More than 70% of Australian COVID deaths had pre-existing conditions

It is known that chronic health conditions can be a risk factor for severe COVID-19, but new data released by the Australian Bureau of Statistics (ABS) has shed light on the prevalence of comorbidities among those who contracted the virus and died in Australia.
 
The report, released on 28 October, reveals that 72.7% of the 682 people who died of the coronavirus in Australia up to 31 August had at least one pre-existing chronic condition listed on their death certificate, with dementia the most common.
 
‘Among these 496 deaths, dementia was noted on 41% of death certificates, chronic cardiac conditions on 32%, diabetes on 17% and hypertension on 16%,’ Lauren Moran, Assistant Director of Mortality Statistics at the ABS, said.
 
As well as comorbidity, the data gives insight into diseases that emerged among those who died, as a consequence of COVID-19.
 
Among the 682 deaths, conditions caused by COVID-19 were reported for 366 people.
 
‘Pneumonia was the most commonly reported consequence of COVID-19, reported on 54% of those 366 death certificates,’ Ms Moran said.
 
‘Respiratory failure (16%), other infections (13%) and cardiac complications (10%) were also reported as consequences of COVID-19.’
 
The overall case fatality rate for COVID-19 in Australia as at 31 August was 2.7%, and rose to 39% for males aged over 90 years.
 
The highest number of COVID-19 deaths occurred among those aged 80–89 (294), and overall more females died (355) compared to males (327 deaths).
 
During the same period, COVID-19 was listed on an additional 18 death certificates; however, they have not been included in the total tally as the virus was not recorded as the underlying cause of death.
 
Provisional mortality statistics from 1 January to 28 July reveals that there were 579 fewer deaths from respiratory diseases, excluding COVID-19, with 6982 compared to an average of 7561 in same period between 2015 and 2019.
 
However, the five year average jumped by 153 in the four week period from 18 March to 14 April, with a total of 1044 respiratory disease deaths.
 
The weekly respiratory death rates started trending down from the week ending 21 April, with 1816 deaths between 3 June and 28 July, 704 below the average.             
 
There were 1365 deaths due to influenza and pneumonia recorded, below the 1600 average, with 42 deaths due to influenza – of which 40 occurred before 22 April.
 
Overall, between 1 January and 28 July, there were 79,878 doctor certified deaths, 288 more than the baseline average over the past five years.
 
Despite this, deaths were largely below the minimum range from 3 June and 28 July, with 1838 fewer deaths recorded compared to the 23,433 average between 2015 and 2019.
 
The data revealed a drop in ischaemic heart disease deaths, the leading cause of mortality in Australia, at 7563 compared to 8578.
 
Similarly, deaths from cerebrovascular diseases such as stroke, cerebral aneurysms and stenosis were also down at 5115 compared to 5582.
 
Among the exceptions were deaths from cancer, with 27,228 recorded compared to 26,540 over the same time period from 2015–2019.
 
The number of cancer deaths was generally higher than baseline averages until the end of May, but were been closer to the baseline average through June and July.
 
Deaths from diabetes were also up at 2740 compared to the average of 2532.
 
A total of 629 diabetes deaths occurred over the six weeks from 25 March to 5 May, 161 more than the historic average for 2015–19.
 
Deaths from dementia, including Alzheimer’s disease, also increased at 8314 from 7601. The numbers peaked over the six weeks from 18 March to 4 May, with 334 more than the historic average.
 
‘[C]ounts of deaths from dementia have increased steadily over the past 20 years. This increase should be taken into consideration when comparing 2020 counts against baseline averages,’ the report notes.
 
The analysis released by the ABS does not include coroner referred deaths, which the report highlights could impact numbers.
 
‘Any changes in patterns of coroner referral could affect counts of doctor certified deaths,’ the report states.
 
‘Some conditions have higher coroner referral rates [ischaemic heart disease, cerebrovascular diseases and to a lesser extent respiratory diseases and diabetes] so counts for those conditions would be more likely to be affected by such changes.’
 
Peak numbers of COVID-19 infections were recorded in Australia from mid-March to mid-April, and decreased through to mid-June before rising throughout June and July as infection rates in Victoria increased.
 
The ABS plans to update the report on a monthly basis to provide more insight into COVID-19 mortality during the second period of higher infection rates.
 
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