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Analysis of Possible
Excess COVID-19
Deaths in Ireland
From Jan 2020 to Jun
2020
Notes on determining the existence of and
estimating the numbers of excess deaths not
directly attributed to COVID-19 in Ireland
from January 2020 to June 2020
Alan McSweeney
July 2020
http://ie.linkedin.com/in/alanmcsweeney
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 2
Contents
Summary .............................................................................................................................................................4
Introduction ........................................................................................................................................................5
COVID-19 Deaths................................................................................................................................................8
Irish COVID-19 Deaths......................................................................................................................................12
Irish Mortality ...................................................................................................................................................12
Irish Mortality Rates......................................................................................................................................16
RIP.ie Web Site Data.........................................................................................................................................19
RIP.ie 2018 and 2019 Data Summary.............................................................................................................21
RIP.ie 2020 Q1 and Q2 Data ..........................................................................................................................24
Hospital, Nursing Home and Hospice Death Analysis .........................................................................................26
Possible Excess COVID-19 Death Analysis .........................................................................................................27
Irish Population Estimates.............................................................................................................................28
Estimation Approach 1 – Comparable Year COVID-19 Estimates ...................................................................31
Estimation Approach 2 – Age Specific Mortality Rate Estimates ....................................................................35
Estimation Approach 3 – Death Rate Per 1,000 Population Estimates ............................................................39
Appendix ...........................................................................................................................................................41
Tourist and Visitor Deaths .............................................................................................................................41
Influenza Deaths............................................................................................................................................42
CSO Restatement of Migration Statistics and Population Estimates................................................................45
Annual Population Estimates Revisions .....................................................................................................45
Migration Estimates Revisions ...................................................................................................................47
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 3
List of Figures
Figure 1 – Sample Model of Excess COVID-19 Deaths...........................................................................................5
Figure 2 – More Complex Model for Excess COVID-19 Deaths ..............................................................................6
Figure 3 – Hypothetical COVID-19 Negative Feedback Loop Leading to Higher Overall Mortality .......................6
Figure 4 – COVID-19 Deaths/Cases, Cases/Population and Deaths/Population for Top 60 Affected Countries.........9
Figure 5 – Population Age Profiles for Various Countries ....................................................................................11
Figure 6 – Ireland COVID-19 Deaths Jan-Jun 2020 ............................................................................................12
Figure 7 – Numbers of Deaths and Death Rate per 1,000 Population from 1960 Q1 to 2019 Q4 ............................13
Figure 8 – Deaths Per Quarter 2014 to 2019 ........................................................................................................14
Figure 9 – Death Rate Per 1,000 of Population Per Quarter 2014 to 2019 ............................................................15
Figure 10 – Average, Minimum and Maximum Daily Death Rates per Quarter per 1,000 of Population for the
Years 2014 to 2019 .............................................................................................................................................16
Figure 11 – Irish Life Table 16 Male and Female Mortality Rates........................................................................17
Figure 12 – Weighted Average Male and Female Mortality Rates for Ages 0 to 100 for Irish Life Tables 13, 14, 15
and 16................................................................................................................................................................18
Figure 13 – weighted Average Male and Female Mortality Rates for Ages 0 to 8 for Irish Life Tables 13, 14, 15 and
16 ......................................................................................................................................................................18
Figure 14 – Weighted Average Male and Female Mortality Rates for Ages 65 to 100 for Irish Life Tables 13, 14, 15
and 16................................................................................................................................................................19
Figure 15 – Differences Between CSO and RIP.ie Mortality Data........................................................................20
Figure 16 – RIP.ie Deaths for 2018 and 2019 by Day of Week .............................................................................22
Figure 17 – RIP.ie Deaths for 2018 and 2019 by Month.......................................................................................22
Figure 18 – RIP.ie Deaths for 2018 and 2018 by Day ..........................................................................................23
Figure 19 – RIP.ie Deaths for Jan to Mar 2018 and 2018 by Day.........................................................................23
Figure 20 – RIP.ie Deaths for 2018 and 2018 by Day Showing Trends.................................................................24
Figure 21 – RIP.ie Deaths for 2018, 2019 and First Six Months of 2020 by Month ...............................................25
Figure 22 – RIP.ie Daily Deaths from 1 Jan to 21 Feb 2019 and 2020..................................................................26
Figure 23 – Annual Hospital, Nursing Home and Hospice Deaths CSO and RIP.ie 2013 to 2019 ..........................27
Figure 24 – Quarterly Population Estimates Derived from CSO Tome Series VSQ04............................................29
Figure 25 – Ireland Population Profile 1996 and 2019 .........................................................................................30
Figure 26 – Estimate of 2020 Deaths Based on Previous Year Values ..................................................................31
Figure 27 – Applying Age Specific Survival Rates to Estimate Population Cohorts..............................................36
Figure 28 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2018 ...................................................................44
Figure 29 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2019 ...................................................................44
Figure 30 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2020 ...................................................................45
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 4
Summary
This analysis seeks to determine if there are excess deaths that occurred in Ireland in the interval Jan – Jun 2020
that can be attributed to COVID-19. Excess deaths means deaths in excess of the number of expected deaths plus
the number of deaths directly attributed to COVID-19. On the other hand a deficiency of deaths would occur when
the number of expected deaths plus the number of deaths directly attributed to COVID-19 is less than the actual
deaths.
This analysis uses number of deaths taken from the web site RIP.ie to generate an estimate of the number of
deaths in Jan – Jun 2020 in the absence of any other official source. The last data extract from the RIP.ie web site
was taken on 3 Jul 2020.
The analysis uses historical data from RIP.ie from 2018 and 2019 to assess its accuracy as a data source.
The analysis then uses the following three estimation approaches to assess the excess or deficiency of deaths:
1. The pattern of deaths in 2020 can be compared to previous comparable year or years. The additional COVID-
19 deaths can be added to the comparable year and the difference between the expected, actual from RIP.ie
and actual COVID-19 deaths can be analysed to generate an estimate of any excess or deficiency.
2. The age-specific mortality rates described on page 16 can be applied to estimates of population numbers to
generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19
deaths to generate an estimate of any excess or deficiency.
3. The range of death rates per 1,000 of population as described in Figure 10 on page 16 can be applied to
estimates of population numbers to generates an estimate of expected deaths. This can be compared to the
actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency.
Estimation approach 2 is the most problematic and its results the least reliable.
The results of these analyses are summarised in the following table.
Estimated
Deaths Without
COVID-19
Estimated
Deaths With
COVID-19
Estimated
Deaths +
COVID-19
Deaths
RIP.ie
Measured
Actual Deaths
Difference
Estimate 1 16,188
1,736
17,924
17,046
-878
Estimate 2 16,834 18,570 -1,524
Estimate 3 16,397 18,133 -1,087
In all cases, this analysis has determined that there are no excess deaths due to COVID-19 in Ireland in the interval
Jan – Jun 2020. It has found that there is a deficiency of deaths in the range from -800 to -1,000. This means that
the excess deaths caused by COVID-19 are of the order of 750 to 950.
These conclusions are based on the assumption that the data derived from the RIP.ie web site is accurate.
This is not to suggest or imply that deaths attributed to COVID-19 were not correct. It simply identifies that many
of these deaths would have occurred normally within roughly the same interval from other causes.
The following table shows the numbers generated from this analysis for 2018, 2019 and the first six months of 2020
from the RIP.ie data for deaths in Hospitals, Nursing Homes and Hospices.
2018 2019 2020
Location Number of
Deaths
%Age of
Deaths
Number of
Deaths
%Age of
Deaths
Number of
Deaths
%Age of
Deaths
Hospitals 11,401 36.43% 11,343 36.32% 11,343 33.16%
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 5
Nursing Homes 3,725 11.90% 3,791 12.14% 3,791 14.90%
Hospices 2,756 8.81% 2,715 8.69% 2,715 7.43%
Total Deaths 31,295 31,230 17,046
It shows a slight but significant increase in nursing home deaths for the first six months of 2020. Over the six
months this equates to an extra 500 deaths in nursing homes.
Introduction
There have been discussions about the existence of excess deaths during the current COVID-19 pandemic.
The UK Office of National Statistics (ONS) has done good work on this topic of excess deaths – see
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregister
edweeklyinenglandandwalesprovisional/weekending5june2020.
Simplistically, the model for excess deaths could be represented as follows:
Figure 1 – Sample Model of Excess COVID-19 Deaths
However, the reality is more complex. There is no standard definition of how a death is attributed to COVID-19.
The attribution can be done inclusively – COVID-19 is assigned as a cause of death if it was present or a
contributing factor – or exclusively – COVID-19 is assigned as a cause of death only if it directly caused the death
and there was no reasonable chance of any underlying condition being a contributory factor. This more complex
model can be represented as follows:
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Figure 2 – More Complex Model for Excess COVID-19 Deaths
It is possible to hypothesise a feedback loop along the following lines that gives rise to higher overall mortality
rates.
Figure 3 – Hypothetical COVID-19 Negative Feedback Loop Leading to Higher Overall Mortality
There is some anecdotal evidence that this negative feedback look was experienced in areas such as the peak of
COVID-19 cases in countries and locations such as Italy and New York.
The differences in the expected and actual number of deaths within an interval will be due to factors such as:
• Reduced expected deaths due to lockdown-related factors and associated reduction of economic activities –
road traffic1 and other travel-related, crime, public consumption of alcohol, workplace accidents, reduced
deaths of foreign visitors to Ireland who would have died while in Ireland because of the absence of tourism
and business travel.
• Deaths caused by COVID-19 that would not have happened.
• Deaths attributed to COVID-19 but which would have happened anyway within the measurement interval.
1 The road traffic deaths for the first half of 2020 are actually slightly higher than those for 2019 - see
https://www.garda.ie/en/roads-policing/statistics/roads-policing-fatalities-to-date-for-2020/. Deaths due to road traffic accidents
are a small proportion of overall deaths. There were 141 deaths in 2019 representing less than 0.4% of all deaths – see
https://www.rsa.ie/RSA/Road-Safety/RSA-Statistics/Deaths-injuries-on-Irish-roads/. More detail on road traffic deaths can be
obtained from the CSO time series ROA11 Road Fatalities by Month of Fatality and Year -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=ROA11&PLanguage=0. Road traffic deaths
have falling for some time:
2004 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Deaths 335 374 396 365 338 279 238 212 186 163 188 192 162 184 156 142 141
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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• Excess deaths due to but not attributed to COVID-19.
• Excess deaths due to factors such as failure to seek medical attention for serious illness, failure of emergency
services to respond to call sufficiently quickly because of perceived or actual excess workload, possible
increased rate of suicide and lockdown-related factors such as reduced income, reduced exercise, increased
anxiety.
• Excess deaths due to Irish people who would have died on holidays abroad but who now have died while
remaining in Ireland2.
• Effective cessation of all migration – both immigration and emigration – and its consequent impact on the size
and age profile of the Irish population and thus population mortality rates and numbers3.
• Changing rates of and differences in seasonal rates of suicide4.
These are all sources of noise that makes any analysis complex and problematic.
This analysis is hampered by the lack of detailed and current mortality statistics for Ireland.
The UK publish weekly mortality statistics – see
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisi
onalfiguresondeathsregisteredinenglandandwales. This level of detail data made available publicly makes open and
independent analysis possible.
2 The topic of tourist and visitor deaths is covered in more detail on page 8.
3 As can be seen from the data on Irish mortality rates on page 9, mortality rates for people under 65 are low. The proportion of
immigrants and emigrants aged 65 and over is small. The following summary is taken from CSO time series PEA03 Estimated
Migration (Persons in April) by Age Group, Sex, Inward or Outward Flow and Year
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA03&PLanguage=0. This shows the
proportion of estimated emigration and immigration from the 65 years and over age category.
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Emigration 1.59% 4.22% 2.53% 2.09% 2.94% 2.14% 2.57% 2.16% 2.66% 2.19%
Immigration 4.55% 2.44% 5.06% 4.78% 5.11% 4.75% 2.92% 2.72% 3.65% 2.93%
So, the likely cessation of migration caused by COVID-19, while it might cause a net 30,000 or more reduction in what would
have been the total population of Ireland in normal circumstances, will not have a major impact on increased or decreased
overall mortality rates.
4 See Temporal Variation in Irish Suicide Rates - Paul Corcoran, MSc, Marie Reilly, PhD, Agus Salim, PhD,
Aline Brennan, MPhil, Helen S. Keeley, MRCPsych, and Ivan J. Perry, MD PhD https://nsrf.ie/wp-
content/uploads/journals/04-03/TemporalVariation_IrishSuicideRates.pdf. The shows that between 1990 and 1998 there was an
annual increase in the male suicide rate of 4.5% since 1990. Figure 3 in this paper Male and female suicide rates in Ireland
by calendar month, 1990–1998 shows small seasonal differences in suicide rates.
Data on suicides from the CSO such as VSD31 Suicides by Sex, Year and Statistic
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD31&PLanguage=0 gives a suicides rate
per 100,000 of population for the years 2002 to 2019 as follows. There is a warning that the information for the years 2016
onwards is provisional.
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Rate 12.2 12.5 12.2 11.6 10.8 10.5 11.3 12.2 10.9 12.1 11.8 10.6 10.5 9.1 9.2 8 7.2 8.6
Number 478 497 493 481 460 458 506 552 495 554 541 487 486 425 437 383 352 421
This show a general decrease in suicide rates.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 8
No such detailed and up-to-date information is available for Ireland. The Central Statistics Office (CSO) publish a
range of mortality time series:
VSQ04 Total Births, Deaths and Marriages Registered by Statistic and Quarter -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ04&PLanguage=0
VSQ01 Births and Deaths Registered by Statistic, Quarter and Sex (1960Q1-2019Q4) -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ01&PLanguage=0
VSAQ2 Deaths Registered Provisional by Age at Death and Quarter (1960Q1-2019Q4) -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSAQ2&PLanguage=0
VSQ17 Deaths Registered Provisional by Sex, Statistic and Quarter (1960Q1-2019Q4) -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ17&PLanguage=0
VSQ20 Deaths Registered by Age Group, ICD 10 Diagnostic Group and Quarter (2015Q1-2019Q4)
- https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ20&PLanguage=0
Irish mortality data is produced quarterly. The most recent quarter for which data is available is 2019Q4 before the
COVID-19 pandemic.
Some mortality data such as that containing details where deaths occurred such as hospitals, nursing homes and
hospices is no longer produced. For example, see:
• VSD36 Deaths by Age Group, Place of Occurrence and Year (2013-2017) -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD36&PLanguage=0
This represents a poor state of affairs. It precludes detailed analysis of mortality data.
This analysis attempts to use mortality data from RIP.ie combined with that from the CSO. The RIP.ie web site
contains death notices from which more recent and more detailed mortality data can be inferred. However, this
data has issues that need to be overcome before it can be used in this analysis.
This analysis uses data from Jan 2018 to June 2020 (Q1 2018 to Q2 2020).
COVID-19 Deaths
One of the many issues with regard to analysing the topic of COVID-19 deaths is that there is no standard
agreement on what constitutes a death from COVID-19.
The following chart5 shows the deaths/cases, cases/population and deaths/population for the top 60 countries by
number of COVID-19 cases.
5 This information is a taken from https://www.worldometers.info/coronavirus/,
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 9
Figure 4 – COVID-19 Deaths/Cases, Cases/Population and Deaths/Population for Top 60 Affected Countries
The values for deaths/population are shown on the right-hand vertical axis of the chart. The index values for
Ireland are highlighted. This chart shows considerably variability across these countries for these three indices.
There are many reasons for such variability including:
• Population density, both absolute and measured by population concentrations into urbanised areas, and
implied rate of contact
• Economic activity and measure of population of internal and external movement
• Land borders with other countries and the freedom of movement across those borders
• Population age profile
• Approach to testing and testing rate to count number of cases
• Degree of restrictions of movement imposed
• Approach to classification of deaths from COVID-19
• Quality of health service
• Availability of health service
The age-specific mortality rates for COVID-196 are of the order of
Age Range Mortality Rate
0 - 17 years old 0.06%
18 - 44 years old 3.9%
45 - 64 years old 22.4%
65 - 74 years old 24.9%
75+ years old 48.7%
6 This information is taken from https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 10
The following charts show the estimated age profiles in 2020 for various countries, including Ireland7. The
estimated proportion of the Irish population that is aged 65 and over is 13.82%. For Germany, it is 22.99%. This
illustrates one very obvious cause of differences in mortality rates.
Ireland UK
Italy Germany
USA France
7 For the sake of consistency, these demographic profile snapshots are taken from the CIA World Factbook -
https://www.cia.gov/library/publications/the-world-factbook/.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Spain Sweden
Belgium Russia
Portugal
Figure 5 – Population Age Profiles for Various Countries
The information contained in these charts is shown in the table below.
Ireland UK Italy Germany USA France Spain Sweden Belgium Russia
0-14 Years 21.15% 17.63% 13.45% 12.89% 18.46% 18.36% 15.02% 17.71% 17.22% 17.24%
15-24 Years 12.08% 11.49% 9.61% 9.81% 12.91% 11.88% 9.90% 10.80% 11.20% 9.54%
25-54 Years 42.19% 39.67% 40.86% 38.58% 38.92% 36.83% 43.61% 39.01% 39.23% 43.38%
55-64 Years 10.77% 12.73% 14% 15.74% 12.86% 12.47% 12.99% 11.90% 13.14% 14.31%
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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65 Years and
Over
13.82% 18.48% 22.08% 22.99% 16.85% 20.46% 18.49% 20.59% 19.21% 15.53%
This shows considerable variability in the age group with the highest probability of dying after becoming infected
with COVID-19.
Irish COVID-19 Deaths
Irish COVID-19 death data is available from https://data.gov.ie/dataset/covidstatisticsprofilehpscirelandopendata.
The following chart summarises this data.
Figure 6 – Ireland COVID-19 Deaths Jan-Jun 2020
This data contains negative deaths (“denotifications”) for two days:
25 May 2020
1 June 2020
In both cases, I changed the negative value to zero and reduced the number of deaths on the following day by
negative value.
Irish Mortality
To assess the expected mortality for the first two quarters of 2020, historical mortality data can be analysed as one
source of estimates. This section provides background information and a context for the estimates of excess
COVID-19 mortality rates.
Mortality is a complex issue. Any attempts to estimate excess COVID-19 deaths needs to engage with the
complexity.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 13
The following information is taken from the CSO time series VSQ04 Total Births, Deaths and Marriages Registered
by Statistic and Quarter
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ04&PLanguage=0.
As background information, the following chart shows Irish mortality data from 1960 to 2016.
Figure 7 – Numbers of Deaths and Death Rate per 1,000 Population from 1960 Q1 to 2019 Q4
This shows that while the numbers dying have remained the same, the average mortality rate has dropped quite
significantly from 11.475 to 6.35 per 1,000 of the population. This is due to both improvements in life expectancy
and changes in the age profile of the Irish population.
There is a clear and consistent pattern of seasonality in both the numbers of deaths and the death rate. Deaths are
highest in the first quarter, fall and remain roughly level in the second and third quarters and being to increase
again in the fourth quarter. The sizes of these winter peaks vary.
There are many reasons for variations in both numbers of deaths and mortality rates, such as:
• Changes in the age profile of the underlying population.
• Changes in the mortality rates of people at different ages.
• Differences in seasonal illness and mortality rates.
The following chart shows the numbers of deaths per quarter for the years 2014 to 2019.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 14
Figure 8 – Deaths Per Quarter 2014 to 2019
This shows in more detail a common trend in the pattern of deaths over the four quarters of these six years: high
numbers in the first quarter, falls in the second and third quarters and then an increase in the fourth quarter. The
chart shows an apparently high number of deaths in 2019 Q4. The information contained in this chart is shown in
the following table
2014 2015 2016 2017 2018 2019
Q1 (Jan - Mar) 8,110 8,604 8,609 9,067 9,278 8,618
Q2 (Apr - Jun) 7,197 7,565 7,697 7,315 7,592 7,519
Q3 (Jul - Sep) 7,001 6,851 7,129 6,987 7,143 7,358
Q4 (Oct - Dec) 6,787 6,932 6,955 7,115 7,103 7,639
Total 29,095 29,952 30,390 30,484 31,116 31,134
However, the following chart shows the mortality rates per 1,000 of the (estimated8) population. The apparently
high number of deaths in 2019 Q4 is now shown as a lower but still slightly increased rate.
8 See the details on population estimates on page 9 for more information on the annual population estimates produced by the
CSO.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 15
Figure 9 – Death Rate Per 1,000 of Population Per Quarter 2014 to 2019
The information contained in this chart is shown in the following table.
2014 2015 2016 2017 2018 2019
Q1 (Jan - Mar) 7.1 7.5 7.4 7.8 7.7 7.1
Q2 (Apr - Jun) 6.2 6.5 6.6 6.1 6.3 6.2
Q3 (Jul - Sep) 6.1 5.9 6.1 5.8 5.9 6.1
Q4 (Oct - Dec) 5.9 6 6 5.9 5.8 5.9
This information needs to be examined further. The number of days in each quarter is not the same. Further, 2016,
like 2020, is a leap year so quarter 1 contains an extra day.
Number of Days
Q1 (Jan - Mar) 90
Q2 (Apr - Jun) 91
Q3 (Jul - Sep) 92
Q4 (Oct - Dec) 92
The average number of deaths per day, allowing for leap years, for each quarter of the years 2014 to 2019 is shown
in the following table.
2014 2015 2016 2017 2018 2019
Q1 (Jan - Mar) 90.11 95.60 94.60 100.74 103.09 95.76
Q2 (Apr - Jun) 79.09 83.13 84.58 80.38 83.43 82.63
Q3 (Jul - Sep) 76.10 74.47 77.49 75.95 77.64 79.98
Q4 (Oct - Dec) 73.77 75.35 75.60 77.34 77.21 83.03
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 16
The mortality rate per 1,000 of population per day, allowing for leap years, for each quarter of the years 2014 to
2019 is shown in the following table.
2014 2015 2016 2017 2018 2019
Q1 (Jan - Mar) 0.0789 0.0833 0.0813 0.0867 0.0856 0.0789
Q2 (Apr - Jun) 0.0681 0.0714 0.0725 0.0670 0.0692 0.0670
Q3 (Jul - Sep) 0.0663 0.0641 0.0663 0.0630 0.0641 0.0652
Q4 (Oct - Dec) 0.0641 0.0652 0.0652 0.0641 0.0630 0.0674
The following chart shows the average and span of mortality rates per day of each quarter per 1,000 of population
for the four quarters of the years 2014 to 2019.
Figure 10 – Average, Minimum and Maximum Daily Death Rates per Quarter per 1,000 of Population for the Years 2014 to 2019
This shows that mortality rates in the years 2014 to 2019 following a narrow band. There is greatest variation in
the first quarter and much lower variations in other quarters.
The information contained in this chart is shown in the following table.
Average Minimum Maximum Variation
Q1 (Jan - Mar) 0.0824 0.0789 0.0867 0.007778
Q2 (Apr - Jun) 0.0692 0.0670 0.0725 0.005495
Q3 (Jul - Sep) 0.0649 0.0630 0.0663 0.003261
Q4 (Oct - Dec) 0.0649 0.0630 0.0674 0.004348
Irish Mortality Rates
Irish mortality rates are published in the Irish Life Table series. The most recent four of these are as follows:
Life Table Interval Covered Details
Irish Life Table 16 2010-2012 https://www.cso.ie/en/releasesandpublications/er/ilt/irishlifetablesno16
2010-2012/
Irish Life Table 15 2005-2007 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt
hsdm/2007/irishlife_2005-2007.pdf
Irish Life Table 14 2001-2003 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt
hsdm/2003/irishlife_2001-2003.pdf
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 17
Irish Life Table 13 1995-1997 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt
hsdm/archivedreports/Irish_Life_Table_No._13_1995-1997.pdf
These life tables give mortality rates for men and women separately. The following information averages these
mortality rates. Life expectancy for rates for men and women being to vary at age 60. The male mortality rate
increases at a higher rate.
The following chart shows the mortality rates for men and women for Irish Life Table 16:
Figure 11 – Irish Life Table 16 Male and Female Mortality Rates
The downward kink in male mortality is caused by a lower probability of dying aged 99 and 100 for a male than for
those aged 98 as highlighted in red in the table below.
Age Number
Surviving to
Age x Out of the
Original
100,000
Number of
Deaths in the
Year of Age x to
x+1
Probability of
Surviving a
Year
Rate of
Mortality or the
Probability of
Dying in a Year
95 4,969 1442 0.7097812 0.29021876
96 3,527 1117 0.6832348 0.31676523
97 2,410 831 0.6551755 0.34482447
98 1,579 580 0.6324683 0.36753170
99 999 350 0.6491586 0.35084135
100 648 196 0.6968287 0.30317131
101 452 172 0.6197644 0.38023555
102 280 204 0.2727366 0.72726337
103 76 40 0.4811619 0.51883813
The following chart shows the weighted combined average mortality rate for males and females by year of age for
these four life tables:
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Figure 12 – Weighted Average Male and Female Mortality Rates for Ages 0 to 100 for Irish Life Tables 13, 14, 15 and 16
There are a number of characteristics that can be seen from this:
• Mortality rates are relatively high for ages 0-2.
• Mortality rates then fall and remain low up to age 55 or so.
• Mortality rates then consistently increase.
• Mortality rates are improving even over the interval 1995 to 2012 covered by these four life tables.
The following chart shows the weighted combined mortality rates for males and females for the four recent life
tables for the ages 0 to 8 years to show the rates at a greater level of granularity that is apparent from the overall
chart.
Figure 13 – weighted Average Male and Female Mortality Rates for Ages 0 to 8 for Irish Life Tables 13, 14, 15 and 16
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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The following chart shows the weighted combined mortality rates for males and females for the four recent life
tables for the ages 65 to 100 years again to show the rates at a greater level of granularity that is apparent from the
overall chart.
Figure 14 – Weighted Average Male and Female Mortality Rates for Ages 65 to 100 for Irish Life Tables 13, 14, 15 and 16
RIP.ie Web Site Data
This analysis uses data from RIP.ie from Jan 2018 to Jul 2020. The purpose of using the years 2018 and 2019 is to
compare with the CSO mortality data published for those years. This is used to validate the RIP.ie data so any
inferences based on 2020 data are reliable.
RIP.ie is a web site that contains death notices that are also published in newspapers. The information available on
a death on RIP.ie includes:
• Name of deceased
• Six-digit reference
• Date death notice was published
• Date of death
• Text of death notice
The data is informal. RIP.ie is the only source of detailed death data in Ireland. However, the information needs to
be filtered to make it usable.
The following schematic illustrates the key differences between the CSO and RIP.ie datasets.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Figure 15 – Differences Between CSO and RIP.ie Mortality Data
The CSO data is taken from deaths registered in Ireland. This includes anyone who died in Ireland. The reporting
of deaths is mandatory so the data can be assumed to be very accurate. A small number of deaths may occur that
may not be registered but this is likely to be very small.
The use of RIP.ie is not mandatory for deaths. The RIP.ie data has the following issues:
• There are duplicate notices for the same death.
• There are notices for deaths that occur in Northern Ireland.
• There are for deaths of Irish people that occurred outside Ireland other than Northern Ireland. This status
cannot be determined exactly.
• Death notices are not published for foreign nationals who have died in Ireland, including both visitors and
temporary workers but whose deaths will appear in the CSO data.
• Death notices are frequently not published for the deaths of very young children but whose deaths will appear
in the CSO data.
• Some deaths will not have a death notice but these deaths will appear in the CSO data.
• Deaths for which a notice is published in one year may have occurred in a prior year.
• There are data errors. For example, the date of death in some cases is after the date of publication of the death
notice.
• Some death notices have a date published value but no date of death value. In these cases, I have assumed
that the date is death is the date of publication.
The following table summarises the processing of the RIP.ie data:
2018 2019 2020 Jan to Jun
Number of Death Notices 42,003 42,459 23,280
After Removal of Duplicates and Deaths from
Northern Ireland
32,300 32,226 17,451
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Deaths in Previous Years 129 95 109
Deaths in Subsequent Year Brought Back 93 101 0
Foreign Deaths 876 901 298
Net Deaths 31,295 31,230 17,044
The following table summarises the differences between the RIP.ie and CSO VSQ04 time series for the numbers of
deaths in the four quarters of the years 2018 and 2019.
2018 2019
RIP CSO Difference %
Difference
RIP CSO Difference %
Difference
Q1 9,229 9,278 -49 -0.53% 8,251 8,618 -367 -4.45%
Q2 7,310 7,592 -282 -3.86% 7,577 7,519 58 0.77%
Q3 6,980 7,143 -163 -2.34% 7,014 7,358 -344 -4.90%
Q4 7,776 7,103 673 8.65% 8,388 7,639 749 8.93%
Total 31,295 31,116 179 0.57% 31,230 31,134 96 0.31%
While the two sets of numbers are quite close, the differences are large in terms of the 1,700 deaths in Ireland
attributed to COVID-19.
Some of these differences will be caused by the errors in classifying RIP.ie notices as referring to deaths that
occurred outside Ireland. In 2019, there were 786 notices for deaths where the difference between the date of
publication of the notice and the date of the death was 10 or more days. Of these 595 notices clearly referred to
deaths outside Ireland. In 2018, the corresponding numbers were 812 and 629. So, a long duration between the date
of date and the date of publication of a death notices on RIP.ie is a good indicator that the death occurred outside
Ireland. Some of these deaths that have not be classified as such may have occurred outside Ireland.
The implicit assumption here is that the CSO death statistics are completely accurate.
RIP.ie 2018 and 2019 Data Summary
The following chart shows the deaths from RIP.ie for the years 2018 and 2019 by day of the week. There is no real
obvious pattern indicating the deaths regularly occur more frequently on some days of the week over others.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Figure 16 – RIP.ie Deaths for 2018 and 2019 by Day of Week
The following chart shows the deaths from RIP.ie for the years 2018 and 2019 by calendar month. The previously
indicated pattern where deaths are highest in the first quarter, fall and remain roughly level in the second and third
quarters and being to increase again in the fourth quarter can be seen.
Figure 17 – RIP.ie Deaths for 2018 and 2019 by Month
The information in this chart is shown in the following table.
Month 2018 2019
Jan 3,012 3,474
Feb 2,605 2,773
Mar 2,634 2,982
Apr 2,539 2,590
May 2,643 2,420
Jun 2,395 2,300
Jul 2,413 2,411
Aug 2,314 2,298
Sep 2,287 2,271
Oct 2,716 2,549
Nov 2,652 2,561
Dec 3,020 2,666
Total 31,230 31,295
The following chart shows the deaths from RIP.ie for each day of the years 2018 and 2019. The first day of 2018
was a Monday while the first day of 2019 was a Tuesday. The same pattern where deaths are highest in the first
quarter, fall and remain roughly level in the second and third quarters and being to increase again in the fourth
quarter can be seen.
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Figure 18 – RIP.ie Deaths for 2018 and 2018 by Day
The number of deaths in the early weeks of 2018 is higher than those for 2019. The following chart shows the
deaths for the first three months of 2018 and 2019. It also shows the trends for deaths over these intervals.
Figure 19 – RIP.ie Deaths for Jan to Mar 2018 and 2018 by Day
The deaths recorded by RIP.ie and the CSO and the recorded influenza deaths for the first quarter of 2018 and
2019 are shown in the following table.
RIP.ie Deaths CSO Deaths Recorded Seasonal
Influenza Deaths
2019 Q1 8,163 8,618 54
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2018 Q1 9,132 9,278 183
Difference 969 660 129
There is more detail on recorded seasonal influenza deaths on page 42. While the number of influenza deaths in
2018 compared with 2019 would not account for the total difference in the number of deaths, it may be that higher
influenza deaths are an indicator of higher seasonal deaths from other causes.
The following chart shows the same information as is contained in Figure 10 on page 16 with the addition of trend
lines for the two years.
This shows that the high number of deaths in 2018, perhaps associated with a higher rate of recorded seasonal
influenza deaths and other, perhaps related, seasonal deaths shows a reduction in the mortality rate in quarters 2
and 3 when compared with 2019.
It may be the case that higher seasonal deaths are not additive to underlying deaths but are semi-additive. This
could be caused by seasonal events that cause higher initial mortality effectively bringing forward or accelerating
deaths that would otherwise have occurred later in the year.
Figure 20 – RIP.ie Deaths for 2018 and 2018 by Day Showing Trends
RIP.ie 2020 Q1 and Q2 Data
The 2020 RIP.ie data was collected on 3 Jul 2020. This means that deaths that occurred from Jan to Jun 2020 but
where the death notices are published after this date will not be included in the analysis.
It must be remembered that 2020 was a leap year. This will lead to additional deaths. RIP.ie recorded 71 deaths for
the day of 29 Feb 2020.
The following chart extends the information displayed in Figure 17 on page 22 with deaths by month from RIP.ie
for the first six months of 2020.
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Figure 21 – RIP.ie Deaths for 2018, 2019 and First Six Months of 2020 by Month
Not surprisingly, this shows a large difference in Apr 2020 when the recorded number of COVID-19 deaths were
highest.
2018 RIP.ie
Deaths
2019 RIP.ie
Deaths
2020 RIP.ie
Deaths
COVID-19
RIP.ie
Deaths
Difference
Jan 3,474 3,012 2,976 0
Feb 2,773 2,605 2,674 0
Mar 2,982 2,634 2,861 71
Apr 2,590 2,539 3,574 1161
May 2,420 2,643 2,735 420
Jun 2,300 2,395 2,226 84
TOTAL 15,828 16,539 17,046 1,736
The following chart shows the RIP.ie daily number of deaths from 1 Jan to 21 Feb of the years 2019 and 2020.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Figure 22 – RIP.ie Daily Deaths from 1 Jan to 21 Feb 2019 and 2020
Intuitively, these series appear quite similar. Their means and variances are shown in the following table.
Mean Variance
2019 95.981 122.137
2020 95.096 123.892
The F value is 1.014. The F Critical one-tail value is 1.592. So, statistically the variances of the two series of
numbers of deaths are the same,
The t-statistic of the two series is 0.407. This is less than t Critical two-tail value of 1.983. So, the two series are
statistically similar.
Hospital, Nursing Home and Hospice Death Analysis
As referred to in the introduction, the CSO time series VSD36 Deaths by Age Group, Place of Occurrence and
Year (2013-2017)
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD36&PLanguage=0 contains
information on deaths by location such as hospitals, nursing homes and hospices.
The data is only available for the years 2013 to 2017. The annual total deaths in this time series do not agree with
the total in other CSO time series such VSQ04. The following table shows the number of deaths in hospitals,
nursing homes and hospices from this time series.
Location 2013 2014 2015 2016 2017
Hospitals 15,860 15,466 15,593 15,370 14,969
Nursing Homes 3,976 3,860 4,408 5,117 5,201
Hospices 1,883 2,074 2,285 2,388 2,455
Total VSD36 Deaths 29,504 29,252 30,127 30,667 30,418
Total VSQ04 Deaths 30,018 29,095 29,952 30,390 30,484
Information on deaths in hospitals, nursing homes and hospices can be derived from the RIP.ie web site. The
accuracy is not guaranteed. The approach I have taken is to look for the text strings “hospital”, “nursing home”
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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and “hospice” in the narrative text of the death notice. Where two or more of these text strings occur in the same
death notice, I have assumed that the death occurred in a hospital. That is, the person was, for example, living in a
nursing home but was moved to a hospital where the person died. This is not an exact approach. The absence of
any CSO data with which to compare this data is disappointing.
The following table shows the numbers generated from this analysis for 2018, 2019 and the first six months of 2020.
2018 2019 2020
Location Number of
Deaths
%Age of
Deaths
Number of
Deaths
%Age of
Deaths
Number of
Deaths
%Age of
Deaths
Hospitals 11,401 36.43% 11,343 36.32% 11,343 33.16%
Nursing Homes 3,725 11.90% 3,791 12.14% 3,791 14.90%
Hospices 2,756 8.81% 2,715 8.69% 2,715 7.43%
Total Deaths 31,295 31,230 17,046
It shows a slight but significant increase in nursing home deaths for the first six months of 2020. Over the six
months this equates to an extra 500 deaths in nursing homes.
The RIP.ie information on deaths in hospitals, nursing homes and hospices is lower than that recorded in the CSO
time series VSD36.
Figure 23 – Annual Hospital, Nursing Home and Hospice Deaths CSO and RIP.ie 2013 to 2019
This difference cannot be easily explained. It may be that the text of the death notices published onRIP.ie does not
always contain nursing home information. It may be that the CSO data is not accurate.
Possible Excess COVID-19 Death Analysis
There are several ways in which possible excess deaths during the interval Jan – Jun 2020 can be identified. Any
such analysis needs to check the alternative hypothesis: that there is a deficiency in actual versus expected deaths.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Any analysis should use multiple approaches and compare the results generated to validate any conclusions. The
possible approaches are:
1. The pattern of deaths in 2020 can be compared to previous comparable year or years. The additional COVID-
19 deaths can be added to the comparable year and the difference between the expected, actual from RIP.ie
and actual COVID-19 deaths can be analysed to generate an estimate of any excess or deficiency.
2. The age-specific mortality rates described on page 16 can be applied to estimates of population numbers to
generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19
deaths to generate an estimate of any excess or deficiency.
3. The range of death rates per 1,000 of population as described in Figure 10 on page 16 can be applied to
estimates of population numbers to generates an estimate of expected deaths. This can be compared to the
actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency.
The problem with approaches 2 and 3 is that they require reasonably accurate population estimates. This is
discussed in the next section.
Irish Population Estimates
The CSO publish a number of population estimates, including the following series:
• PEA01 Population Estimates (Persons in April) by Age Group, Sex and Year
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA01 contains annual
population estimates up to 2019.
• PEA15 Annual Population Change by Component and Year
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA15&PLanguage=0
contains details of the estimated components of population change: births, deaths, immigration, emigration
The information in these series applies to April of the year in question as April is when the Irish 5-year census takes
place. The information on page 45 onwards contains notes on some issues with CSO population estimates.
You can also use the death rates per 1,000 contained in the CSO time series VSQ04 (see page 12) as shown in the
table below:
2014 2015 2016 2017 2018 2019
Q1 (Jan - Mar) 7.1 7.5 7.4 7.8 7.7 7.1
Q2 (Apr - Jun) 6.2 6.5 6.6 6.1 6.3 6.2
Q3 (Jul - Sep) 6.1 5.9 6.1 5.8 5.9 6.1
Q4 (Oct - Dec) 5.9 6 6 5.9 5.8 5.9
Using these rates, the following population estimates are derived:
2014 Q1 4,569,014
2014 Q2 4,643,226
2014 Q3 4,590,820
2014 Q4 4,601,356
2015 Q1 4,588,800
2015 Q2 4,655,385
2015 Q3 4,644,746
2015 Q4 4,621,333
2016 Q1 4,653,514
2016 Q2 4,664,848
2016 Q3 4,674,754
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2016 Q4 4,636,667
2017 Q1 4,649,744
2017 Q2 4,796,721
2017 Q3 4,818,621
2017 Q4 4,823,729
2018 Q1 4,819,740
2018 Q2 4,820,317
2018 Q3 4,842,712
2018 Q4 4,898,621
2019 Q1 4,855,211
2019 Q2 4,930,492
2019 Q3 4,905,333
2019 Q4 4,928,387
Figure 24 – Quarterly Population Estimates Derived from CSO Tome Series VSQ04
The population estimates from the series PEA15 and those derived from VSQ04 are inconsistent as shown in the
table below.
VSQ04 PEA15
Quarter Quarter
Population
Quarter
Change
Annual
Change
Population Annual
Births
Annual
Deaths
Net
Migration
Annual
Change
2014 Q1 4,569,014
2014 Q2 4,643,226 74,212 4,645,400 68,400 29,200 -8,500 30,700
2014 Q3 4,590,820 -52,406
2014 Q4 4,601,356 10,536
2015 Q1 4,588,800 -12,556
2015 Q2 4,655,385 66,585 12,159 4,687,800 66,400 29,900 5,900 42,400
2015 Q3 4,644,746 -10,639
2015 Q4 4,621,333 -23,412
2016 Q1 4,653,514 32,180
2016 Q2 4,664,848 11,335 9,464 4,739,600 65,400 29,800 16,200 51,700
2016 Q3 4,674,754 9,906
2016 Q4 4,636,667 -38,087
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2017 Q1 4,649,744 13,077
2017 Q2 4,796,721 146,978 131,873 4,792,500 63,900 30,800 19,800 52,900
2017 Q3 4,818,621 21,899
2017 Q4 4,823,729 5,108
2018 Q1 4,819,740 -3,989
2018 Q2 4,820,317 577 23,596 4,857,000 61,200 30,700 34,000 64,500
2018 Q3 4,842,712 22,394
2018 Q4 4,898,621 55,909
2019 Q1 4,855,211 -43,409
2019 Q2 4,930,492 75,281 110,174 4,921,500 61,200 30,400 33,700 64,500
2019 Q3 4,905,333 -25,158
2019 Q4 4,928,387 23,054
The following diagram shows the profile of the Irish population for two years: 1996 and 2016.
Figure 25 – Ireland Population Profile 1996 and 2019
Both the size and the profile of the Irish population have changed substantially in this 25-year interval.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Estimation Approach 1 – Comparable Year COVID-19 Estimates
The following chart shows an estimate of daily deaths in the first six months of 2020. It contains four series:
1. COVID-19 Deaths – these are the values on page 12.
2. Estimated Expected Deaths in Q1 and Q2 2020 – this is an estimate of 2020 deaths based on an average of
RIP.ie daily deaths for 2018 and 2019. As shown on page 24, the RIP.ie deaths in year 2019 are very close to
2020. Averaging these with the higher deaths for 2018 allows for errors.
3. Expected + COVID-19 – this adds the expected deaths to the COVID-19 deaths.
4. Actual Deaths (RIP.ie) – these are the actual daily deaths recorded by RIP.ie.
Figure 26 – Estimate of 2020 Deaths Based on Previous Year Values
Date COVID-19 Deaths Estimated Expected
Deaths in Q1 and
Q2 2020
Expected + COVID-
19
Actual Deaths
(RIP.ie)
01/01/2020 95.5 95.5 97
02/01/2020 98 98 109
03/01/2020 94.5 94.5 107
04/01/2020 93.5 93.5 107
05/01/2020 118 118 85
06/01/2020 118 118 98
07/01/2020 111.5 111.5 106
08/01/2020 104.5 104.5 85
09/01/2020 109.5 109.5 96
10/01/2020 108 108 113
11/01/2020 105 105 93
12/01/2020 107 107 123
13/01/2020 112 112 111
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Date COVID-19 Deaths Estimated Expected
Deaths in Q1 and
Q2 2020
Expected + COVID-
19
Actual Deaths
(RIP.ie)
14/01/2020 99 99 91
15/01/2020 104.5 104.5 89
16/01/2020 120 120 101
17/01/2020 92.5 92.5 80
18/01/2020 97.5 97.5 91
19/01/2020 114.5 114.5 96
20/01/2020 104 104 77
21/01/2020 106 106 100
22/01/2020 87 87 96
23/01/2020 105.5 105.5 88
24/01/2020 110.5 110.5 104
25/01/2020 94.5 94.5 88
26/01/2020 92.5 92.5 85
27/01/2020 112.5 112.5 87
28/01/2020 102 102 109
29/01/2020 115.5 115.5 68
30/01/2020 100 100 118
31/01/2020 99 99 78
01/02/2020 119 119 97
02/02/2020 91 91 88
03/02/2020 91.5 91.5 93
04/02/2020 100 100 82
05/02/2020 106.5 106.5 98
06/02/2020 86.5 86.5 83
07/02/2020 111 111 96
08/02/2020 118 118 99
09/02/2020 104.5 104.5 102
10/02/2020 89.5 89.5 81
11/02/2020 107 107 96
12/02/2020 92 92 110
13/02/2020 100 100 89
14/02/2020 102.5 102.5 111
15/02/2020 102.5 102.5 98
16/02/2020 89 89 85
17/02/2020 106.5 106.5 94
18/02/2020 88.5 88.5 91
19/02/2020 97 97 98
20/02/2020 81 81 89
21/02/2020 94 94 89
22/02/2020 77 77 92
23/02/2020 93 93 79
24/02/2020 96 96 91
25/02/2020 74 74 93
26/02/2020 93.5 93.5 83
27/02/2020 100.5 100.5 109
28/02/2020 93.5 93.5 87
29/02/2020 71
01/03/2020 103 103 81
02/03/2020 87 87 93
03/03/2020 96.5 96.5 89
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Date COVID-19 Deaths Estimated Expected
Deaths in Q1 and
Q2 2020
Expected + COVID-
19
Actual Deaths
(RIP.ie)
04/03/2020 94.5 94.5 77
05/03/2020 91.5 91.5 93
06/03/2020 101 101 99
07/03/2020 92.5 92.5 91
08/03/2020 108 108 91
09/03/2020 92.5 92.5 78
10/03/2020 101.5 101.5 93
11/03/2020 1 95 96 99
12/03/2020 78.5 78.5 92
13/03/2020 98 98 85
14/03/2020 1 93.5 94.5 95
15/03/2020 92 92 80
16/03/2020 92.5 92.5 91
17/03/2020 80.5 80.5 83
18/03/2020 80 80 72
19/03/2020 1 81.5 82.5 89
20/03/2020 90.5 90.5 89
21/03/2020 88.5 88.5 95
22/03/2020 1 86 87 92
23/03/2020 2 92.5 94.5 102
24/03/2020 1 79.5 80.5 89
25/03/2020 2 81 83 119
26/03/2020 10 80.5 90.5 108
27/03/2020 3 77 80 86
28/03/2020 14 97 111 92
29/03/2020 10 92.5 102.5 95
30/03/2020 8 86 94 104
31/03/2020 17 97 114 119
01/04/2020 14 83 97 115
02/04/2020 13 70.5 83.5 112
03/04/2020 22 85.5 107.5 128
04/04/2020 17 89 106 143
05/04/2020 21 79.5 100.5 133
06/04/2020 16 90 106 110
07/04/2020 36 92.5 128.5 157
08/04/2020 25 88.5 113.5 114
09/04/2020 28 85 113 117
10/04/2020 24 87 111 123
11/04/2020 33 86.5 119.5 143
12/04/2020 14 91.5 105.5 147
13/04/2020 31 88 119 126
14/04/2020 41 85 126 130
15/04/2020 38 72.5 110.5 116
16/04/2020 42 95 137 113
17/04/2020 44 88 132 138
18/04/2020 41 89 130 114
19/04/2020 39 96.5 135.5 93
20/04/2020 77 81 158 135
21/04/2020 43 75.5 118.5 104
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Date COVID-19 Deaths Estimated Expected
Deaths in Q1 and
Q2 2020
Expected + COVID-
19
Actual Deaths
(RIP.ie)
22/04/2020 39 89 128 105
23/04/2020 25 86 111 112
24/04/2020 220 72.5 292.5 121
25/04/2020 49 89 138 89
26/04/2020 24 81 105 118
27/04/2020 15 79 94 117
28/04/2020 57 78.5 135.5 98
29/04/2020 31 76.5 107.5 100
30/04/2020 42 79 121 103
01/05/2020 33 68 101 95
02/05/2020 21 80.5 101.5 105
03/05/2020 17 80.5 97.5 97
04/05/2020 16 95.5 111.5 94
05/05/2020 20 72 92 92
06/05/2020 36 82.5 118.5 107
07/05/2020 28 85 113 98
08/05/2020 26 77.5 103.5 99
09/05/2020 17 91.5 108.5 96
10/05/2020 12 76 88 82
11/05/2020 9 82.5 91.5 76
12/05/2020 21 90 111 78
13/05/2020 9 73 82 100
14/05/2020 9 79.5 88.5 94
15/05/2020 12 75 87 90
16/05/2020 15 90 105 93
17/05/2020 10 80 90 92
18/05/2020 4 83.5 87.5 86
19/05/2020 14 71 85 88
20/05/2020 10 66.5 76.5 76
21/05/2020 12 88.5 100.5 69
22/05/2020 9 81.5 90.5 78
23/05/2020 12 86 98 85
24/05/2020 4 81 85 77
25/05/2020 78 78 89
26/05/2020 7 78.5 85.5 89
27/05/2020 16 89.5 105.5 68
28/05/2020 8 82 90 79
29/05/2020 6 72 78 95
30/05/2020 6 106.5 112.5 89
31/05/2020 1 89.5 90.5 79
01/06/2020 80 80 90
02/06/2020 6 70.5 76.5 84
03/06/2020 1 67.5 68.5 68
04/06/2020 5 80 85 68
05/06/2020 6 81 87 71
06/06/2020 8 70 78 73
07/06/2020 1 82 83 79
08/06/2020 4 82 86 80
09/06/2020 8 73.5 81.5 79
10/06/2020 4 81 85 81
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Date COVID-19 Deaths Estimated Expected
Deaths in Q1 and
Q2 2020
Expected + COVID-
19
Actual Deaths
(RIP.ie)
11/06/2020 8 83.5 91.5 59
12/06/2020 2 74.5 76.5 82
13/06/2020 80 80 63
14/06/2020 1 82 83 90
15/06/2020 82.5 82.5 88
16/06/2020 3 88 91 78
17/06/2020 1 83.5 84.5 55
18/06/2020 4 80.5 84.5 84
19/06/2020 75 75 92
20/06/2020 1 75 76 78
21/06/2020 77.5 77.5 52
22/06/2020 2 73 75 70
23/06/2020 3 87 90 74
24/06/2020 6 96.5 102.5 73
25/06/2020 1 81 82 72
26/06/2020 3 78.5 81.5 64
27/06/2020 4 74 78 67
28/06/2020 1 78 79 78
29/06/2020 74 74 68
30/06/2020 1 89 90 66
1,736 16,188 17,924 17,046
This indicates a potential difference of -878 between the expected + COVID-19 recorded deaths and the actual
deaths as recorded in RIP.ie. This indicates the excess deaths directly linked to COVID-19 are 859 rather than
1,736. This indicates an overall deficiency rather than an excess of deaths linked to COVID-19.
Estimation Approach 2 – Age Specific Mortality Rate Estimates
The information is included for the sake of completeness.
This estimation approach involves applying age specific survival or mortality rates to a set of population cohorts in
one interval to estimate either the size of the remaining cohort or the number of deaths at the next interval.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 36
Figure 27 – Applying Age Specific Survival Rates to Estimate Population Cohorts
To these, you then have to add estimates of births and age-specific immigration and emigration estimates.
Because of the variability of male and female mortality rates you generally split the population into its male and
female components by age and apply the different male and female mortality rates.
This estimate approach is complex because the underlying model has many components, many requirements and
many underpinning assumptions, including:
1. You need accurate age-specific population estimates
2. You need accurate age-specific and interval-specific mortality rates – mortality rates are higher in winter ad
lowest in summer
3. You need accurate estimates for births
4. You need accurate estimates of age-specific male and female immigration and emigration
The first two of these are important for generating accurate estimates of deaths.
The third and fourth are more important for estimating population size.
As can be seen from the information on page 28 onwards, there are different age-specific population estimates.
The last Irish Life Table data on page 16 on page 12onwards is based on data collected from 2010 - 2012. The
previous Irish Life Table 15 was based on data collected from 2005 – 2007. Measured mortality rates reduced even
in the five years between these two dates. It is likely that mortality rates have reduced further.
The large number of assumptions means these models can be overengineered ad can get very inaccurate very
quickly.
Age Cohort Number of Males Number of Females Estimated Male
Deaths Based on
Irish Life Table 16
Estimated Female
Deaths Based on
Irish Life Table 16
Under 1 year 31,225 30,171 59.17 49.63
1 year 31,538 30,401 5.51 10.30
2 years 33,068 31,552 1.79 1.40
3 years 32,181 30,681 1.18 0.96
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Age Cohort Number of Males Number of Females Estimated Male
Deaths Based on
Irish Life Table 16
Estimated Female
Deaths Based on
Irish Life Table 16
4 years 33,063 31,368 1.36 1.04
5 years 34,358 32,465 1.76 1.24
6 years 35,072 33,475 1.96 1.21
7 years 36,468 34,828 1.98 1.00
8 years 37,046 35,726 1.82 0.88
9 years 37,281 35,538 1.61 0.84
10 years 37,097 35,389 1.45 0.89
11 years 36,754 35,125 1.39 1.00
12 years 34,619 32,761 1.42 1.11
13 years 33,434 31,798 1.75 1.34
14 years 33,303 31,139 2.61 1.66
15 years 33,023 31,833 3.85 2.15
16 years 32,769 32,073 5.38 2.69
17 years 32,596 31,885 7.17 3.20
18 years 31,964 30,901 8.97 3.51
19 years 31,942 30,945 10.90 3.69
20 years 32,072 30,756 12.72 3.58
21 years 31,986 30,905 14.14 3.39
22 years 30,047 28,976 14.21 3.02
23 years 29,089 28,260 14.17 2.96
24 years 28,341 27,711 13.73 3.22
25 years 28,578 27,706 13.31 3.90
26 years 28,510 27,739 12.37 4.14
27 years 28,686 28,815 11.46 3.53
28 years 30,399 29,857 11.78 3.48
29 years 29,152 29,804 11.60 3.81
30 years 31,414 32,339 13.00 4.64
31 years 29,736 32,070 12.84 5.16
32 years 31,156 33,814 14.07 6.07
33 years 33,582 36,389 15.90 7.28
34 years 33,934 36,373 16.90 8.10
35 years 35,149 38,385 18.45 9.49
36 years 36,696 40,395 20.36 11.06
37 years 38,186 40,998 22.45 12.42
38 years 40,469 42,284 25.26 14.14
39 years 41,477 43,009 27.56 15.86
40 years 38,247 40,375 27.12 16.40
41 years 37,775 38,751 28.64 17.31
42 years 37,033 37,887 30.09 18.58
43 years 37,554 37,930 32.76 20.41
44 years 36,802 37,512 34.55 22.13
45 years 36,077 36,798 36.52 23.77
46 years 35,711 36,109 39.06 25.53
47 years 34,527 35,056 40.88 27.11
48 years 35,005 34,953 44.94 29.54
49 years 33,364 33,459 46.54 30.90
50 years 31,833 31,515 48.32 31.79
51 years 31,133 31,472 51.51 34.67
52 years 30,717 30,794 55.49 37.04
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Age Cohort Number of Males Number of Females Estimated Male
Deaths Based on
Irish Life Table 16
Estimated Female
Deaths Based on
Irish Life Table 16
53 years 30,569 31,069 60.39 40.80
54 years 30,280 31,120 65.51 44.63
55 years 29,498 30,387 70.00 47.61
56 years 28,754 29,670 74.94 50.79
57 years 28,053 28,424 80.40 53.19
58 years 28,022 28,657 88.43 58.65
59 years 26,816 27,619 93.30 61.87
60 years 26,858 27,007 103.14 66.27
61 years 25,518 26,214 108.28 70.51
62 years 25,097 25,289 117.80 74.65
63 years 24,412 24,693 126.86 80.07
64 years 24,074 24,624 138.64 87.82
65 years 22,903 23,261 146.29 91.36
66 years 22,717 23,231 161.07 100.62
67 years 21,491 21,832 169.26 104.44
68 years 20,994 21,225 183.79 112.33
69 years 20,328 21,306 197.93 124.95
70 years 19,898 20,497 215.59 133.44
71 years 19,389 19,790 233.88 143.30
72 years 18,323 18,869 246.16 152.27
73 years 17,373 18,194 260.02 163.98
74 years 15,801 16,706 263.53 168.52
75 years 14,670 15,567 272.69 176.16
76 years 13,161 14,553 272.68 185.18
77 years 11,766 12,752 271.72 182.90
78 years 10,704 12,138 275.51 196.72
79 years 10,294 11,847 295.25 217.53
80 years 9,325 11,266 297.96 234.92
81 years 8,384 10,171 298.34 241.30
82 years 7,632 9,516 302.31 257.14
83 years 6,996 9,142 308.30 281.49
84 years 6,361 8,643 311.66 303.16
85 years 5,503 7,599 299.53 303.34
86 years 4,462 6,373 269.57 289.04
87 years 3,641 5,613 243.90 288.54
88 years 3,225 5,132 239.27 298.11
89 years 2,684 4,568 220.27 298.73
90 years 2,131 4,047 193.17 296.65
91 years 1,633 3,242 163.25 265.05
92 years 1,237 2,678 136.15 242.82
93 years 942 2,176 113.93 217.48
94 years 792 1,781 105.04 194.89
95 years 561 1,460 81.41 173.68
96 years 426 1,159 67.47 148.75
97 years 304 931 52.41 127.89
98 years 244 709 44.84 103.37
99 years and over 522 1,493 130.50 373.25
Total By Sex 2,438,006 2,483,490 9,428 8,484
Total 4,921,496 17,912
This approach generates an estimate of deaths for 2020 Q1 and Q2 of 17,912. This is an overestimate.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 39
This approach uses mortality data that dates from 2010-12. In the measurement intervals from 2001-03 to 2005-07
and from 2005-07 to 2010-12, life expectancy consistently improved across all age groups.
Irish Life
Table
Measurement
Interval
%Age Life Expectancy Improvement at
Birth
Average %Age Life Expectancy
Improvement Across All Ages
Male Female Male Female
14 2001-03
15 2005-07 2.26% 1.62% 4.26% 3.12%
16 2010-12 2.08% 1.47% 3.12% 2.45%
Cumulative
Increase
4.30% 3.06% 7.74% 5.45%
Based on these historical life expectancy improvements, the estimated deaths generated from the 2010-12
measurement interval mortality rates could be reduced by around 6% from 17,912 to 16,834. This is 208 deaths less
than the 17,046 deaths obtained from RIP.ie data.
Estimation Approach 3 – Death Rate Per 1,000 Population Estimates
Using a death rate per 1,000 of the population is an easy but crude approach to estimating overall mortality
numbers. The rate per 1,000 does not consider changes in the age profile of the underlying population. Different age
groups have different mortality rates. If the relative proportions of the numbers for each year of age changes, the
mortality profile of the population will change.
Based on the population estimates shown on page 28, the average of the estimated deaths for 2020 Q1 and Q2
would be 17,161. This is close to the total deaths recorded in RIP.ie for the same interval of 17,046. Based on this
approach and its implicit assumptions:
• That the RIP,ie numbers of deaths are accurate
• That the population estimates are accurate
• That historical death rates per 1,000 of population are applicable
This shows that the recorded deaths for 2020 Q1 and Q2, including COVID-19 deaths, are as expected.
If we use the death rate per day per 1,000 for just 2019 as shown below:
Quarter Average
Death Rate
Per Day Per
1,000
Population
2018 Q1 0.0789
2018 Q2 0.0670
2018 Q3 0.0652
2018 Q4 0.0674
and use the quarterly population estimates derived from CSO time series VSQ04 up to 2019Q4 (see page 28) the
following estimates are generated:
Quarter Estimated
Quarterly
Average
Estimated
CSO Actual
Number of
Difference
Between
COVID-19
Deaths
Average
Estimated
RIP.ie
Number of
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 40
Population Number of
Deaths
Without
COVID-19
Deaths Average and
Actual CSO
Number of
Deaths Plus
COVID-19
Deaths
2018 Q1 4,819,740 8,555 9,278 -723 9,229
2018 Q2 4,820,317 7,351 7,592 -241 7,310
2018 Q3 4,842,712 7,264 7,143 121 6,980
2018 Q4 4,898,621 7,593 7,103 490 7,776
2019 Q1 4,855,211 8,618 9,229 -611 8,251
2019 Q2 4,930,492 7,519 7,310 209 7,577
2019 Q3 4,905,333 7,358 6,980 378 7,014
2019 Q4 4,928,387 7,639 7,776 -137 8,388
2020 Q1 4,935,887 8,859 71 8,930 8,511
2020 Q2 4,943,387 7,539 1,665 9,204 8,535
Total for
2020 Q1
and Q2
16,397 -514 1,736 18,133 17,046
The population estimates for 2020 Q1 and 2020 Q2 are generated by simply adding the expected net births over
deaths for each quarter to the estimate for 2019 Q4.
This indicates a potential difference of -1,087 between the expected + COVID-19 recorded deaths and the actual
deaths as recorded in RIP.ie. This indicates the excess deaths directly linked to COVID-19 are 649rather than 1,736.
This indicates an overall deficiency rather than an excess of deaths linked to COVID-19.
This estimate is similar to the results from estimation approach 1 on page 31.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Appendix
This appendix contains information on the following topics that relate to a lesser or greater extent to estimating
mortality numbers and to the identification of patterns in excess deaths:
• Tourist and Visitor Deaths
• Influenza Deaths
• CSO Restatement of Migration Statistics and Population Estimates
Tourist and Visitor Deaths
A characteristic of the COVID-19 pandemic is the reduction or effective cessation in foreign travel, both in and out
of Ireland from March 2020. This in turn will lead to a reduction in deaths recorded. While deaths of Irish people
abroad are not recorded as Irish deaths, there will be a (corresponding) number of deaths of foreign visitors to
Ireland who would have died while visiting Ireland. Also, some of the deaths of Irish short-term visitors that would
have occurred abroad will occur in Ireland.
The CSO publish a number of time series that contain information of tourism numbers9.
There is also an interesting paper10 on the topic of deaths of Irish civilians. This contains an analysis of 654 reports
received between Jan 2016 and Apr 2018 (28-month interval) by the Consular Division of the Department of
Foreign Affairs and Trade Irish civilians dying abroad.
There is no breakdown in whether these deaths related to short-term Irish tourists or Irish people who may have
been living abroad for a longer interval. Also, the number of deaths does not include all Irish deaths abroad. It
includes just those that notified the Consular Division of the Department of Foreign Affairs and Trade. This paper
estimates that “at least 25% of Irish deaths abroad can be considered preventable”. This implies that 75% of
the deaths (or a proportion of them) were due to factors such as cardiovascular diseases and natural causes that
may occur if those people stayed in Ireland.
However, it does indicate that deaths of Irish people abroad do occur. The paper states that there over “300
bereavements of Irish citizens overseas in 2017, the highest number of deaths the DoFA had ever dealt
with in a single year”. The Department of Foreign Affairs and Trade publish numbers of requests11 for assistance
from Irish citizens abroad. There is no breakdown of how these relate to Irish tourists and other short-term visitors
and longer-term residents.
9 See:
TMQ11: Overseas Trips to and from Ireland by Trips and Quarter -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=TMQ11&PLanguage=0
and:
TMQ08: Overseas Trips to and from Ireland by Reason for Journey, Quarter and Statistic -
https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=TMQ08&PLanguage=0
10 Deaths of Irish Civilians Abroad: Analysis of National Mortality Data, 2016-2018
Darrat M, Flaherty GT. Deaths of Irish civilians abroad: Analysis of National Mortality Data, 2016-2018. Int J Travel Med
Glob Health. 2018;6(4):149-153. doi:10.15171/ijtmgh.2018.27
https://www.researchgate.net/publication/333224586_Deaths_of_Irish_Civilians_Abroad_Analysis_of_National_Mortality_Dat
a_2016-2018
11 See https://www.dfa.ie/travel/statistics/.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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2018 2018 2018 2019
Foreign Deaths Taken from RIP.ie (see on page 19 onwards) 876 901
Department of Foreign Affairs and Trade Requests Relating to Deaths 272 250 320 292
The additional deaths in Ireland caused by Irish people staying in the country will be offset by the reduction of
deaths of foreign visitors to Ireland.
The following table summarises information from the CSO time series TMQ08.
2019Q1 2019Q2 2019Q3 2019Q4 Total
Overseas Trips to Ireland by Non-Residents (Thousand) 2,027 3,022 3,334 2,425 10,808
Average Length of Stay by Overseas Travellers to Ireland
(Nights)
6 6.5 7 6.2
Overseas Trips by Irish Residents (Thousand) 1,727 2,404 2,774 1,910 8,815
Average Length of Stay by Irish Residents on Overseas Trips
(Nights)
6.4 6.8 9.1 6.5
Total Overseas Visitors Nights (Thousands) 12,162 19,643 23,338 15,035 70,178
Total Irish Visits Abroad Nights (Thousands) 11,053 16,347 25,243 12,415 65,058
Difference of Overseas and Irish Travellers 10.04% 20.16% -7.55% 21.10% 7.87%
This shows that Irish travellers spent 65,058,000 nights abroad in 2019 while overseas travellers spent 70,178,000
nights in Ireland. The two numbers are roughly equal.
The CSO estimate the population of Ireland in (April) 2010 was 4,921,500. Simplistically this corresponds to
1,796,347,500 people nights. So, the 65,058,000 nights spent abroad by Irish travellers represents 3.62% of the
total person nights. This does not mean that 3.62% of deaths occur abroad. This would amount to 1,128 deaths. It
indicates without any surprises that sick and dying people tend not to not travel abroad.
There are no statistics on the number of deaths of overseas visitors to Ireland. Ireland is a safer place than many
other countries with lower crime rates and other factors such as the absence of venomous wildlife. So intuitively the
number of deaths of overseas visitors to Ireland should be lower than those of Irish travellers abroad. However
other factors such as different age profiles of overseas visitors to Ireland and Irish visitors abroad may cancel this
possible reduction.
In summary, this section indicates that the absence of deaths of overseas visitors to Ireland and the possible deaths
in Ireland of Irish short-term visitors abroad that would have occurred abroad could affect patterns of mortality
but that it is not possible to assess the impact.
Influenza Deaths
Influenza is a seasonal disease that has variable mortality rates. This section examines whether these deaths can
influence the overall mortality number and pattern.
Details on influenza deaths for 2019-2020 can be obtained from https://www.hpsc.ie/a-
z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20192020season/.
Details on influenza deaths for 2018-2019 can be obtained from https://www.hpsc.ie/a-
z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/previousinfluenzaseasonssurveill
ancereports/20182019season/.
The following table shows the number of deaths reported from influenza for the first two quarters of the years 2018
to 2020 and the deaths recorded by RIP.ie.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 43
Week Deaths All
Deaths
Week Deaths All
Deaths
Week Deaths All
Deaths
06/01/2020 - 12/01/2020 5 714 07/01/2019 - 13/01/2019 0 693 08/01/2018 - 14/01/2018 14 811
13/01/2020 - 19/01/2020 5 659 14/01/2019 - 20/01/2019 12 640 15/01/2018 - 21/01/2018 10 814
20/01/2020 - 26/01/2020 6 638 21/01/2019 - 27/01/2019 4 698 22/01/2018 - 28/01/2018 21 716
27/01/2020 - 02/02/2020 2 645 28/01/2019 - 03/02/2019 5 687 29/01/2018 - 04/02/2018 15 751
03/02/2020 - 09/02/2020 3 653 04/02/2019 - 10/02/2019 4 687 05/02/2018 - 11/02/2018 22 747
10/02/2020 - 16/02/2020 1 670 11/02/2019 - 17/02/2019 4 676 12/02/2018 - 18/02/2018 10 699
17/02/2020 - 23/02/2020 2 632 18/02/2019 - 24/02/2019 7 588 19/02/2018 - 25/02/2018 14 656
24/02/2020 - 01/03/2020 0 615 25/02/2019 - 03/03/2019 9 635 26/02/2018 - 04/03/2018 20 684
02/03/2020 - 08/03/2020 1 633 04/03/2019 - 10/03/2019 3 640 05/03/2018 - 11/03/2018 12 718
09/03/2020 - 15/03/2020 0 622 11/03/2019 - 17/03/2019 2 592 12/03/2018 - 18/03/2018 25 665
16/03/2020 - 22/03/2020 0 611 18/03/2019 - 24/03/2019 2 566 19/03/2018 - 25/03/2018 10 622
23/03/2020 - 29/03/2020 0 691 25/03/2019 - 31/03/2019 2 601 26/03/2018 - 01/04/2018 10 625
30/03/2020 - 05/04/2020 0 854 01/04/2019 - 07/04/2019 2 546 02/04/2018 - 08/04/2018 8 632
06/04/2020 - 12/04/2020 0 911 08/04/2019 - 14/04/2019 3 630 09/04/2018 - 15/04/2018 8 592
13/04/2020 - 19/04/2020 0 830 15/04/2019 - 21/04/2019 0 583 16/04/2018 - 22/04/2018 4 612
20/04/2020 - 26/04/2020 0 784 22/04/2019 - 28/04/2019 2 572 23/04/2018 - 29/04/2018 4 576
27/04/2020 - 03/05/2020 0 715 29/04/2019 - 05/05/2019 1 562 30/04/2018 - 06/05/2018 3 542
04/05/2020 - 10/05/2020 0 668 06/05/2019 - 12/05/2019 1 637 07/05/2018 - 13/05/2018 1 514
11/05/2020 - 17/05/2020 0 623 13/05/2019 - 19/05/2019 2 578 14/05/2018 - 20/05/2018 1 529
18/05/2020 - 24/05/2020 0 559 20/05/2019 - 26/05/2019 0 564 21/05/2018 - 27/05/2018 0 574
25/05/2020 - 31/05/2020 0 588 27/05/2019 - 02/06/2019 0 612 28/05/2018 - 03/06/2018 0 562
01/06/2020 - 07/06/2020 0 533 03/06/2019 - 09/06/2019 0 537 04/06/2018 - 10/06/2018 0 542
08/06/2020 - 14/06/2020 0 534 10/06/2019 - 16/06/2019 0 578 11/06/2018 - 17/06/2018 0 549
15/06/2020 - 21/06/2020 0 527 17/06/2019 - 23/06/2019 0 616 18/06/2018 - 24/06/2018 0 507
22/06/2020 - 28/06/2020 0 498 24/06/2019 - 30/06/2019 0 555 25/06/2018 - 01/07/2018 0 582
Total Deaths 25 16,407 65 15,273 212 15,821
The recorded number of influenza deaths in 2018 was significantly higher than in 2019 and 2020. However, in the
context of the total number of deaths the number is not significant.
However, recorded numbers of deaths may only be a subset of the actual number of deaths. So, a larger number of
recorded influenza deaths in 2018 may indicate a higher number of deaths not attributed to influenza and well as
other seasonal factors.
The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2018. The values for the
RIP.ie deaths are show on the left vertical axis. The values for influenza deaths are shown on the right vertical axis.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 44
Figure 28 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2018
It is possible to identify a high degree of technical correlation between these two series with an R2 = 0.926612:
y = 0.0003x=3x2 + 0.359x + 105.92
The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2019.
Figure 29 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2019
As before, it is possible to identify a high degree of technical correlation between these two series with an R2 =
0.9731:
y = 0.0003x=3x2 + 0.3589x + 106.77
The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2020.
12 I am always wary of high R2 values. For some good examples of amusing an spurious apparently high correlations see
https://www.tylervigen.com/spurious-correlations.
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
Page 45
Figure 30 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2020
The shows the larger number of deaths associated with COVID-19 in March, April and May 2020.
Recorded influenza deaths in 2020 were low when compared with 2018 and 2018.
Higher numbers of seasonal influenza deaths in2018 and 2019 show a correlation with higher numbers of all deaths
in the same interval.
So, rates of seasonal influenza deaths may indicate two trends:
1. Higher seasonal influenza deaths may indicate higher general seasonal death rates
2. Lower seasonal influenza deaths may indicate higher death rates later in the year
CSO Restatement of Migration Statistics and Population Estimates
Annual Population Estimates Revisions
The CSO publish population estimates. Some of the relevant data series are:
• PEA01 Population Estimates (Persons in April) by Age Group, Sex and Year13
• PEA11 Population estimates from 1926 by Single Year of Age, Sex and Year14
These datasets interpolate annual intercensal values from the quinquennial census data. They are useful in two
ways:
1. The annual estimates are more granular and their analysis can be used to yield more accurate analyses.
2. They provide an insight into how the CSO produce these estimates and possible errors in their approach to this
There are differences between these two series, perhaps because the two sets of data are not date-aligned. The
census counts population in April. The estimates may be at the end of the year, though this is not stated.
13 http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA01
14 http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA11
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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The CSO revised their annual population estimates because the 2016 census showed a population increase that was
greater than the expected value from their annual estimates. The 2016 population estimate from their two series
that was published in 2016 was 4,673,700. The 2016 census gave the population as 4,761,865. That is a difference of
88,165.
The CSO appear to derive estimates using a dead-reckoning approach by adding births, subtracting deaths, adding
estimated immigration and subtracting estimated emigration.
2012 estimate = 2011 census + births in 2011 – deaths in 2011 + immigration in 2011 – emigration in 2011
2013 estimate = 2012 estimate + births in 2012 – deaths in 2012 + immigration in 2012 – emigration in 2012
2014 estimate = 2013 estimate + births in 2013 – deaths in 2013 + immigration in 2013 – emigration in 2013
2015 estimate = 2014 estimate + births in 2014 – deaths in 2014 + immigration in 2014 – emigration in 2014
2016 estimate = 2015 estimate + births in 2015 – deaths in 2014 + immigration in 2015 – emigration in 2015
It is clear that the 2016 population estimate diverged from the actual numbers. Of the four components that
comprise the estimate, the numbers of births and deaths are generally very accurate. So the reasons for the positive
divergence are an underestimate of immigration or an overestimate of emigration or both.
The CSO have revised their population estimates in series PEA01 for years 2012 to 2016. In general they have
increased their estimates for population aged 15-39 and reduced the estimates for other age groups. In 2016, they
increased the population estimates for cohorts 15-39 was 92.6 thousand. They decreased the population estimates
for cohorts 0-14 by 33.7 thousand.
The detail of the changes made to the annual population estimates is:
Year 2012 2013 2014 2015 2016
All ages 8,300 21,600 35,800 52,400 65,900
Under 1 year -1,800 -2,600 -1,400 -3,900 -4,000
0 - 4 years -6,400 -12,700 -17,200 -23,000 -24,200
1 - 4 years -4,600 -10,100 -15,900 -19,000 -20,200
5 - 9 years 500 -100 200 -3,100 -7,900
10 - 14 years -900 -1,000 -1,300 -1,700 -1,600
15 - 19 years 5,800 9,900 11,500 12,900 13,100
20 - 24 years 7,400 20,100 32,300 42,000 46,700
25 - 29 years 300 1,800 900 8,300 14,300
30 - 34 years 1,700 3,900 4,400 5,300 9,100
35 - 39 years 900 3,000 5,000 8,300 9,400
40 - 44 years -1,100 -1,800 -700 1,200 2,000
45 - 49 years -400 -2,000 -2,300 -2,500 -1,400
50 - 54 years 0 -300 -400 -600 -1,200
55 - 59 years 0 0 400 700 1,500
60 - 64 years -100 -400 0 100 1,900
65 - 69 years 100 600 900 1,000 1,400
70 - 74 years 400 500 1,100 1,400 1,300
75 - 79 years 300 600 800 1,100 1,100
80 - 84 years 500 800 1,200 1,900 1,700
85 years and
over
-700 -1,400 -1,100 -1,100 -1,100
Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020
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Migration Estimates Revisions
The CSO also revised their estimates for numbers of emigrants and immigrants as contained in their data series
PEA16 Estimated Emigration15 and PEA17 Estimated Immigration16.
The revisions in the estimated emigration numbers were:
Year Irish UK EU Other
Nationalities
Total
2012 3,200 3,200 -10,100 -400 -4,100
2013 -2,600 2,800 -8,500 600 -7,700
2014 4,300 3,100 -10,200 -4,200 -7,000
2015 7,200 1,800 -11,000 -8,900 -10,900
2016 5,300 2,600 -10,700 -7,100 -9,900
Total 17,400 13,500 -50,500 -20,000 -39,600
#
Estimated migration over the five years from 2012 to 2016 was reduced by 39,600.
The revisions in the estimated immigration numbers were:
Year Irish UK EU Other
Nationalities
Total
2012 -500 1,700 -2,000 5,300 4,500
2013 6,000 -800 -1,200 2,700 6,700
2014 11,200 -700 1,800 -6,500 5,800
2015 14,500 0 700 -8,500 6,700
2016 7,300 1,400 2,600 -8,200 3,100
Total 38,500 1,600 1,900 -15,200 26,800
Estimated immigration over the five years from 2012 to 2016 was increased by 26,800.
Net Migration = Immigration (PEA17) – Emigration (PEA16).
The CSO revised the net migration numbers from 2012 to 2016 by 66,400. The CSO had previously estimated that
net migration in the interval 2012 to 2016 was -77,400, that is, there was net emigration. This has been revised to -
11,000, a much smaller net emigration estimate.
15 PEA16 Estimated Emigration (Persons in April) by Sex, Nationality and Year -
http://www.cso.ie/px/pxeirestat/statire/SelectVarVal/Define.asp?MainTable=PEA16
16 PEA17: Estimated Immigration (Persons in April) by Sex, Nationality and Year -
http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA17
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Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020

  • 1. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Notes on determining the existence of and estimating the numbers of excess deaths not directly attributed to COVID-19 in Ireland from January 2020 to June 2020 Alan McSweeney July 2020 http://ie.linkedin.com/in/alanmcsweeney
  • 2. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 2 Contents Summary .............................................................................................................................................................4 Introduction ........................................................................................................................................................5 COVID-19 Deaths................................................................................................................................................8 Irish COVID-19 Deaths......................................................................................................................................12 Irish Mortality ...................................................................................................................................................12 Irish Mortality Rates......................................................................................................................................16 RIP.ie Web Site Data.........................................................................................................................................19 RIP.ie 2018 and 2019 Data Summary.............................................................................................................21 RIP.ie 2020 Q1 and Q2 Data ..........................................................................................................................24 Hospital, Nursing Home and Hospice Death Analysis .........................................................................................26 Possible Excess COVID-19 Death Analysis .........................................................................................................27 Irish Population Estimates.............................................................................................................................28 Estimation Approach 1 – Comparable Year COVID-19 Estimates ...................................................................31 Estimation Approach 2 – Age Specific Mortality Rate Estimates ....................................................................35 Estimation Approach 3 – Death Rate Per 1,000 Population Estimates ............................................................39 Appendix ...........................................................................................................................................................41 Tourist and Visitor Deaths .............................................................................................................................41 Influenza Deaths............................................................................................................................................42 CSO Restatement of Migration Statistics and Population Estimates................................................................45 Annual Population Estimates Revisions .....................................................................................................45 Migration Estimates Revisions ...................................................................................................................47
  • 3. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 3 List of Figures Figure 1 – Sample Model of Excess COVID-19 Deaths...........................................................................................5 Figure 2 – More Complex Model for Excess COVID-19 Deaths ..............................................................................6 Figure 3 – Hypothetical COVID-19 Negative Feedback Loop Leading to Higher Overall Mortality .......................6 Figure 4 – COVID-19 Deaths/Cases, Cases/Population and Deaths/Population for Top 60 Affected Countries.........9 Figure 5 – Population Age Profiles for Various Countries ....................................................................................11 Figure 6 – Ireland COVID-19 Deaths Jan-Jun 2020 ............................................................................................12 Figure 7 – Numbers of Deaths and Death Rate per 1,000 Population from 1960 Q1 to 2019 Q4 ............................13 Figure 8 – Deaths Per Quarter 2014 to 2019 ........................................................................................................14 Figure 9 – Death Rate Per 1,000 of Population Per Quarter 2014 to 2019 ............................................................15 Figure 10 – Average, Minimum and Maximum Daily Death Rates per Quarter per 1,000 of Population for the Years 2014 to 2019 .............................................................................................................................................16 Figure 11 – Irish Life Table 16 Male and Female Mortality Rates........................................................................17 Figure 12 – Weighted Average Male and Female Mortality Rates for Ages 0 to 100 for Irish Life Tables 13, 14, 15 and 16................................................................................................................................................................18 Figure 13 – weighted Average Male and Female Mortality Rates for Ages 0 to 8 for Irish Life Tables 13, 14, 15 and 16 ......................................................................................................................................................................18 Figure 14 – Weighted Average Male and Female Mortality Rates for Ages 65 to 100 for Irish Life Tables 13, 14, 15 and 16................................................................................................................................................................19 Figure 15 – Differences Between CSO and RIP.ie Mortality Data........................................................................20 Figure 16 – RIP.ie Deaths for 2018 and 2019 by Day of Week .............................................................................22 Figure 17 – RIP.ie Deaths for 2018 and 2019 by Month.......................................................................................22 Figure 18 – RIP.ie Deaths for 2018 and 2018 by Day ..........................................................................................23 Figure 19 – RIP.ie Deaths for Jan to Mar 2018 and 2018 by Day.........................................................................23 Figure 20 – RIP.ie Deaths for 2018 and 2018 by Day Showing Trends.................................................................24 Figure 21 – RIP.ie Deaths for 2018, 2019 and First Six Months of 2020 by Month ...............................................25 Figure 22 – RIP.ie Daily Deaths from 1 Jan to 21 Feb 2019 and 2020..................................................................26 Figure 23 – Annual Hospital, Nursing Home and Hospice Deaths CSO and RIP.ie 2013 to 2019 ..........................27 Figure 24 – Quarterly Population Estimates Derived from CSO Tome Series VSQ04............................................29 Figure 25 – Ireland Population Profile 1996 and 2019 .........................................................................................30 Figure 26 – Estimate of 2020 Deaths Based on Previous Year Values ..................................................................31 Figure 27 – Applying Age Specific Survival Rates to Estimate Population Cohorts..............................................36 Figure 28 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2018 ...................................................................44 Figure 29 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2019 ...................................................................44 Figure 30 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2020 ...................................................................45
  • 4. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 4 Summary This analysis seeks to determine if there are excess deaths that occurred in Ireland in the interval Jan – Jun 2020 that can be attributed to COVID-19. Excess deaths means deaths in excess of the number of expected deaths plus the number of deaths directly attributed to COVID-19. On the other hand a deficiency of deaths would occur when the number of expected deaths plus the number of deaths directly attributed to COVID-19 is less than the actual deaths. This analysis uses number of deaths taken from the web site RIP.ie to generate an estimate of the number of deaths in Jan – Jun 2020 in the absence of any other official source. The last data extract from the RIP.ie web site was taken on 3 Jul 2020. The analysis uses historical data from RIP.ie from 2018 and 2019 to assess its accuracy as a data source. The analysis then uses the following three estimation approaches to assess the excess or deficiency of deaths: 1. The pattern of deaths in 2020 can be compared to previous comparable year or years. The additional COVID- 19 deaths can be added to the comparable year and the difference between the expected, actual from RIP.ie and actual COVID-19 deaths can be analysed to generate an estimate of any excess or deficiency. 2. The age-specific mortality rates described on page 16 can be applied to estimates of population numbers to generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency. 3. The range of death rates per 1,000 of population as described in Figure 10 on page 16 can be applied to estimates of population numbers to generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency. Estimation approach 2 is the most problematic and its results the least reliable. The results of these analyses are summarised in the following table. Estimated Deaths Without COVID-19 Estimated Deaths With COVID-19 Estimated Deaths + COVID-19 Deaths RIP.ie Measured Actual Deaths Difference Estimate 1 16,188 1,736 17,924 17,046 -878 Estimate 2 16,834 18,570 -1,524 Estimate 3 16,397 18,133 -1,087 In all cases, this analysis has determined that there are no excess deaths due to COVID-19 in Ireland in the interval Jan – Jun 2020. It has found that there is a deficiency of deaths in the range from -800 to -1,000. This means that the excess deaths caused by COVID-19 are of the order of 750 to 950. These conclusions are based on the assumption that the data derived from the RIP.ie web site is accurate. This is not to suggest or imply that deaths attributed to COVID-19 were not correct. It simply identifies that many of these deaths would have occurred normally within roughly the same interval from other causes. The following table shows the numbers generated from this analysis for 2018, 2019 and the first six months of 2020 from the RIP.ie data for deaths in Hospitals, Nursing Homes and Hospices. 2018 2019 2020 Location Number of Deaths %Age of Deaths Number of Deaths %Age of Deaths Number of Deaths %Age of Deaths Hospitals 11,401 36.43% 11,343 36.32% 11,343 33.16%
  • 5. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 5 Nursing Homes 3,725 11.90% 3,791 12.14% 3,791 14.90% Hospices 2,756 8.81% 2,715 8.69% 2,715 7.43% Total Deaths 31,295 31,230 17,046 It shows a slight but significant increase in nursing home deaths for the first six months of 2020. Over the six months this equates to an extra 500 deaths in nursing homes. Introduction There have been discussions about the existence of excess deaths during the current COVID-19 pandemic. The UK Office of National Statistics (ONS) has done good work on this topic of excess deaths – see https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregister edweeklyinenglandandwalesprovisional/weekending5june2020. Simplistically, the model for excess deaths could be represented as follows: Figure 1 – Sample Model of Excess COVID-19 Deaths However, the reality is more complex. There is no standard definition of how a death is attributed to COVID-19. The attribution can be done inclusively – COVID-19 is assigned as a cause of death if it was present or a contributing factor – or exclusively – COVID-19 is assigned as a cause of death only if it directly caused the death and there was no reasonable chance of any underlying condition being a contributory factor. This more complex model can be represented as follows:
  • 6. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 6 Figure 2 – More Complex Model for Excess COVID-19 Deaths It is possible to hypothesise a feedback loop along the following lines that gives rise to higher overall mortality rates. Figure 3 – Hypothetical COVID-19 Negative Feedback Loop Leading to Higher Overall Mortality There is some anecdotal evidence that this negative feedback look was experienced in areas such as the peak of COVID-19 cases in countries and locations such as Italy and New York. The differences in the expected and actual number of deaths within an interval will be due to factors such as: • Reduced expected deaths due to lockdown-related factors and associated reduction of economic activities – road traffic1 and other travel-related, crime, public consumption of alcohol, workplace accidents, reduced deaths of foreign visitors to Ireland who would have died while in Ireland because of the absence of tourism and business travel. • Deaths caused by COVID-19 that would not have happened. • Deaths attributed to COVID-19 but which would have happened anyway within the measurement interval. 1 The road traffic deaths for the first half of 2020 are actually slightly higher than those for 2019 - see https://www.garda.ie/en/roads-policing/statistics/roads-policing-fatalities-to-date-for-2020/. Deaths due to road traffic accidents are a small proportion of overall deaths. There were 141 deaths in 2019 representing less than 0.4% of all deaths – see https://www.rsa.ie/RSA/Road-Safety/RSA-Statistics/Deaths-injuries-on-Irish-roads/. More detail on road traffic deaths can be obtained from the CSO time series ROA11 Road Fatalities by Month of Fatality and Year - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=ROA11&PLanguage=0. Road traffic deaths have falling for some time: 2004 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Deaths 335 374 396 365 338 279 238 212 186 163 188 192 162 184 156 142 141
  • 7. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 7 • Excess deaths due to but not attributed to COVID-19. • Excess deaths due to factors such as failure to seek medical attention for serious illness, failure of emergency services to respond to call sufficiently quickly because of perceived or actual excess workload, possible increased rate of suicide and lockdown-related factors such as reduced income, reduced exercise, increased anxiety. • Excess deaths due to Irish people who would have died on holidays abroad but who now have died while remaining in Ireland2. • Effective cessation of all migration – both immigration and emigration – and its consequent impact on the size and age profile of the Irish population and thus population mortality rates and numbers3. • Changing rates of and differences in seasonal rates of suicide4. These are all sources of noise that makes any analysis complex and problematic. This analysis is hampered by the lack of detailed and current mortality statistics for Ireland. The UK publish weekly mortality statistics – see https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisi onalfiguresondeathsregisteredinenglandandwales. This level of detail data made available publicly makes open and independent analysis possible. 2 The topic of tourist and visitor deaths is covered in more detail on page 8. 3 As can be seen from the data on Irish mortality rates on page 9, mortality rates for people under 65 are low. The proportion of immigrants and emigrants aged 65 and over is small. The following summary is taken from CSO time series PEA03 Estimated Migration (Persons in April) by Age Group, Sex, Inward or Outward Flow and Year https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA03&PLanguage=0. This shows the proportion of estimated emigration and immigration from the 65 years and over age category. 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Emigration 1.59% 4.22% 2.53% 2.09% 2.94% 2.14% 2.57% 2.16% 2.66% 2.19% Immigration 4.55% 2.44% 5.06% 4.78% 5.11% 4.75% 2.92% 2.72% 3.65% 2.93% So, the likely cessation of migration caused by COVID-19, while it might cause a net 30,000 or more reduction in what would have been the total population of Ireland in normal circumstances, will not have a major impact on increased or decreased overall mortality rates. 4 See Temporal Variation in Irish Suicide Rates - Paul Corcoran, MSc, Marie Reilly, PhD, Agus Salim, PhD, Aline Brennan, MPhil, Helen S. Keeley, MRCPsych, and Ivan J. Perry, MD PhD https://nsrf.ie/wp- content/uploads/journals/04-03/TemporalVariation_IrishSuicideRates.pdf. The shows that between 1990 and 1998 there was an annual increase in the male suicide rate of 4.5% since 1990. Figure 3 in this paper Male and female suicide rates in Ireland by calendar month, 1990–1998 shows small seasonal differences in suicide rates. Data on suicides from the CSO such as VSD31 Suicides by Sex, Year and Statistic https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD31&PLanguage=0 gives a suicides rate per 100,000 of population for the years 2002 to 2019 as follows. There is a warning that the information for the years 2016 onwards is provisional. 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Rate 12.2 12.5 12.2 11.6 10.8 10.5 11.3 12.2 10.9 12.1 11.8 10.6 10.5 9.1 9.2 8 7.2 8.6 Number 478 497 493 481 460 458 506 552 495 554 541 487 486 425 437 383 352 421 This show a general decrease in suicide rates.
  • 8. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 8 No such detailed and up-to-date information is available for Ireland. The Central Statistics Office (CSO) publish a range of mortality time series: VSQ04 Total Births, Deaths and Marriages Registered by Statistic and Quarter - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ04&PLanguage=0 VSQ01 Births and Deaths Registered by Statistic, Quarter and Sex (1960Q1-2019Q4) - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ01&PLanguage=0 VSAQ2 Deaths Registered Provisional by Age at Death and Quarter (1960Q1-2019Q4) - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSAQ2&PLanguage=0 VSQ17 Deaths Registered Provisional by Sex, Statistic and Quarter (1960Q1-2019Q4) - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ17&PLanguage=0 VSQ20 Deaths Registered by Age Group, ICD 10 Diagnostic Group and Quarter (2015Q1-2019Q4) - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ20&PLanguage=0 Irish mortality data is produced quarterly. The most recent quarter for which data is available is 2019Q4 before the COVID-19 pandemic. Some mortality data such as that containing details where deaths occurred such as hospitals, nursing homes and hospices is no longer produced. For example, see: • VSD36 Deaths by Age Group, Place of Occurrence and Year (2013-2017) - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD36&PLanguage=0 This represents a poor state of affairs. It precludes detailed analysis of mortality data. This analysis attempts to use mortality data from RIP.ie combined with that from the CSO. The RIP.ie web site contains death notices from which more recent and more detailed mortality data can be inferred. However, this data has issues that need to be overcome before it can be used in this analysis. This analysis uses data from Jan 2018 to June 2020 (Q1 2018 to Q2 2020). COVID-19 Deaths One of the many issues with regard to analysing the topic of COVID-19 deaths is that there is no standard agreement on what constitutes a death from COVID-19. The following chart5 shows the deaths/cases, cases/population and deaths/population for the top 60 countries by number of COVID-19 cases. 5 This information is a taken from https://www.worldometers.info/coronavirus/,
  • 9. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 9 Figure 4 – COVID-19 Deaths/Cases, Cases/Population and Deaths/Population for Top 60 Affected Countries The values for deaths/population are shown on the right-hand vertical axis of the chart. The index values for Ireland are highlighted. This chart shows considerably variability across these countries for these three indices. There are many reasons for such variability including: • Population density, both absolute and measured by population concentrations into urbanised areas, and implied rate of contact • Economic activity and measure of population of internal and external movement • Land borders with other countries and the freedom of movement across those borders • Population age profile • Approach to testing and testing rate to count number of cases • Degree of restrictions of movement imposed • Approach to classification of deaths from COVID-19 • Quality of health service • Availability of health service The age-specific mortality rates for COVID-196 are of the order of Age Range Mortality Rate 0 - 17 years old 0.06% 18 - 44 years old 3.9% 45 - 64 years old 22.4% 65 - 74 years old 24.9% 75+ years old 48.7% 6 This information is taken from https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/.
  • 10. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 10 The following charts show the estimated age profiles in 2020 for various countries, including Ireland7. The estimated proportion of the Irish population that is aged 65 and over is 13.82%. For Germany, it is 22.99%. This illustrates one very obvious cause of differences in mortality rates. Ireland UK Italy Germany USA France 7 For the sake of consistency, these demographic profile snapshots are taken from the CIA World Factbook - https://www.cia.gov/library/publications/the-world-factbook/.
  • 11. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 11 Spain Sweden Belgium Russia Portugal Figure 5 – Population Age Profiles for Various Countries The information contained in these charts is shown in the table below. Ireland UK Italy Germany USA France Spain Sweden Belgium Russia 0-14 Years 21.15% 17.63% 13.45% 12.89% 18.46% 18.36% 15.02% 17.71% 17.22% 17.24% 15-24 Years 12.08% 11.49% 9.61% 9.81% 12.91% 11.88% 9.90% 10.80% 11.20% 9.54% 25-54 Years 42.19% 39.67% 40.86% 38.58% 38.92% 36.83% 43.61% 39.01% 39.23% 43.38% 55-64 Years 10.77% 12.73% 14% 15.74% 12.86% 12.47% 12.99% 11.90% 13.14% 14.31%
  • 12. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 12 65 Years and Over 13.82% 18.48% 22.08% 22.99% 16.85% 20.46% 18.49% 20.59% 19.21% 15.53% This shows considerable variability in the age group with the highest probability of dying after becoming infected with COVID-19. Irish COVID-19 Deaths Irish COVID-19 death data is available from https://data.gov.ie/dataset/covidstatisticsprofilehpscirelandopendata. The following chart summarises this data. Figure 6 – Ireland COVID-19 Deaths Jan-Jun 2020 This data contains negative deaths (“denotifications”) for two days: 25 May 2020 1 June 2020 In both cases, I changed the negative value to zero and reduced the number of deaths on the following day by negative value. Irish Mortality To assess the expected mortality for the first two quarters of 2020, historical mortality data can be analysed as one source of estimates. This section provides background information and a context for the estimates of excess COVID-19 mortality rates. Mortality is a complex issue. Any attempts to estimate excess COVID-19 deaths needs to engage with the complexity.
  • 13. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 13 The following information is taken from the CSO time series VSQ04 Total Births, Deaths and Marriages Registered by Statistic and Quarter https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSQ04&PLanguage=0. As background information, the following chart shows Irish mortality data from 1960 to 2016. Figure 7 – Numbers of Deaths and Death Rate per 1,000 Population from 1960 Q1 to 2019 Q4 This shows that while the numbers dying have remained the same, the average mortality rate has dropped quite significantly from 11.475 to 6.35 per 1,000 of the population. This is due to both improvements in life expectancy and changes in the age profile of the Irish population. There is a clear and consistent pattern of seasonality in both the numbers of deaths and the death rate. Deaths are highest in the first quarter, fall and remain roughly level in the second and third quarters and being to increase again in the fourth quarter. The sizes of these winter peaks vary. There are many reasons for variations in both numbers of deaths and mortality rates, such as: • Changes in the age profile of the underlying population. • Changes in the mortality rates of people at different ages. • Differences in seasonal illness and mortality rates. The following chart shows the numbers of deaths per quarter for the years 2014 to 2019.
  • 14. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 14 Figure 8 – Deaths Per Quarter 2014 to 2019 This shows in more detail a common trend in the pattern of deaths over the four quarters of these six years: high numbers in the first quarter, falls in the second and third quarters and then an increase in the fourth quarter. The chart shows an apparently high number of deaths in 2019 Q4. The information contained in this chart is shown in the following table 2014 2015 2016 2017 2018 2019 Q1 (Jan - Mar) 8,110 8,604 8,609 9,067 9,278 8,618 Q2 (Apr - Jun) 7,197 7,565 7,697 7,315 7,592 7,519 Q3 (Jul - Sep) 7,001 6,851 7,129 6,987 7,143 7,358 Q4 (Oct - Dec) 6,787 6,932 6,955 7,115 7,103 7,639 Total 29,095 29,952 30,390 30,484 31,116 31,134 However, the following chart shows the mortality rates per 1,000 of the (estimated8) population. The apparently high number of deaths in 2019 Q4 is now shown as a lower but still slightly increased rate. 8 See the details on population estimates on page 9 for more information on the annual population estimates produced by the CSO.
  • 15. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 15 Figure 9 – Death Rate Per 1,000 of Population Per Quarter 2014 to 2019 The information contained in this chart is shown in the following table. 2014 2015 2016 2017 2018 2019 Q1 (Jan - Mar) 7.1 7.5 7.4 7.8 7.7 7.1 Q2 (Apr - Jun) 6.2 6.5 6.6 6.1 6.3 6.2 Q3 (Jul - Sep) 6.1 5.9 6.1 5.8 5.9 6.1 Q4 (Oct - Dec) 5.9 6 6 5.9 5.8 5.9 This information needs to be examined further. The number of days in each quarter is not the same. Further, 2016, like 2020, is a leap year so quarter 1 contains an extra day. Number of Days Q1 (Jan - Mar) 90 Q2 (Apr - Jun) 91 Q3 (Jul - Sep) 92 Q4 (Oct - Dec) 92 The average number of deaths per day, allowing for leap years, for each quarter of the years 2014 to 2019 is shown in the following table. 2014 2015 2016 2017 2018 2019 Q1 (Jan - Mar) 90.11 95.60 94.60 100.74 103.09 95.76 Q2 (Apr - Jun) 79.09 83.13 84.58 80.38 83.43 82.63 Q3 (Jul - Sep) 76.10 74.47 77.49 75.95 77.64 79.98 Q4 (Oct - Dec) 73.77 75.35 75.60 77.34 77.21 83.03
  • 16. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 16 The mortality rate per 1,000 of population per day, allowing for leap years, for each quarter of the years 2014 to 2019 is shown in the following table. 2014 2015 2016 2017 2018 2019 Q1 (Jan - Mar) 0.0789 0.0833 0.0813 0.0867 0.0856 0.0789 Q2 (Apr - Jun) 0.0681 0.0714 0.0725 0.0670 0.0692 0.0670 Q3 (Jul - Sep) 0.0663 0.0641 0.0663 0.0630 0.0641 0.0652 Q4 (Oct - Dec) 0.0641 0.0652 0.0652 0.0641 0.0630 0.0674 The following chart shows the average and span of mortality rates per day of each quarter per 1,000 of population for the four quarters of the years 2014 to 2019. Figure 10 – Average, Minimum and Maximum Daily Death Rates per Quarter per 1,000 of Population for the Years 2014 to 2019 This shows that mortality rates in the years 2014 to 2019 following a narrow band. There is greatest variation in the first quarter and much lower variations in other quarters. The information contained in this chart is shown in the following table. Average Minimum Maximum Variation Q1 (Jan - Mar) 0.0824 0.0789 0.0867 0.007778 Q2 (Apr - Jun) 0.0692 0.0670 0.0725 0.005495 Q3 (Jul - Sep) 0.0649 0.0630 0.0663 0.003261 Q4 (Oct - Dec) 0.0649 0.0630 0.0674 0.004348 Irish Mortality Rates Irish mortality rates are published in the Irish Life Table series. The most recent four of these are as follows: Life Table Interval Covered Details Irish Life Table 16 2010-2012 https://www.cso.ie/en/releasesandpublications/er/ilt/irishlifetablesno16 2010-2012/ Irish Life Table 15 2005-2007 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt hsdm/2007/irishlife_2005-2007.pdf Irish Life Table 14 2001-2003 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt hsdm/2003/irishlife_2001-2003.pdf
  • 17. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 17 Irish Life Table 13 1995-1997 https://www.cso.ie/en/media/csoie/releasespublications/documents/birt hsdm/archivedreports/Irish_Life_Table_No._13_1995-1997.pdf These life tables give mortality rates for men and women separately. The following information averages these mortality rates. Life expectancy for rates for men and women being to vary at age 60. The male mortality rate increases at a higher rate. The following chart shows the mortality rates for men and women for Irish Life Table 16: Figure 11 – Irish Life Table 16 Male and Female Mortality Rates The downward kink in male mortality is caused by a lower probability of dying aged 99 and 100 for a male than for those aged 98 as highlighted in red in the table below. Age Number Surviving to Age x Out of the Original 100,000 Number of Deaths in the Year of Age x to x+1 Probability of Surviving a Year Rate of Mortality or the Probability of Dying in a Year 95 4,969 1442 0.7097812 0.29021876 96 3,527 1117 0.6832348 0.31676523 97 2,410 831 0.6551755 0.34482447 98 1,579 580 0.6324683 0.36753170 99 999 350 0.6491586 0.35084135 100 648 196 0.6968287 0.30317131 101 452 172 0.6197644 0.38023555 102 280 204 0.2727366 0.72726337 103 76 40 0.4811619 0.51883813 The following chart shows the weighted combined average mortality rate for males and females by year of age for these four life tables:
  • 18. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 18 Figure 12 – Weighted Average Male and Female Mortality Rates for Ages 0 to 100 for Irish Life Tables 13, 14, 15 and 16 There are a number of characteristics that can be seen from this: • Mortality rates are relatively high for ages 0-2. • Mortality rates then fall and remain low up to age 55 or so. • Mortality rates then consistently increase. • Mortality rates are improving even over the interval 1995 to 2012 covered by these four life tables. The following chart shows the weighted combined mortality rates for males and females for the four recent life tables for the ages 0 to 8 years to show the rates at a greater level of granularity that is apparent from the overall chart. Figure 13 – weighted Average Male and Female Mortality Rates for Ages 0 to 8 for Irish Life Tables 13, 14, 15 and 16
  • 19. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 19 The following chart shows the weighted combined mortality rates for males and females for the four recent life tables for the ages 65 to 100 years again to show the rates at a greater level of granularity that is apparent from the overall chart. Figure 14 – Weighted Average Male and Female Mortality Rates for Ages 65 to 100 for Irish Life Tables 13, 14, 15 and 16 RIP.ie Web Site Data This analysis uses data from RIP.ie from Jan 2018 to Jul 2020. The purpose of using the years 2018 and 2019 is to compare with the CSO mortality data published for those years. This is used to validate the RIP.ie data so any inferences based on 2020 data are reliable. RIP.ie is a web site that contains death notices that are also published in newspapers. The information available on a death on RIP.ie includes: • Name of deceased • Six-digit reference • Date death notice was published • Date of death • Text of death notice The data is informal. RIP.ie is the only source of detailed death data in Ireland. However, the information needs to be filtered to make it usable. The following schematic illustrates the key differences between the CSO and RIP.ie datasets.
  • 20. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 20 Figure 15 – Differences Between CSO and RIP.ie Mortality Data The CSO data is taken from deaths registered in Ireland. This includes anyone who died in Ireland. The reporting of deaths is mandatory so the data can be assumed to be very accurate. A small number of deaths may occur that may not be registered but this is likely to be very small. The use of RIP.ie is not mandatory for deaths. The RIP.ie data has the following issues: • There are duplicate notices for the same death. • There are notices for deaths that occur in Northern Ireland. • There are for deaths of Irish people that occurred outside Ireland other than Northern Ireland. This status cannot be determined exactly. • Death notices are not published for foreign nationals who have died in Ireland, including both visitors and temporary workers but whose deaths will appear in the CSO data. • Death notices are frequently not published for the deaths of very young children but whose deaths will appear in the CSO data. • Some deaths will not have a death notice but these deaths will appear in the CSO data. • Deaths for which a notice is published in one year may have occurred in a prior year. • There are data errors. For example, the date of death in some cases is after the date of publication of the death notice. • Some death notices have a date published value but no date of death value. In these cases, I have assumed that the date is death is the date of publication. The following table summarises the processing of the RIP.ie data: 2018 2019 2020 Jan to Jun Number of Death Notices 42,003 42,459 23,280 After Removal of Duplicates and Deaths from Northern Ireland 32,300 32,226 17,451
  • 21. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 21 Deaths in Previous Years 129 95 109 Deaths in Subsequent Year Brought Back 93 101 0 Foreign Deaths 876 901 298 Net Deaths 31,295 31,230 17,044 The following table summarises the differences between the RIP.ie and CSO VSQ04 time series for the numbers of deaths in the four quarters of the years 2018 and 2019. 2018 2019 RIP CSO Difference % Difference RIP CSO Difference % Difference Q1 9,229 9,278 -49 -0.53% 8,251 8,618 -367 -4.45% Q2 7,310 7,592 -282 -3.86% 7,577 7,519 58 0.77% Q3 6,980 7,143 -163 -2.34% 7,014 7,358 -344 -4.90% Q4 7,776 7,103 673 8.65% 8,388 7,639 749 8.93% Total 31,295 31,116 179 0.57% 31,230 31,134 96 0.31% While the two sets of numbers are quite close, the differences are large in terms of the 1,700 deaths in Ireland attributed to COVID-19. Some of these differences will be caused by the errors in classifying RIP.ie notices as referring to deaths that occurred outside Ireland. In 2019, there were 786 notices for deaths where the difference between the date of publication of the notice and the date of the death was 10 or more days. Of these 595 notices clearly referred to deaths outside Ireland. In 2018, the corresponding numbers were 812 and 629. So, a long duration between the date of date and the date of publication of a death notices on RIP.ie is a good indicator that the death occurred outside Ireland. Some of these deaths that have not be classified as such may have occurred outside Ireland. The implicit assumption here is that the CSO death statistics are completely accurate. RIP.ie 2018 and 2019 Data Summary The following chart shows the deaths from RIP.ie for the years 2018 and 2019 by day of the week. There is no real obvious pattern indicating the deaths regularly occur more frequently on some days of the week over others.
  • 22. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 22 Figure 16 – RIP.ie Deaths for 2018 and 2019 by Day of Week The following chart shows the deaths from RIP.ie for the years 2018 and 2019 by calendar month. The previously indicated pattern where deaths are highest in the first quarter, fall and remain roughly level in the second and third quarters and being to increase again in the fourth quarter can be seen. Figure 17 – RIP.ie Deaths for 2018 and 2019 by Month The information in this chart is shown in the following table. Month 2018 2019 Jan 3,012 3,474 Feb 2,605 2,773 Mar 2,634 2,982 Apr 2,539 2,590 May 2,643 2,420 Jun 2,395 2,300 Jul 2,413 2,411 Aug 2,314 2,298 Sep 2,287 2,271 Oct 2,716 2,549 Nov 2,652 2,561 Dec 3,020 2,666 Total 31,230 31,295 The following chart shows the deaths from RIP.ie for each day of the years 2018 and 2019. The first day of 2018 was a Monday while the first day of 2019 was a Tuesday. The same pattern where deaths are highest in the first quarter, fall and remain roughly level in the second and third quarters and being to increase again in the fourth quarter can be seen.
  • 23. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 23 Figure 18 – RIP.ie Deaths for 2018 and 2018 by Day The number of deaths in the early weeks of 2018 is higher than those for 2019. The following chart shows the deaths for the first three months of 2018 and 2019. It also shows the trends for deaths over these intervals. Figure 19 – RIP.ie Deaths for Jan to Mar 2018 and 2018 by Day The deaths recorded by RIP.ie and the CSO and the recorded influenza deaths for the first quarter of 2018 and 2019 are shown in the following table. RIP.ie Deaths CSO Deaths Recorded Seasonal Influenza Deaths 2019 Q1 8,163 8,618 54
  • 24. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 24 2018 Q1 9,132 9,278 183 Difference 969 660 129 There is more detail on recorded seasonal influenza deaths on page 42. While the number of influenza deaths in 2018 compared with 2019 would not account for the total difference in the number of deaths, it may be that higher influenza deaths are an indicator of higher seasonal deaths from other causes. The following chart shows the same information as is contained in Figure 10 on page 16 with the addition of trend lines for the two years. This shows that the high number of deaths in 2018, perhaps associated with a higher rate of recorded seasonal influenza deaths and other, perhaps related, seasonal deaths shows a reduction in the mortality rate in quarters 2 and 3 when compared with 2019. It may be the case that higher seasonal deaths are not additive to underlying deaths but are semi-additive. This could be caused by seasonal events that cause higher initial mortality effectively bringing forward or accelerating deaths that would otherwise have occurred later in the year. Figure 20 – RIP.ie Deaths for 2018 and 2018 by Day Showing Trends RIP.ie 2020 Q1 and Q2 Data The 2020 RIP.ie data was collected on 3 Jul 2020. This means that deaths that occurred from Jan to Jun 2020 but where the death notices are published after this date will not be included in the analysis. It must be remembered that 2020 was a leap year. This will lead to additional deaths. RIP.ie recorded 71 deaths for the day of 29 Feb 2020. The following chart extends the information displayed in Figure 17 on page 22 with deaths by month from RIP.ie for the first six months of 2020.
  • 25. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 25 Figure 21 – RIP.ie Deaths for 2018, 2019 and First Six Months of 2020 by Month Not surprisingly, this shows a large difference in Apr 2020 when the recorded number of COVID-19 deaths were highest. 2018 RIP.ie Deaths 2019 RIP.ie Deaths 2020 RIP.ie Deaths COVID-19 RIP.ie Deaths Difference Jan 3,474 3,012 2,976 0 Feb 2,773 2,605 2,674 0 Mar 2,982 2,634 2,861 71 Apr 2,590 2,539 3,574 1161 May 2,420 2,643 2,735 420 Jun 2,300 2,395 2,226 84 TOTAL 15,828 16,539 17,046 1,736 The following chart shows the RIP.ie daily number of deaths from 1 Jan to 21 Feb of the years 2019 and 2020.
  • 26. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 26 Figure 22 – RIP.ie Daily Deaths from 1 Jan to 21 Feb 2019 and 2020 Intuitively, these series appear quite similar. Their means and variances are shown in the following table. Mean Variance 2019 95.981 122.137 2020 95.096 123.892 The F value is 1.014. The F Critical one-tail value is 1.592. So, statistically the variances of the two series of numbers of deaths are the same, The t-statistic of the two series is 0.407. This is less than t Critical two-tail value of 1.983. So, the two series are statistically similar. Hospital, Nursing Home and Hospice Death Analysis As referred to in the introduction, the CSO time series VSD36 Deaths by Age Group, Place of Occurrence and Year (2013-2017) https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=VSD36&PLanguage=0 contains information on deaths by location such as hospitals, nursing homes and hospices. The data is only available for the years 2013 to 2017. The annual total deaths in this time series do not agree with the total in other CSO time series such VSQ04. The following table shows the number of deaths in hospitals, nursing homes and hospices from this time series. Location 2013 2014 2015 2016 2017 Hospitals 15,860 15,466 15,593 15,370 14,969 Nursing Homes 3,976 3,860 4,408 5,117 5,201 Hospices 1,883 2,074 2,285 2,388 2,455 Total VSD36 Deaths 29,504 29,252 30,127 30,667 30,418 Total VSQ04 Deaths 30,018 29,095 29,952 30,390 30,484 Information on deaths in hospitals, nursing homes and hospices can be derived from the RIP.ie web site. The accuracy is not guaranteed. The approach I have taken is to look for the text strings “hospital”, “nursing home”
  • 27. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 27 and “hospice” in the narrative text of the death notice. Where two or more of these text strings occur in the same death notice, I have assumed that the death occurred in a hospital. That is, the person was, for example, living in a nursing home but was moved to a hospital where the person died. This is not an exact approach. The absence of any CSO data with which to compare this data is disappointing. The following table shows the numbers generated from this analysis for 2018, 2019 and the first six months of 2020. 2018 2019 2020 Location Number of Deaths %Age of Deaths Number of Deaths %Age of Deaths Number of Deaths %Age of Deaths Hospitals 11,401 36.43% 11,343 36.32% 11,343 33.16% Nursing Homes 3,725 11.90% 3,791 12.14% 3,791 14.90% Hospices 2,756 8.81% 2,715 8.69% 2,715 7.43% Total Deaths 31,295 31,230 17,046 It shows a slight but significant increase in nursing home deaths for the first six months of 2020. Over the six months this equates to an extra 500 deaths in nursing homes. The RIP.ie information on deaths in hospitals, nursing homes and hospices is lower than that recorded in the CSO time series VSD36. Figure 23 – Annual Hospital, Nursing Home and Hospice Deaths CSO and RIP.ie 2013 to 2019 This difference cannot be easily explained. It may be that the text of the death notices published onRIP.ie does not always contain nursing home information. It may be that the CSO data is not accurate. Possible Excess COVID-19 Death Analysis There are several ways in which possible excess deaths during the interval Jan – Jun 2020 can be identified. Any such analysis needs to check the alternative hypothesis: that there is a deficiency in actual versus expected deaths.
  • 28. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 28 Any analysis should use multiple approaches and compare the results generated to validate any conclusions. The possible approaches are: 1. The pattern of deaths in 2020 can be compared to previous comparable year or years. The additional COVID- 19 deaths can be added to the comparable year and the difference between the expected, actual from RIP.ie and actual COVID-19 deaths can be analysed to generate an estimate of any excess or deficiency. 2. The age-specific mortality rates described on page 16 can be applied to estimates of population numbers to generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency. 3. The range of death rates per 1,000 of population as described in Figure 10 on page 16 can be applied to estimates of population numbers to generates an estimate of expected deaths. This can be compared to the actual RIP.ie and actual COVID-19 deaths to generate an estimate of any excess or deficiency. The problem with approaches 2 and 3 is that they require reasonably accurate population estimates. This is discussed in the next section. Irish Population Estimates The CSO publish a number of population estimates, including the following series: • PEA01 Population Estimates (Persons in April) by Age Group, Sex and Year https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA01 contains annual population estimates up to 2019. • PEA15 Annual Population Change by Component and Year https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA15&PLanguage=0 contains details of the estimated components of population change: births, deaths, immigration, emigration The information in these series applies to April of the year in question as April is when the Irish 5-year census takes place. The information on page 45 onwards contains notes on some issues with CSO population estimates. You can also use the death rates per 1,000 contained in the CSO time series VSQ04 (see page 12) as shown in the table below: 2014 2015 2016 2017 2018 2019 Q1 (Jan - Mar) 7.1 7.5 7.4 7.8 7.7 7.1 Q2 (Apr - Jun) 6.2 6.5 6.6 6.1 6.3 6.2 Q3 (Jul - Sep) 6.1 5.9 6.1 5.8 5.9 6.1 Q4 (Oct - Dec) 5.9 6 6 5.9 5.8 5.9 Using these rates, the following population estimates are derived: 2014 Q1 4,569,014 2014 Q2 4,643,226 2014 Q3 4,590,820 2014 Q4 4,601,356 2015 Q1 4,588,800 2015 Q2 4,655,385 2015 Q3 4,644,746 2015 Q4 4,621,333 2016 Q1 4,653,514 2016 Q2 4,664,848 2016 Q3 4,674,754
  • 29. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 29 2016 Q4 4,636,667 2017 Q1 4,649,744 2017 Q2 4,796,721 2017 Q3 4,818,621 2017 Q4 4,823,729 2018 Q1 4,819,740 2018 Q2 4,820,317 2018 Q3 4,842,712 2018 Q4 4,898,621 2019 Q1 4,855,211 2019 Q2 4,930,492 2019 Q3 4,905,333 2019 Q4 4,928,387 Figure 24 – Quarterly Population Estimates Derived from CSO Tome Series VSQ04 The population estimates from the series PEA15 and those derived from VSQ04 are inconsistent as shown in the table below. VSQ04 PEA15 Quarter Quarter Population Quarter Change Annual Change Population Annual Births Annual Deaths Net Migration Annual Change 2014 Q1 4,569,014 2014 Q2 4,643,226 74,212 4,645,400 68,400 29,200 -8,500 30,700 2014 Q3 4,590,820 -52,406 2014 Q4 4,601,356 10,536 2015 Q1 4,588,800 -12,556 2015 Q2 4,655,385 66,585 12,159 4,687,800 66,400 29,900 5,900 42,400 2015 Q3 4,644,746 -10,639 2015 Q4 4,621,333 -23,412 2016 Q1 4,653,514 32,180 2016 Q2 4,664,848 11,335 9,464 4,739,600 65,400 29,800 16,200 51,700 2016 Q3 4,674,754 9,906 2016 Q4 4,636,667 -38,087
  • 30. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 30 2017 Q1 4,649,744 13,077 2017 Q2 4,796,721 146,978 131,873 4,792,500 63,900 30,800 19,800 52,900 2017 Q3 4,818,621 21,899 2017 Q4 4,823,729 5,108 2018 Q1 4,819,740 -3,989 2018 Q2 4,820,317 577 23,596 4,857,000 61,200 30,700 34,000 64,500 2018 Q3 4,842,712 22,394 2018 Q4 4,898,621 55,909 2019 Q1 4,855,211 -43,409 2019 Q2 4,930,492 75,281 110,174 4,921,500 61,200 30,400 33,700 64,500 2019 Q3 4,905,333 -25,158 2019 Q4 4,928,387 23,054 The following diagram shows the profile of the Irish population for two years: 1996 and 2016. Figure 25 – Ireland Population Profile 1996 and 2019 Both the size and the profile of the Irish population have changed substantially in this 25-year interval.
  • 31. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 31 Estimation Approach 1 – Comparable Year COVID-19 Estimates The following chart shows an estimate of daily deaths in the first six months of 2020. It contains four series: 1. COVID-19 Deaths – these are the values on page 12. 2. Estimated Expected Deaths in Q1 and Q2 2020 – this is an estimate of 2020 deaths based on an average of RIP.ie daily deaths for 2018 and 2019. As shown on page 24, the RIP.ie deaths in year 2019 are very close to 2020. Averaging these with the higher deaths for 2018 allows for errors. 3. Expected + COVID-19 – this adds the expected deaths to the COVID-19 deaths. 4. Actual Deaths (RIP.ie) – these are the actual daily deaths recorded by RIP.ie. Figure 26 – Estimate of 2020 Deaths Based on Previous Year Values Date COVID-19 Deaths Estimated Expected Deaths in Q1 and Q2 2020 Expected + COVID- 19 Actual Deaths (RIP.ie) 01/01/2020 95.5 95.5 97 02/01/2020 98 98 109 03/01/2020 94.5 94.5 107 04/01/2020 93.5 93.5 107 05/01/2020 118 118 85 06/01/2020 118 118 98 07/01/2020 111.5 111.5 106 08/01/2020 104.5 104.5 85 09/01/2020 109.5 109.5 96 10/01/2020 108 108 113 11/01/2020 105 105 93 12/01/2020 107 107 123 13/01/2020 112 112 111
  • 32. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 32 Date COVID-19 Deaths Estimated Expected Deaths in Q1 and Q2 2020 Expected + COVID- 19 Actual Deaths (RIP.ie) 14/01/2020 99 99 91 15/01/2020 104.5 104.5 89 16/01/2020 120 120 101 17/01/2020 92.5 92.5 80 18/01/2020 97.5 97.5 91 19/01/2020 114.5 114.5 96 20/01/2020 104 104 77 21/01/2020 106 106 100 22/01/2020 87 87 96 23/01/2020 105.5 105.5 88 24/01/2020 110.5 110.5 104 25/01/2020 94.5 94.5 88 26/01/2020 92.5 92.5 85 27/01/2020 112.5 112.5 87 28/01/2020 102 102 109 29/01/2020 115.5 115.5 68 30/01/2020 100 100 118 31/01/2020 99 99 78 01/02/2020 119 119 97 02/02/2020 91 91 88 03/02/2020 91.5 91.5 93 04/02/2020 100 100 82 05/02/2020 106.5 106.5 98 06/02/2020 86.5 86.5 83 07/02/2020 111 111 96 08/02/2020 118 118 99 09/02/2020 104.5 104.5 102 10/02/2020 89.5 89.5 81 11/02/2020 107 107 96 12/02/2020 92 92 110 13/02/2020 100 100 89 14/02/2020 102.5 102.5 111 15/02/2020 102.5 102.5 98 16/02/2020 89 89 85 17/02/2020 106.5 106.5 94 18/02/2020 88.5 88.5 91 19/02/2020 97 97 98 20/02/2020 81 81 89 21/02/2020 94 94 89 22/02/2020 77 77 92 23/02/2020 93 93 79 24/02/2020 96 96 91 25/02/2020 74 74 93 26/02/2020 93.5 93.5 83 27/02/2020 100.5 100.5 109 28/02/2020 93.5 93.5 87 29/02/2020 71 01/03/2020 103 103 81 02/03/2020 87 87 93 03/03/2020 96.5 96.5 89
  • 33. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 33 Date COVID-19 Deaths Estimated Expected Deaths in Q1 and Q2 2020 Expected + COVID- 19 Actual Deaths (RIP.ie) 04/03/2020 94.5 94.5 77 05/03/2020 91.5 91.5 93 06/03/2020 101 101 99 07/03/2020 92.5 92.5 91 08/03/2020 108 108 91 09/03/2020 92.5 92.5 78 10/03/2020 101.5 101.5 93 11/03/2020 1 95 96 99 12/03/2020 78.5 78.5 92 13/03/2020 98 98 85 14/03/2020 1 93.5 94.5 95 15/03/2020 92 92 80 16/03/2020 92.5 92.5 91 17/03/2020 80.5 80.5 83 18/03/2020 80 80 72 19/03/2020 1 81.5 82.5 89 20/03/2020 90.5 90.5 89 21/03/2020 88.5 88.5 95 22/03/2020 1 86 87 92 23/03/2020 2 92.5 94.5 102 24/03/2020 1 79.5 80.5 89 25/03/2020 2 81 83 119 26/03/2020 10 80.5 90.5 108 27/03/2020 3 77 80 86 28/03/2020 14 97 111 92 29/03/2020 10 92.5 102.5 95 30/03/2020 8 86 94 104 31/03/2020 17 97 114 119 01/04/2020 14 83 97 115 02/04/2020 13 70.5 83.5 112 03/04/2020 22 85.5 107.5 128 04/04/2020 17 89 106 143 05/04/2020 21 79.5 100.5 133 06/04/2020 16 90 106 110 07/04/2020 36 92.5 128.5 157 08/04/2020 25 88.5 113.5 114 09/04/2020 28 85 113 117 10/04/2020 24 87 111 123 11/04/2020 33 86.5 119.5 143 12/04/2020 14 91.5 105.5 147 13/04/2020 31 88 119 126 14/04/2020 41 85 126 130 15/04/2020 38 72.5 110.5 116 16/04/2020 42 95 137 113 17/04/2020 44 88 132 138 18/04/2020 41 89 130 114 19/04/2020 39 96.5 135.5 93 20/04/2020 77 81 158 135 21/04/2020 43 75.5 118.5 104
  • 34. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 34 Date COVID-19 Deaths Estimated Expected Deaths in Q1 and Q2 2020 Expected + COVID- 19 Actual Deaths (RIP.ie) 22/04/2020 39 89 128 105 23/04/2020 25 86 111 112 24/04/2020 220 72.5 292.5 121 25/04/2020 49 89 138 89 26/04/2020 24 81 105 118 27/04/2020 15 79 94 117 28/04/2020 57 78.5 135.5 98 29/04/2020 31 76.5 107.5 100 30/04/2020 42 79 121 103 01/05/2020 33 68 101 95 02/05/2020 21 80.5 101.5 105 03/05/2020 17 80.5 97.5 97 04/05/2020 16 95.5 111.5 94 05/05/2020 20 72 92 92 06/05/2020 36 82.5 118.5 107 07/05/2020 28 85 113 98 08/05/2020 26 77.5 103.5 99 09/05/2020 17 91.5 108.5 96 10/05/2020 12 76 88 82 11/05/2020 9 82.5 91.5 76 12/05/2020 21 90 111 78 13/05/2020 9 73 82 100 14/05/2020 9 79.5 88.5 94 15/05/2020 12 75 87 90 16/05/2020 15 90 105 93 17/05/2020 10 80 90 92 18/05/2020 4 83.5 87.5 86 19/05/2020 14 71 85 88 20/05/2020 10 66.5 76.5 76 21/05/2020 12 88.5 100.5 69 22/05/2020 9 81.5 90.5 78 23/05/2020 12 86 98 85 24/05/2020 4 81 85 77 25/05/2020 78 78 89 26/05/2020 7 78.5 85.5 89 27/05/2020 16 89.5 105.5 68 28/05/2020 8 82 90 79 29/05/2020 6 72 78 95 30/05/2020 6 106.5 112.5 89 31/05/2020 1 89.5 90.5 79 01/06/2020 80 80 90 02/06/2020 6 70.5 76.5 84 03/06/2020 1 67.5 68.5 68 04/06/2020 5 80 85 68 05/06/2020 6 81 87 71 06/06/2020 8 70 78 73 07/06/2020 1 82 83 79 08/06/2020 4 82 86 80 09/06/2020 8 73.5 81.5 79 10/06/2020 4 81 85 81
  • 35. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 35 Date COVID-19 Deaths Estimated Expected Deaths in Q1 and Q2 2020 Expected + COVID- 19 Actual Deaths (RIP.ie) 11/06/2020 8 83.5 91.5 59 12/06/2020 2 74.5 76.5 82 13/06/2020 80 80 63 14/06/2020 1 82 83 90 15/06/2020 82.5 82.5 88 16/06/2020 3 88 91 78 17/06/2020 1 83.5 84.5 55 18/06/2020 4 80.5 84.5 84 19/06/2020 75 75 92 20/06/2020 1 75 76 78 21/06/2020 77.5 77.5 52 22/06/2020 2 73 75 70 23/06/2020 3 87 90 74 24/06/2020 6 96.5 102.5 73 25/06/2020 1 81 82 72 26/06/2020 3 78.5 81.5 64 27/06/2020 4 74 78 67 28/06/2020 1 78 79 78 29/06/2020 74 74 68 30/06/2020 1 89 90 66 1,736 16,188 17,924 17,046 This indicates a potential difference of -878 between the expected + COVID-19 recorded deaths and the actual deaths as recorded in RIP.ie. This indicates the excess deaths directly linked to COVID-19 are 859 rather than 1,736. This indicates an overall deficiency rather than an excess of deaths linked to COVID-19. Estimation Approach 2 – Age Specific Mortality Rate Estimates The information is included for the sake of completeness. This estimation approach involves applying age specific survival or mortality rates to a set of population cohorts in one interval to estimate either the size of the remaining cohort or the number of deaths at the next interval.
  • 36. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 36 Figure 27 – Applying Age Specific Survival Rates to Estimate Population Cohorts To these, you then have to add estimates of births and age-specific immigration and emigration estimates. Because of the variability of male and female mortality rates you generally split the population into its male and female components by age and apply the different male and female mortality rates. This estimate approach is complex because the underlying model has many components, many requirements and many underpinning assumptions, including: 1. You need accurate age-specific population estimates 2. You need accurate age-specific and interval-specific mortality rates – mortality rates are higher in winter ad lowest in summer 3. You need accurate estimates for births 4. You need accurate estimates of age-specific male and female immigration and emigration The first two of these are important for generating accurate estimates of deaths. The third and fourth are more important for estimating population size. As can be seen from the information on page 28 onwards, there are different age-specific population estimates. The last Irish Life Table data on page 16 on page 12onwards is based on data collected from 2010 - 2012. The previous Irish Life Table 15 was based on data collected from 2005 – 2007. Measured mortality rates reduced even in the five years between these two dates. It is likely that mortality rates have reduced further. The large number of assumptions means these models can be overengineered ad can get very inaccurate very quickly. Age Cohort Number of Males Number of Females Estimated Male Deaths Based on Irish Life Table 16 Estimated Female Deaths Based on Irish Life Table 16 Under 1 year 31,225 30,171 59.17 49.63 1 year 31,538 30,401 5.51 10.30 2 years 33,068 31,552 1.79 1.40 3 years 32,181 30,681 1.18 0.96
  • 37. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 37 Age Cohort Number of Males Number of Females Estimated Male Deaths Based on Irish Life Table 16 Estimated Female Deaths Based on Irish Life Table 16 4 years 33,063 31,368 1.36 1.04 5 years 34,358 32,465 1.76 1.24 6 years 35,072 33,475 1.96 1.21 7 years 36,468 34,828 1.98 1.00 8 years 37,046 35,726 1.82 0.88 9 years 37,281 35,538 1.61 0.84 10 years 37,097 35,389 1.45 0.89 11 years 36,754 35,125 1.39 1.00 12 years 34,619 32,761 1.42 1.11 13 years 33,434 31,798 1.75 1.34 14 years 33,303 31,139 2.61 1.66 15 years 33,023 31,833 3.85 2.15 16 years 32,769 32,073 5.38 2.69 17 years 32,596 31,885 7.17 3.20 18 years 31,964 30,901 8.97 3.51 19 years 31,942 30,945 10.90 3.69 20 years 32,072 30,756 12.72 3.58 21 years 31,986 30,905 14.14 3.39 22 years 30,047 28,976 14.21 3.02 23 years 29,089 28,260 14.17 2.96 24 years 28,341 27,711 13.73 3.22 25 years 28,578 27,706 13.31 3.90 26 years 28,510 27,739 12.37 4.14 27 years 28,686 28,815 11.46 3.53 28 years 30,399 29,857 11.78 3.48 29 years 29,152 29,804 11.60 3.81 30 years 31,414 32,339 13.00 4.64 31 years 29,736 32,070 12.84 5.16 32 years 31,156 33,814 14.07 6.07 33 years 33,582 36,389 15.90 7.28 34 years 33,934 36,373 16.90 8.10 35 years 35,149 38,385 18.45 9.49 36 years 36,696 40,395 20.36 11.06 37 years 38,186 40,998 22.45 12.42 38 years 40,469 42,284 25.26 14.14 39 years 41,477 43,009 27.56 15.86 40 years 38,247 40,375 27.12 16.40 41 years 37,775 38,751 28.64 17.31 42 years 37,033 37,887 30.09 18.58 43 years 37,554 37,930 32.76 20.41 44 years 36,802 37,512 34.55 22.13 45 years 36,077 36,798 36.52 23.77 46 years 35,711 36,109 39.06 25.53 47 years 34,527 35,056 40.88 27.11 48 years 35,005 34,953 44.94 29.54 49 years 33,364 33,459 46.54 30.90 50 years 31,833 31,515 48.32 31.79 51 years 31,133 31,472 51.51 34.67 52 years 30,717 30,794 55.49 37.04
  • 38. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 38 Age Cohort Number of Males Number of Females Estimated Male Deaths Based on Irish Life Table 16 Estimated Female Deaths Based on Irish Life Table 16 53 years 30,569 31,069 60.39 40.80 54 years 30,280 31,120 65.51 44.63 55 years 29,498 30,387 70.00 47.61 56 years 28,754 29,670 74.94 50.79 57 years 28,053 28,424 80.40 53.19 58 years 28,022 28,657 88.43 58.65 59 years 26,816 27,619 93.30 61.87 60 years 26,858 27,007 103.14 66.27 61 years 25,518 26,214 108.28 70.51 62 years 25,097 25,289 117.80 74.65 63 years 24,412 24,693 126.86 80.07 64 years 24,074 24,624 138.64 87.82 65 years 22,903 23,261 146.29 91.36 66 years 22,717 23,231 161.07 100.62 67 years 21,491 21,832 169.26 104.44 68 years 20,994 21,225 183.79 112.33 69 years 20,328 21,306 197.93 124.95 70 years 19,898 20,497 215.59 133.44 71 years 19,389 19,790 233.88 143.30 72 years 18,323 18,869 246.16 152.27 73 years 17,373 18,194 260.02 163.98 74 years 15,801 16,706 263.53 168.52 75 years 14,670 15,567 272.69 176.16 76 years 13,161 14,553 272.68 185.18 77 years 11,766 12,752 271.72 182.90 78 years 10,704 12,138 275.51 196.72 79 years 10,294 11,847 295.25 217.53 80 years 9,325 11,266 297.96 234.92 81 years 8,384 10,171 298.34 241.30 82 years 7,632 9,516 302.31 257.14 83 years 6,996 9,142 308.30 281.49 84 years 6,361 8,643 311.66 303.16 85 years 5,503 7,599 299.53 303.34 86 years 4,462 6,373 269.57 289.04 87 years 3,641 5,613 243.90 288.54 88 years 3,225 5,132 239.27 298.11 89 years 2,684 4,568 220.27 298.73 90 years 2,131 4,047 193.17 296.65 91 years 1,633 3,242 163.25 265.05 92 years 1,237 2,678 136.15 242.82 93 years 942 2,176 113.93 217.48 94 years 792 1,781 105.04 194.89 95 years 561 1,460 81.41 173.68 96 years 426 1,159 67.47 148.75 97 years 304 931 52.41 127.89 98 years 244 709 44.84 103.37 99 years and over 522 1,493 130.50 373.25 Total By Sex 2,438,006 2,483,490 9,428 8,484 Total 4,921,496 17,912 This approach generates an estimate of deaths for 2020 Q1 and Q2 of 17,912. This is an overestimate.
  • 39. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 39 This approach uses mortality data that dates from 2010-12. In the measurement intervals from 2001-03 to 2005-07 and from 2005-07 to 2010-12, life expectancy consistently improved across all age groups. Irish Life Table Measurement Interval %Age Life Expectancy Improvement at Birth Average %Age Life Expectancy Improvement Across All Ages Male Female Male Female 14 2001-03 15 2005-07 2.26% 1.62% 4.26% 3.12% 16 2010-12 2.08% 1.47% 3.12% 2.45% Cumulative Increase 4.30% 3.06% 7.74% 5.45% Based on these historical life expectancy improvements, the estimated deaths generated from the 2010-12 measurement interval mortality rates could be reduced by around 6% from 17,912 to 16,834. This is 208 deaths less than the 17,046 deaths obtained from RIP.ie data. Estimation Approach 3 – Death Rate Per 1,000 Population Estimates Using a death rate per 1,000 of the population is an easy but crude approach to estimating overall mortality numbers. The rate per 1,000 does not consider changes in the age profile of the underlying population. Different age groups have different mortality rates. If the relative proportions of the numbers for each year of age changes, the mortality profile of the population will change. Based on the population estimates shown on page 28, the average of the estimated deaths for 2020 Q1 and Q2 would be 17,161. This is close to the total deaths recorded in RIP.ie for the same interval of 17,046. Based on this approach and its implicit assumptions: • That the RIP,ie numbers of deaths are accurate • That the population estimates are accurate • That historical death rates per 1,000 of population are applicable This shows that the recorded deaths for 2020 Q1 and Q2, including COVID-19 deaths, are as expected. If we use the death rate per day per 1,000 for just 2019 as shown below: Quarter Average Death Rate Per Day Per 1,000 Population 2018 Q1 0.0789 2018 Q2 0.0670 2018 Q3 0.0652 2018 Q4 0.0674 and use the quarterly population estimates derived from CSO time series VSQ04 up to 2019Q4 (see page 28) the following estimates are generated: Quarter Estimated Quarterly Average Estimated CSO Actual Number of Difference Between COVID-19 Deaths Average Estimated RIP.ie Number of
  • 40. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 40 Population Number of Deaths Without COVID-19 Deaths Average and Actual CSO Number of Deaths Plus COVID-19 Deaths 2018 Q1 4,819,740 8,555 9,278 -723 9,229 2018 Q2 4,820,317 7,351 7,592 -241 7,310 2018 Q3 4,842,712 7,264 7,143 121 6,980 2018 Q4 4,898,621 7,593 7,103 490 7,776 2019 Q1 4,855,211 8,618 9,229 -611 8,251 2019 Q2 4,930,492 7,519 7,310 209 7,577 2019 Q3 4,905,333 7,358 6,980 378 7,014 2019 Q4 4,928,387 7,639 7,776 -137 8,388 2020 Q1 4,935,887 8,859 71 8,930 8,511 2020 Q2 4,943,387 7,539 1,665 9,204 8,535 Total for 2020 Q1 and Q2 16,397 -514 1,736 18,133 17,046 The population estimates for 2020 Q1 and 2020 Q2 are generated by simply adding the expected net births over deaths for each quarter to the estimate for 2019 Q4. This indicates a potential difference of -1,087 between the expected + COVID-19 recorded deaths and the actual deaths as recorded in RIP.ie. This indicates the excess deaths directly linked to COVID-19 are 649rather than 1,736. This indicates an overall deficiency rather than an excess of deaths linked to COVID-19. This estimate is similar to the results from estimation approach 1 on page 31.
  • 41. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 41 Appendix This appendix contains information on the following topics that relate to a lesser or greater extent to estimating mortality numbers and to the identification of patterns in excess deaths: • Tourist and Visitor Deaths • Influenza Deaths • CSO Restatement of Migration Statistics and Population Estimates Tourist and Visitor Deaths A characteristic of the COVID-19 pandemic is the reduction or effective cessation in foreign travel, both in and out of Ireland from March 2020. This in turn will lead to a reduction in deaths recorded. While deaths of Irish people abroad are not recorded as Irish deaths, there will be a (corresponding) number of deaths of foreign visitors to Ireland who would have died while visiting Ireland. Also, some of the deaths of Irish short-term visitors that would have occurred abroad will occur in Ireland. The CSO publish a number of time series that contain information of tourism numbers9. There is also an interesting paper10 on the topic of deaths of Irish civilians. This contains an analysis of 654 reports received between Jan 2016 and Apr 2018 (28-month interval) by the Consular Division of the Department of Foreign Affairs and Trade Irish civilians dying abroad. There is no breakdown in whether these deaths related to short-term Irish tourists or Irish people who may have been living abroad for a longer interval. Also, the number of deaths does not include all Irish deaths abroad. It includes just those that notified the Consular Division of the Department of Foreign Affairs and Trade. This paper estimates that “at least 25% of Irish deaths abroad can be considered preventable”. This implies that 75% of the deaths (or a proportion of them) were due to factors such as cardiovascular diseases and natural causes that may occur if those people stayed in Ireland. However, it does indicate that deaths of Irish people abroad do occur. The paper states that there over “300 bereavements of Irish citizens overseas in 2017, the highest number of deaths the DoFA had ever dealt with in a single year”. The Department of Foreign Affairs and Trade publish numbers of requests11 for assistance from Irish citizens abroad. There is no breakdown of how these relate to Irish tourists and other short-term visitors and longer-term residents. 9 See: TMQ11: Overseas Trips to and from Ireland by Trips and Quarter - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=TMQ11&PLanguage=0 and: TMQ08: Overseas Trips to and from Ireland by Reason for Journey, Quarter and Statistic - https://statbank.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=TMQ08&PLanguage=0 10 Deaths of Irish Civilians Abroad: Analysis of National Mortality Data, 2016-2018 Darrat M, Flaherty GT. Deaths of Irish civilians abroad: Analysis of National Mortality Data, 2016-2018. Int J Travel Med Glob Health. 2018;6(4):149-153. doi:10.15171/ijtmgh.2018.27 https://www.researchgate.net/publication/333224586_Deaths_of_Irish_Civilians_Abroad_Analysis_of_National_Mortality_Dat a_2016-2018 11 See https://www.dfa.ie/travel/statistics/.
  • 42. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 42 2018 2018 2018 2019 Foreign Deaths Taken from RIP.ie (see on page 19 onwards) 876 901 Department of Foreign Affairs and Trade Requests Relating to Deaths 272 250 320 292 The additional deaths in Ireland caused by Irish people staying in the country will be offset by the reduction of deaths of foreign visitors to Ireland. The following table summarises information from the CSO time series TMQ08. 2019Q1 2019Q2 2019Q3 2019Q4 Total Overseas Trips to Ireland by Non-Residents (Thousand) 2,027 3,022 3,334 2,425 10,808 Average Length of Stay by Overseas Travellers to Ireland (Nights) 6 6.5 7 6.2 Overseas Trips by Irish Residents (Thousand) 1,727 2,404 2,774 1,910 8,815 Average Length of Stay by Irish Residents on Overseas Trips (Nights) 6.4 6.8 9.1 6.5 Total Overseas Visitors Nights (Thousands) 12,162 19,643 23,338 15,035 70,178 Total Irish Visits Abroad Nights (Thousands) 11,053 16,347 25,243 12,415 65,058 Difference of Overseas and Irish Travellers 10.04% 20.16% -7.55% 21.10% 7.87% This shows that Irish travellers spent 65,058,000 nights abroad in 2019 while overseas travellers spent 70,178,000 nights in Ireland. The two numbers are roughly equal. The CSO estimate the population of Ireland in (April) 2010 was 4,921,500. Simplistically this corresponds to 1,796,347,500 people nights. So, the 65,058,000 nights spent abroad by Irish travellers represents 3.62% of the total person nights. This does not mean that 3.62% of deaths occur abroad. This would amount to 1,128 deaths. It indicates without any surprises that sick and dying people tend not to not travel abroad. There are no statistics on the number of deaths of overseas visitors to Ireland. Ireland is a safer place than many other countries with lower crime rates and other factors such as the absence of venomous wildlife. So intuitively the number of deaths of overseas visitors to Ireland should be lower than those of Irish travellers abroad. However other factors such as different age profiles of overseas visitors to Ireland and Irish visitors abroad may cancel this possible reduction. In summary, this section indicates that the absence of deaths of overseas visitors to Ireland and the possible deaths in Ireland of Irish short-term visitors abroad that would have occurred abroad could affect patterns of mortality but that it is not possible to assess the impact. Influenza Deaths Influenza is a seasonal disease that has variable mortality rates. This section examines whether these deaths can influence the overall mortality number and pattern. Details on influenza deaths for 2019-2020 can be obtained from https://www.hpsc.ie/a- z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20192020season/. Details on influenza deaths for 2018-2019 can be obtained from https://www.hpsc.ie/a- z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/previousinfluenzaseasonssurveill ancereports/20182019season/. The following table shows the number of deaths reported from influenza for the first two quarters of the years 2018 to 2020 and the deaths recorded by RIP.ie.
  • 43. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 43 Week Deaths All Deaths Week Deaths All Deaths Week Deaths All Deaths 06/01/2020 - 12/01/2020 5 714 07/01/2019 - 13/01/2019 0 693 08/01/2018 - 14/01/2018 14 811 13/01/2020 - 19/01/2020 5 659 14/01/2019 - 20/01/2019 12 640 15/01/2018 - 21/01/2018 10 814 20/01/2020 - 26/01/2020 6 638 21/01/2019 - 27/01/2019 4 698 22/01/2018 - 28/01/2018 21 716 27/01/2020 - 02/02/2020 2 645 28/01/2019 - 03/02/2019 5 687 29/01/2018 - 04/02/2018 15 751 03/02/2020 - 09/02/2020 3 653 04/02/2019 - 10/02/2019 4 687 05/02/2018 - 11/02/2018 22 747 10/02/2020 - 16/02/2020 1 670 11/02/2019 - 17/02/2019 4 676 12/02/2018 - 18/02/2018 10 699 17/02/2020 - 23/02/2020 2 632 18/02/2019 - 24/02/2019 7 588 19/02/2018 - 25/02/2018 14 656 24/02/2020 - 01/03/2020 0 615 25/02/2019 - 03/03/2019 9 635 26/02/2018 - 04/03/2018 20 684 02/03/2020 - 08/03/2020 1 633 04/03/2019 - 10/03/2019 3 640 05/03/2018 - 11/03/2018 12 718 09/03/2020 - 15/03/2020 0 622 11/03/2019 - 17/03/2019 2 592 12/03/2018 - 18/03/2018 25 665 16/03/2020 - 22/03/2020 0 611 18/03/2019 - 24/03/2019 2 566 19/03/2018 - 25/03/2018 10 622 23/03/2020 - 29/03/2020 0 691 25/03/2019 - 31/03/2019 2 601 26/03/2018 - 01/04/2018 10 625 30/03/2020 - 05/04/2020 0 854 01/04/2019 - 07/04/2019 2 546 02/04/2018 - 08/04/2018 8 632 06/04/2020 - 12/04/2020 0 911 08/04/2019 - 14/04/2019 3 630 09/04/2018 - 15/04/2018 8 592 13/04/2020 - 19/04/2020 0 830 15/04/2019 - 21/04/2019 0 583 16/04/2018 - 22/04/2018 4 612 20/04/2020 - 26/04/2020 0 784 22/04/2019 - 28/04/2019 2 572 23/04/2018 - 29/04/2018 4 576 27/04/2020 - 03/05/2020 0 715 29/04/2019 - 05/05/2019 1 562 30/04/2018 - 06/05/2018 3 542 04/05/2020 - 10/05/2020 0 668 06/05/2019 - 12/05/2019 1 637 07/05/2018 - 13/05/2018 1 514 11/05/2020 - 17/05/2020 0 623 13/05/2019 - 19/05/2019 2 578 14/05/2018 - 20/05/2018 1 529 18/05/2020 - 24/05/2020 0 559 20/05/2019 - 26/05/2019 0 564 21/05/2018 - 27/05/2018 0 574 25/05/2020 - 31/05/2020 0 588 27/05/2019 - 02/06/2019 0 612 28/05/2018 - 03/06/2018 0 562 01/06/2020 - 07/06/2020 0 533 03/06/2019 - 09/06/2019 0 537 04/06/2018 - 10/06/2018 0 542 08/06/2020 - 14/06/2020 0 534 10/06/2019 - 16/06/2019 0 578 11/06/2018 - 17/06/2018 0 549 15/06/2020 - 21/06/2020 0 527 17/06/2019 - 23/06/2019 0 616 18/06/2018 - 24/06/2018 0 507 22/06/2020 - 28/06/2020 0 498 24/06/2019 - 30/06/2019 0 555 25/06/2018 - 01/07/2018 0 582 Total Deaths 25 16,407 65 15,273 212 15,821 The recorded number of influenza deaths in 2018 was significantly higher than in 2019 and 2020. However, in the context of the total number of deaths the number is not significant. However, recorded numbers of deaths may only be a subset of the actual number of deaths. So, a larger number of recorded influenza deaths in 2018 may indicate a higher number of deaths not attributed to influenza and well as other seasonal factors. The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2018. The values for the RIP.ie deaths are show on the left vertical axis. The values for influenza deaths are shown on the right vertical axis.
  • 44. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 44 Figure 28 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2018 It is possible to identify a high degree of technical correlation between these two series with an R2 = 0.926612: y = 0.0003x=3x2 + 0.359x + 105.92 The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2019. Figure 29 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2019 As before, it is possible to identify a high degree of technical correlation between these two series with an R2 = 0.9731: y = 0.0003x=3x2 + 0.3589x + 106.77 The following chart shows the recorded influenza deaths and the deaths from RIP.ie for 2020. 12 I am always wary of high R2 values. For some good examples of amusing an spurious apparently high correlations see https://www.tylervigen.com/spurious-correlations.
  • 45. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 45 Figure 30 – RIP.ie and Influenza Deaths by Week for Jan-Jun 2020 The shows the larger number of deaths associated with COVID-19 in March, April and May 2020. Recorded influenza deaths in 2020 were low when compared with 2018 and 2018. Higher numbers of seasonal influenza deaths in2018 and 2019 show a correlation with higher numbers of all deaths in the same interval. So, rates of seasonal influenza deaths may indicate two trends: 1. Higher seasonal influenza deaths may indicate higher general seasonal death rates 2. Lower seasonal influenza deaths may indicate higher death rates later in the year CSO Restatement of Migration Statistics and Population Estimates Annual Population Estimates Revisions The CSO publish population estimates. Some of the relevant data series are: • PEA01 Population Estimates (Persons in April) by Age Group, Sex and Year13 • PEA11 Population estimates from 1926 by Single Year of Age, Sex and Year14 These datasets interpolate annual intercensal values from the quinquennial census data. They are useful in two ways: 1. The annual estimates are more granular and their analysis can be used to yield more accurate analyses. 2. They provide an insight into how the CSO produce these estimates and possible errors in their approach to this There are differences between these two series, perhaps because the two sets of data are not date-aligned. The census counts population in April. The estimates may be at the end of the year, though this is not stated. 13 http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA01 14 http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA11
  • 46. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 46 The CSO revised their annual population estimates because the 2016 census showed a population increase that was greater than the expected value from their annual estimates. The 2016 population estimate from their two series that was published in 2016 was 4,673,700. The 2016 census gave the population as 4,761,865. That is a difference of 88,165. The CSO appear to derive estimates using a dead-reckoning approach by adding births, subtracting deaths, adding estimated immigration and subtracting estimated emigration. 2012 estimate = 2011 census + births in 2011 – deaths in 2011 + immigration in 2011 – emigration in 2011 2013 estimate = 2012 estimate + births in 2012 – deaths in 2012 + immigration in 2012 – emigration in 2012 2014 estimate = 2013 estimate + births in 2013 – deaths in 2013 + immigration in 2013 – emigration in 2013 2015 estimate = 2014 estimate + births in 2014 – deaths in 2014 + immigration in 2014 – emigration in 2014 2016 estimate = 2015 estimate + births in 2015 – deaths in 2014 + immigration in 2015 – emigration in 2015 It is clear that the 2016 population estimate diverged from the actual numbers. Of the four components that comprise the estimate, the numbers of births and deaths are generally very accurate. So the reasons for the positive divergence are an underestimate of immigration or an overestimate of emigration or both. The CSO have revised their population estimates in series PEA01 for years 2012 to 2016. In general they have increased their estimates for population aged 15-39 and reduced the estimates for other age groups. In 2016, they increased the population estimates for cohorts 15-39 was 92.6 thousand. They decreased the population estimates for cohorts 0-14 by 33.7 thousand. The detail of the changes made to the annual population estimates is: Year 2012 2013 2014 2015 2016 All ages 8,300 21,600 35,800 52,400 65,900 Under 1 year -1,800 -2,600 -1,400 -3,900 -4,000 0 - 4 years -6,400 -12,700 -17,200 -23,000 -24,200 1 - 4 years -4,600 -10,100 -15,900 -19,000 -20,200 5 - 9 years 500 -100 200 -3,100 -7,900 10 - 14 years -900 -1,000 -1,300 -1,700 -1,600 15 - 19 years 5,800 9,900 11,500 12,900 13,100 20 - 24 years 7,400 20,100 32,300 42,000 46,700 25 - 29 years 300 1,800 900 8,300 14,300 30 - 34 years 1,700 3,900 4,400 5,300 9,100 35 - 39 years 900 3,000 5,000 8,300 9,400 40 - 44 years -1,100 -1,800 -700 1,200 2,000 45 - 49 years -400 -2,000 -2,300 -2,500 -1,400 50 - 54 years 0 -300 -400 -600 -1,200 55 - 59 years 0 0 400 700 1,500 60 - 64 years -100 -400 0 100 1,900 65 - 69 years 100 600 900 1,000 1,400 70 - 74 years 400 500 1,100 1,400 1,300 75 - 79 years 300 600 800 1,100 1,100 80 - 84 years 500 800 1,200 1,900 1,700 85 years and over -700 -1,400 -1,100 -1,100 -1,100
  • 47. Analysis of Possible Excess COVID-19 Deaths in Ireland From Jan 2020 to Jun 2020 Page 47 Migration Estimates Revisions The CSO also revised their estimates for numbers of emigrants and immigrants as contained in their data series PEA16 Estimated Emigration15 and PEA17 Estimated Immigration16. The revisions in the estimated emigration numbers were: Year Irish UK EU Other Nationalities Total 2012 3,200 3,200 -10,100 -400 -4,100 2013 -2,600 2,800 -8,500 600 -7,700 2014 4,300 3,100 -10,200 -4,200 -7,000 2015 7,200 1,800 -11,000 -8,900 -10,900 2016 5,300 2,600 -10,700 -7,100 -9,900 Total 17,400 13,500 -50,500 -20,000 -39,600 # Estimated migration over the five years from 2012 to 2016 was reduced by 39,600. The revisions in the estimated immigration numbers were: Year Irish UK EU Other Nationalities Total 2012 -500 1,700 -2,000 5,300 4,500 2013 6,000 -800 -1,200 2,700 6,700 2014 11,200 -700 1,800 -6,500 5,800 2015 14,500 0 700 -8,500 6,700 2016 7,300 1,400 2,600 -8,200 3,100 Total 38,500 1,600 1,900 -15,200 26,800 Estimated immigration over the five years from 2012 to 2016 was increased by 26,800. Net Migration = Immigration (PEA17) – Emigration (PEA16). The CSO revised the net migration numbers from 2012 to 2016 by 66,400. The CSO had previously estimated that net migration in the interval 2012 to 2016 was -77,400, that is, there was net emigration. This has been revised to - 11,000, a much smaller net emigration estimate. 15 PEA16 Estimated Emigration (Persons in April) by Sex, Nationality and Year - http://www.cso.ie/px/pxeirestat/statire/SelectVarVal/Define.asp?MainTable=PEA16 16 PEA17: Estimated Immigration (Persons in April) by Sex, Nationality and Year - http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=PEA17
  • 48. For more information, please contact: http://ie.linkedin.com/in/alanmcsweeney