Not good, not terrible? - More on Hungary's excess mortality

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Excess mortality in Hungary was over 55% in March 2021 relative to March 2019. The Central Statistical Office (KSH) has revised mortality statistics twice for the first 13 weeks of this year, which resulted in 733 more deaths. And upward revisions are not over. A deeper look into mortality statistics, in which we compare apples to apples.
A közmunkások verhetik be az utolsó szöget a nyugdíjrendszer koporsójába

Balázs Pártos co-authored this analysis.

As Hungary has been leading the world rankings for weeks in terms of COVID-19 deaths per one million population (3,005 as of 13 May), the government - in a bid to somehow mask or show in a better light the absolutely dreadful mortality statistics - has shifted the focus of its pandemic-related rhetoric (besides the huge success of its vaccination campaign) to excess mortality, saying that it did not reach even 10% last year, coming in below the EU average. Well, it depends on how you look at it.

Let’s take a brief look at excess mortality in 2020.

  • 2020 vs. 2015-2019 average: 143,161 – 131,357 = 11,804 (8.98%)
  • 2020 vs. 2019: 143,161 – 129,275 = 13,886 (10.74%).
  • In the middle of 2020, on the 33rd week (summer), 2020 mortality was 3,398 people behind the 2015-2019 average.
  • 3,398 + 13,886 = 17,284, which means 17,284 more people died in the second half of 2020 than the five-year average.
  • (17,284 / 129,275) x 100 = 13.37%. This is last year’s excess mortality over 2019 we chalk up to COVID-19 (directly or indirectly). And revisions are to ensue.

And here's the above findings on charts (click to enlarge):

210514excess

Before delving into specifics and comparing shorter periods in the pandemic rather than the whole of 2020 to previous years or five-year averages, here's a taste of what you should prepare to see. A weekly breakdown of excess mortality rates. You don't find many ten percents, do you?

210513plot02f

Unfortunately, all we have are mind-boggling numbers, but bear with us.

First, let's take a look only at 2021. And narrow our focus even more only to March, and a bit later to just the first 13 weeks (up to 4 April). The Central Statistical Office (KSH) has published (preliminary!) mortality data up to the 15th week already (up to 18 April), but it has carried out two revisions up to week 13. That's part of the story here. Here we go.

  • 16,018 people have died in Hungary in weeks 10-13 (March 8-Apr 4) this year. Since 27 April, this marks an upward revision of 473. The stats office will keep revising the figures for months and the final data could be higher by up to 2,000.
  • 10,574 people died in weeks 10-13 (March 2-29) in 2020
  • 10,336 people died in weeks 10-13 (March 4-31) in 2019
  • 10,747 people died in weeks 10-13 in 2015-2019 (average).

Excess mortality in weeks 10-13 in Hungary was:

  • 5,444 people (+51.5%) relative to 2020
  • 5,692 people (+55.1%) relative to 2019
  • 5,271 people (+49.0%) relative to 2015-2019 average

Methodological note: Weeks 10 to 13 spanned between March 4-31 in 2019, March 2-29 in 2020 and March 8-April 4 in 2021. If we make an adjustment for this year and compare previous deaths stats of weeks 10-13 with weeks 9-12 (March 1-28) this year, excess mortality changes to 43.9% over 2020, 47.4% for 2019, and to 41.6% for the 2015-19 average.

What do the tables show us? A deadly March.

The upper section (green header) shows data for separate weeks: the number of deaths in 2021; the weekly differences over 202, 2019 and the average of 2015-19; and the ratios of the differences where the annual difference (for 2020, 2019 and 2015-19) is divided by the total weekly deaths of the given (base) year, not 2021. (It would have made no sense to compare 2021 to 2016-2020 because last year’s data would cause quite a distortion due to the coronavirus pandemic. Hence the comparison to 2015-19.)

The lower section (blue header) shows accumulated figures, i.e. the second week shows deaths for the second AND first weeks, the third for the 3rd, 2nd and 1st, etc. This is why the total on week 13 is the same in both tables.

210513excess01table
210513excess02table

March already stands out in terms of excess mortality, but these are preliminary data and the KSH will continue to revise them and always upwardly. (April will be even worse.) Also note that weeks 10 to 13 do not cover the same days in 2021 as before (see methodological note above).

Excess mortality for weeks 12 and 13 were over 50% and 60%, respectively, compared to the same weeks of 2020, while it was over 70% relative to the same weeks of 2019 and over 60% compared to the 2015-19 average of the same two weeks.

After the upward revisions (which could reach up to 700 per day or 4,500 to 5,000 per week when finalised) excess mortality could go as high as 70 to 80% on even more weeks.

Okay, this one deserves a breakdown, so here it is (estimates): 250 dead (unrelated to COVID-19) + 300 dead in hospitals (with positive PCR tests) + 100 dead in hospitals (without PCR tests), 50-100 dead at home = 700-750 dead per day, cc. 4,900 dead per week. We’re currently at 4,228 in March, and it will be revised upwardly to around 4,400 to 4,500. And April will be worse.

As you can see, the stats office revised the number of deaths for March upwardly by 473 in just two steps.

The upward revision for the first 13 weeks totalled 733, with 358 on the previous week and 375 this week.

Excess mortality reached 24.9% in the first 13 weeks over the same period of 2020.

Preliminary data up to the 15th week (with a revision for week 14) shows 26.3% excess mortality over 2020.

The table below shows the revisions carried out by the KSH since 27 April.

Plot twist No.1

When the government emphasises that excess mortality did not reach even 10% last year and that it was below EU average, well..., it depends on how you look at it.

The cabinet is right but only if we compare January-December 2020 data to the 2015-2019 average. The picture becomes totally different, though, if we compare more relevant periods, i.e. between 1 April 2020 and 1 April 2021 (Hungary had the coronavirus outbreak in mid-March last year), or the 2nd and 3rd ‘waves’ in the pandemic.

Firstly, a period of 53 weeks has been put in the spotlight, in accordance with the stats office's weekly breakdown.

The periods under review span between the 13th or 14th week of the given year and the 14th or 15th week of the following year.

In the following you find the total number of deaths and excess mortality in 2020-21 (constantly revised upwardly by the stats office) in absolute terms and in relative terms compared to the same periods of various years and the 2015-16 – 2019-20 average.

The table and charts show 15-18% excess mortality compared to the last few years and the five-year average. In absolute terms we’re talking about 20,000 to 23,000 more deaths.

These ratios (15-18%) are about double of what the government likes to refer to (9%) when it addresses excess mortality and also more relevant.

210513plot1table
210513plot01b
210513plot01c
210513plot01D

Plot twist No.2

And now about the second plot twist, in which we compared not a full year but only the periods of the 2nd and 3rd ’waves’ in the pandemic with the same periods of the preceding years and a five-year average.

These periods go from the 40th or the 41st week of one year to the 13th or 14th week of the next, encompassing 26 weeks. KSH revisions will take the 2021 figures higher.

If we started this article with a list of shocking figures, we should close it up with a similar list, only this time it’s a different period under review (see above) and it’s shown in a table.

210513plot02a

As you can see, excess mortality was over 35% compared to 2019-2020 and over 38% compared to 2015-2016.

Relative to the five-year average of the same period in 2015/16 – 2019/20 excess mortality was almost 30%.

As shown in the tables above, on some weeks excess mortality exceeded 70% in March, and we are likely to see figures around or over 80% in April, not to mention that the statistics for March will keep worsening due to the revisions.

Put simply, excess mortality in Hungary during the pandemic is expected to reach 35-40%, with weeks, or possibly even a full month with readings of 70 to 80%.

In annual terms, this would correspond to 45,000 to 50,000 more deaths, or – in case the retreat of the pandemic stops or reverses (new and more infectious and more deadly variants, premature re-opening, inferior results in the vaccination campaign, required herd immunity threshold not reached, etc.) Hungary might end up losing 80,000 to 90,000 more people than in ‘peacetime’.

These tables and charts, containing exclusively official KSH data, are eye-opening and rather sobering in themselves (find more of them below), but it’s worth stressing that these are only the ‘current’ deaths. There are also those people that – as the whole health care system has been under immense pressure to cope with COVID-19 – failed to get diagnosed in time, as screenings were put on hold, who were left untreated or missed crucial surgeries. Their quality of life will certainly be worse than it would have been without the pandemic.

This has and still is creating long-lasting problems not only for individuals but also for the health care system, the society, and the entire economy for years or possibly even decades to come.

And then there are the doctors, nurses, paramedics, laboratory technicians, GPs and anyone that contributed to the day-to-day struggle during the pandemic whose physical and emotional stress would definitely need to be addressed. They are the backbone of the health care system that must be kept healthy for the system as a whole to function properly.

Here are the final shocking charts showing excess mortality in Hungary for 26 weeks, the 2nd and 3rd 'waves' of the pandemic between the 40th or the 41st week of one year to the 13th or 14th week of the next.

210513plot02b
210513plot02c
210513plot02d
210513plot02e
210513plot02f

Balázs Pártos co-authored this analysis.

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