Covid-19 and Ireland – Part 2

According to government statistics, there was a pandemic in Ireland in 2020. Between 29 February, when the island had its first confirmed case of Covid-19, and 31 December, there were 2,237 Covid-19 related deaths in the Republic. In the same period, Northern Ireland experienced 1,322 Covid-related deaths. Since then, both jurisdictions have experienced a second wave of Covid-19, bringing the all-island death toll to more than 5,000.

These figures sound alarming, especially in the context of an island whose population is estimated to be around 7.2 million—roughly the same as that of Arizona (The World Factbook, United States Census Bureau). But how do these numbers compare with the mortality one would expect in the absence of a pandemic? Answering this question in an objective and scientific manner is not a trivial matter:

Assignment of cause of death, with infectious diseases and comorbidity, is not only technically difficult ... but also contaminated by physician-bias, politics and news media. (Rancourt 2)

In order to assess the impact of the pandemic, not only do we require reliable data, but we must also make sure that we are comparing like with like. Not all deaths recorded as “Covid related” were actually caused by Covid-19. Some were undoubtedly caused by comorbidities—other diseases or serious underlying health conditions that were also present at the time of death. On more than one occasion during the pandemic, the Republic’s acting Taoiseach [ie Prime Minister] Leo Varadkar admitted that the term “Covid related” was being used to include both deaths from Covid and deaths with Covid, without distinction (for example, Irish Examiner). In other words, the statistics were being deliberately skewed. Varadkar argued that this was the correct approach to take. As we shall see in a later article in this series, the Central Statistics Office tried to determine the true number of deaths from Covid by correcting for this reporting bias.

We must also take into account the deaths that were caused not by the pandemic but by the response to the pandemic—the so-called lockdown deaths, some of which may have been counted as “Covid related”. It is also possible that the measures taken to mitigate the effects of the pandemic reduced deaths in some cases. For example, if such measures were in fact successful in mitigating the spread of Covid-19, then surely they were also successful in mitigating the spread of similar infectious diseases, such as influenza and pneumonia, which exact an annual toll on society.

The devil, then, is in the details. It will take time and no little effort to properly analyse all the data and separate fact from fiction. The first step in this lengthy process, however, is to examine all-cause mortality for the two jurisdictions. This particular statistic treats all deaths as equal, irrespective of the cause of death or the medical history of the deceased. All-cause mortality is largely unbiased and immune from data manipulation:

That is why rigorous epidemiological studies rely instead on all-cause mortality data, which cannot be altered by observational or reporting bias ... A death is a death is a death. (Rancourt 4)

Denis Rancourt, Former Professor of Physics at the University of Ottawa

Mortality Statistics

In the Irish Republic, every death must be registered by law with the General Register Office within three months. In Northern Ireland, deaths must be registered with the General Register Office for Northern Ireland within five working days of the receipt of the Medical Certificate of Cause of Death, unless the death has been referred to the coroner.

There are several sources of possibly reliable mortality statistics for researchers who wish to know how many people died in Ireland over a given period of time:

RIP.ie: In Leo Rosten’s novel The Education of Hyman Kaplan, Hyman conjugates the verb “to die” as “die, dead, funeral,” Almost without exception, death leads within a few days to an inevitable funeral. It is now a matter of course for Irish undertakers to ask bereaved families if they would like to have a death notice published on RIP.ie. This private website keeps track of such notices on a daily basis. It has acquired a reputation of providing early statistics that generally line up well with the official government statistics, which might not be published for months to come.
General Register Office (GRO): This is the official repository for records relating to births, stillbirths, deaths, marriages, civil partnerships and adoptions in the Republic. But despite the legal requirement to register a death within three months, the GRO estimates that only 80% of all deaths are actually registered within this timeframe. After six months, the figure is close to 100%, but some deaths may not be properly registered for years.
Central Statistics Office (CSO): The CSO is the Republic’s national statistical office, charged with impartially collecting, analysing and making available statistics about the state’s people, society and economy. As far as the mortality statistics are concerned, however, the CSO is dependent upon the GRO, which notifies the CSO of every registered death. The CSO’s statistics, therefore, are subject to the same delays as the GRO’s.
General Register Office for Northern Ireland (GRONI): Northern Ireland’s counterpart to the Republic’s GRO. The Registrar General issues quarterly reports throughout the year, which provide provisional statistics. Finalised data for each year are published in the Registrar General Annual Report, which may not appear for many months after the end of the year. For example, the Annual Report for 2019 was not published until 16 December 2020.
Northern Ireland Statistics and Research Agency (NISRA): NISRA, an Agency of the Department of Finance, is the principal source of official statistics on Northern Ireland. It is Northern Ireland’s counterpart to the Republic’s CSO. This is the principal source of online statistics for Northern Ireland.
EuroMOMO: The European Mortality Monitoring Project aims to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. Official national mortality statistics are provided weekly from 29 countries and regions in the EuroMOMO collaborative network, supported by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO), and hosted by Statens Serum Institut, Denmark. EuroMOMO’s data are subject to the same delays as those of the GRO and CSO, so they should be used with due care. EuroMOMO is an excellent resource, however, if one is looking for long-term trends or patterns.

Recently, John Flanagan of the CSO carried out a study to see whether RIP.ie could be used by the CSO as a reliable source of up-to-date mortality statistics. He found that for the years 2016 and 2017 there was a strong correlation between the death notices published promptly by RIP.ie and the official figures eventually published by the CSO. RIP.ie, therefore, can be considered a reliable source of information for those researching the effects of the Covid-19 pandemic.

Tony Holohan, the chairman of NPHET (the Republic’s National Public Health Emergency Team) has also used RIP.ie as a source of up-to-date and reliable data:

“We also have done analysis as a result of the RIP.ie data, which we know captures in excess of 98% of deaths, to look at what that trend tells us and to make comparisons to other countries.” (thejournal.ie, 15 June 2020)

Kieran Morrissey

The onerous task of collating all the relevant information from RIP.ie has already been done for us by Kieran Morrissey, an independent researcher on Global Research. Morrissey’s paper Ireland: Study of Covid-19 Deaths is one of the sources for the article you are now reading. Two other researchers, Gerard McCarthy of Maynooth University and Pádraig MacCarron of the University of Limerick, have also used RIP.ie as a source of data in their analysis of the state’s excess mortality in April 2020.

There is no comparable source of reliable and up-to-date mortality statistics for Northern Ireland. RIP.ie does include some death notices for Northern Ireland and for Irish people who died overseas, but it is not considered a reliable source of data for those regions.

Looking for Patterns

Is there any pattern to mortality, or do people just die randomly throughout the year? To answer this question, we need to take a look at the excess mortality for Ireland over a period of several years. In the next article in this series, we will do just this.

And that’s a good place to stop.

References

Kieran Morrissey, Ireland: Study of COVID-19 Deaths, Global Research (2021)
Denis G Rancourt, All-Cause Mortality during COVID-19: No Plague and a Likely Signature of Mass Homicide by Government Response, Research Gate (2020)

All-Cause Mortality

Mortality Statistics

Looking for Patterns

References

Image Credits

Online Resources