole lot, you’d have to say.
What’s the conclusion, then? First, in a historic context, compared to deadly pandemics past, Covid has not been particularly severe at all. A huge part of that is advances in medical treatment, and general health. How much of it is down to lockdown?
Proponents of lockdown will offer an unfalsifiable answer: That without lockdowns, we’d have had vastly more deaths. There is, put simply, no way to disprove that. Dr. Martin Feeley went some way to punching a hole in it, though, on Gript last week when he compared the Irish experience to that of Sweden.
Ultimately, we ended up with a similar death rate amongst the elderly as the Swedes did, and a very similar death rate to what we had in the (very bad) flu season of 2017. And it’s all come at the cost of the longest lockdown in the world. Was it worth it? We’ll be debating that for generations, but at this early stage, it looks like a very high price to have paid.