Early COVID-19 deaths may have been listed as pneumonia, diabetes, stroke

Hundreds of coronavirus deaths in Australia's first wave of the pandemic may have been attributed to strokes, diabetes, pneumonia, flu and dementia due to limited testing.

Modelling by the Actuaries Institute shows there were more than 500 unexpected deaths in March and April, with researchers suggesting many of them could have been from undetected COVID-19. The figures have fuelled speculation coronavirus may have been circulating in the community in higher numbers than first thought.

Coronavirus testing in the four weeks from March 17 in Australia was limited.Credit:Kate Geraghty

The institute's COVID-19 working group, an army of 80 volunteer boffins that produces reports on the pandemic's effect on industries such as health and life insurance, analysed Australian Bureau of Statistics data and found the higher than expected number of deaths was "not explained by official COVID-19 deaths".

Only 56 COVID-19 deaths were recorded over the four weeks from March 17.

Jennifer Lang, convener of the working group, said it was "statistically plausible" that the true figure was two to three times higher.

Deaths from influenza and pneumonia were "significantly higher than predicted" over the four-week period, the group's report said, while noting COVID-19 "often presents as similar to pneumonia" and testing during this phase of the pandemic in Australia was limited.

"While we cannot be definitive, we expect that more people probably died because of COVID-19 during the first wave of cases (in March and April) than was reported at the time," the report said. "This is likely to be because those people were not tested for COVID-19 so the cause of their illnesses was not known at the time.

"Some of these extra deaths were probably reported as pneumonia, diabetes and possibly stroke, as deaths from these causes were higher than expected during that period and all of these causes of death are related to COVID-19 in some way."

The researchers noted deaths from dementia were also high during the period.

"We wonder whether some of these are also undetected COVID-19 deaths," the report said.



The actuarial modelling, which allowed for improved mortality trends and population growth and ageing, was based on ABS data on doctor-certified deaths. The modelling predicted death rates in 2020 would be lower than the 2015-19 average. There have been 832 COVID-19 deaths in Australia to date.

"Actual deaths this year have been broadly as expected based on our modelling except for the period mid-March to mid-April," Ms Lang said.

For six weeks from March 24, deaths from diabetes – known to be a co-morbidity of COVID-19 – were significantly higher than predicted, the report said, while deaths from strokes and brain haemorrhage spiked over the three-week period from March 31. This may have been linked to a fall in brain scans when hospital presentations declined, it said, although stroke was also a known complication of COVID-19.

Ms Lang said it was pleasing to see no increase in the number of suicides in Victoria, the only state
subject to a lockdown in the second wave, but that experts considered suicide risk could increase with "cumulative effects of stressors" and the pandemic's impact "may yet be seen".

She said future deaths from some causes, such as cancer, might be higher than usual due to delayed diagnoses or missed treatments.

Numbers to call for support: Lifeline 13 11 14; Mensline 1300 789 978; Kids Helpline 1800 551 800; beyondblue 1300 224 636.

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