Explaining Late Excess Death

Post #628

Late excess death is here defined as death that occurred after Omicron variant became predominant. It’s special because Omicron variant is only up to 20% as lethal as original COVID. Omicron variant is even less lethal than flu.

But check out the accumulation of excess death in Hong Kong and Taiwan:

In Taiwan, in the 335 days from 30 Apr 2022 to 31 Mar 2023, there was an accumulation of 1,293 excess deaths per millon (average daily excess of 3.9 per million). But because it takes at least 1,518 cases to get one death (age 60-69 group), then that means that, at minimum, 196% of Taiwan got COVID during those days.

To explain Hong Kong’s excess death with COVID infections requires that, within those short 89 days from 31 Jan 2020 to 30 Apr 2022, there were 2.14 COVID infections per person (a 214% infection rate — i.e., almost 100% per month).

Not even measles (Basic Reproduction Number: 12 to 18) can cause 100% infection incidence in a large population inside of 1.5 months.

But evidence from Denmark reveals that only about 66% of people end up getting Omicron variant COVID infections over a span of 4 months of time. If only 66% catch it, but you need 214% of everyone to catch it, then something is amiss.

Trying to explain Hong Kong’s excess death by way of COVID is a fool’s errand.

Even Taiwan’s experience is outside of the historic bounds set by epidemiology — i.e., no prior infectious disease led to that much of a consistent accrual of excess death for that long of a time window — and all from a variant (Omicron) whose lethality is less than flu.

Reference

[excess deaths per million] — OWID. https://ourworldindata.org/grapher/cumulative-excess-deaths-per-million-covid

[original COVID IFR for those of age 60-69 was 0.5%] — Pezzullo AM, Axfors C, Contopoulos-Ioannidis DG, Apostolatos A, Ioannidis JPA. Age-stratified infection fatality rate of COVID-19 in the non-elderly population. Environ Res. 2023 Jan 1;216(Pt 3):114655. doi: 10.1016/j.envres.2022.114655. Epub 2022 Oct 28. PMID: 36341800; PMCID: PMC9613797. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613797/

[Omicron is up to 20% as lethal] — Differences in case-fatality-rate of emerging SARS-CoV-2 variants. Public Health in Practice. Volume 5, June 2023, 100350. https://doi.org/10.1016/j.puhip.2022.100350

[With Omicron predominance, up to 66% of people are capable of catching COVID] — https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00175-2/fulltext

[up to 90% of people are capable of catching measles] — https://www.emro.who.int/health-topics/measles/disease-and-epidemiology.html