Provisional Mortality Statistics

Provisional deaths data for measuring changes in patterns of mortality during the COVID-19 pandemic and recovery period

• 33,066 doctor certified deaths occurred between 1 January 2020 and 31 March 2020 and were registered by 30 April.
• An average of 32,249 deaths occurred over this same time period between 2015 and 2019.
• The week ending 31 March 2020 had the highest number of recorded deaths of all weeks in the first quarter of the year, at 2,649.
• The highest numbers of deaths from respiratory diseases, diabetes and dementia were also recorded in the week ending 31 March 2020.
   

The data in this report provide an early indication of the pattern of mortality for 2020. However, there are many factors that may influence counts of deaths on a week to week basis, so deviations from baseline counts for individual weeks should be treated with caution. Complete analysis of mortality data is only possible when all death records (both coroner and doctor) are received, processed and analysed.

This report will be updated monthly throughout 2020. The next report will include deaths that occurred up until the end of April and were registered by the end of May.

Mortality data relating to the COVID-19 pandemic has so far focussed on deaths due to the virus. This information has been collected through disease surveillance systems within health departments and provides a measure of the direct burden of the pandemic from a mortality perspective.

Examining mortality data across a broader range of causes provides a more comprehensive view of the impact of the pandemic on public health. This can give an indication of where ‘excess’ mortality might occur beyond deaths directly from COVID-19.

Excess mortality is an epidemiological concept typically defined as the difference between the observed number of deaths in a specified time period and the expected numbers of deaths in that same time period. Estimates of excess deaths can provide information about the burden of mortality potentially related to the COVID-19 pandemic, including deaths that are directly or indirectly attributed to COVID-19.

Throughout this report, counts of deaths for 2020 are compared to an average number of deaths recorded over the past 5 years (2015-2019). These average or baseline counts serve as a proxy for the expected number of deaths, so comparisons against baseline counts can provide an indication of excess mortality. Minimum and maximum counts from 2015-19 are also included to provide an indication of the range of previous counts.

Note: The World Health Organization declared COVID-19 to be a pandemic on 11 March 2020. In Australia, numbers of new infections began to increase in late February, with the highest numbers of daily new cases recorded in late March and early April.

• 33,066 doctor certified deaths occurred between 1 January 2020 and 31 March 2020 and were registered by 30 April. This compares to a baseline average of 32,249 over the past 5 years.
• The week ending 31 March 2020 had the highest number of recorded deaths during this period, at 2,649.
• The baseline average for that week was 2,526 while the highest number recorded during the last 5 years was 2,636.
• The number of deaths occurring in the first quarter of 2020 was above the average baseline for all weeks, but exceeded the maximum recorded over the past 5 years only in weeks 4 and 13.
   

Note: This analysis does not include coroner referred deaths. Any changes in patterns of coroner referral could affect counts of doctor certified deaths. 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.

The graph below shows the number of provisional doctor certified deaths that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows the number of deaths is above the 5 year average for all weeks of the first quarter in 2020. The graph shows in the week ending January 28 and the week ending March 31 the number of deaths was above the maximum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Ischaemic heart disease is the leading cause of death in Australia. The category includes acute conditions such as myocardial infarction and chronic conditions such as coronary atherosclerosis.

• 3,020 deaths occurred from ischaemic heart disease between 1 January 2020 to 31 March 2020.
• The average number of deaths recorded for the same period between 2015 and 2019 was 3,369.
• Apart from the week ending February 18, ischaemic heart disease is below the five year average for the first quarter of 2020.
• Deaths from ischaemic heart disease have been decreasing in Australia for many years.
   

The graph below shows the number of provisional doctor certified deaths due to ischaemic heart diseases that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows the number of ischaemic heart disease deaths is below the 5 year average for all weeks of the first quarter in 2020 except in the week ending February 18 where deaths were slightly above the 5 year maximum. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Cerebrovascular diseases refers to a number of conditions such as stroke, cerebral aneurysms and stenosis that affect blood flow and circulation to the brain.

• 2,013 deaths from cerebrovascular diseases (including strokes) occurred between 1 January and 31 March 2020.
• The average number of deaths recorded for the same period between 2015 and 2019 was 2,245.
• Numbers of deaths due to stroke in 2020 were lower than the baseline averages in all weeks, except for the week ending 11 February.
• Deaths from cerebrovascular diseases have been decreasing over many years.
   

The graph below shows the number of provisional doctor certified deaths due to cerebrovascular diseases that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows the number of cerebrovascular disease deaths is below the 5 year average for all weeks of the first quarter in 2020 except in the week ending February 11 where deaths were slightly above the 5 year average. In the majority of weeks, deaths due to cerebrovascular are below the minimum range for the last five years. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Respiratory diseases include causes of death such as pneumonia, influenza, and chronic lower respiratory diseases (including emphysema and chronic bronchitis). Deaths due to COVID-19 are not included in this category.

• 2,989 deaths from respiratory diseases occurred between 1 January 2020 to 31 March 2020.
• The average number of deaths for the same period between 2015 and 2019 was 2,792.
• Deaths from some respiratory diseases can follow seasonal patterns. These seasonal patterns can vary both in timing and magnitude. This should be considered when comparing counts for 2020 against averages from previous years.
• The week with the highest count of respiratory disease deaths was the week ending 31 March 2020 with 270 deaths.
   

The graph below shows the number of provisional doctor certified deaths due to respiratory diseases that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows the number of respiratory disease deaths fluctuates for the first quarter of 2020 when compared with the five year average. The graph shows in weeks ending 21 January, 24 February, 3, 24 and 31 March the number of respiratory disease deaths are shown to be above the maximum range. In the week ending 11 February it is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Chronic lower respiratory diseases include chronic bronchitis, emphysema, asthma and chronic obstructive pulmonary diseases (COPD). Chronic lower respiratory diseases are a sub-group of respiratory diseases (J00-J99).

• 1,653 deaths from chronic lower respiratory diseases occurred between 1 January to 31 March 2020.
• This average of number of deaths for the same period from 2015 to 2019 was 1,561.
   

The graph below shows the number of provisional doctor certified deaths due to chronic lower respiratory diseases that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows the number of chronic lower respiratory disease deaths fluctuates for the first quarter of 2020 when compared with the five year average. In weeks ending 4 February, 18 February and 3 March number of deaths are shown to be above the maximum range. In the weeks ending 28 January and 11 February it is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Influenza and pneumonia are acute respiratory diseases often grouped together when compiling leading causes of death. They are two distinct diseases: Influenza is a viral infection, while pneumonia can be caused by a virus, bacteria or fungi. Influenza is a common cause of pneumonia. Influenza deaths are highly seasonal and most commonly occur in Australia between the months of May and September. The timing, length and severity of the influenza season varies considerably from year to year. Influenza and pneumonia are a subset of respiratory diseases (J00-J99).

• 581 deaths due to influenza and pneumonia occurred between 1 January to 31 March 2020.
• The average number of deaths recorded over the same period from 2015 to 2019 was 538.
• The highest number of deaths recorded over this period was 76 for the week ending 31 March 2020.
• The increase in the number of deaths in the week ending 31 March is attributable to an increase in pneumonia deaths rather than influenza. Influenza deaths in the first quarter of the year have been low and stable over time.
   

The graph below shows the number of provisional doctor certified deaths due to influenza and pneumonia that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows that the number of influenza and pneumonia deaths is relatively stable against the baseline for the first 8 weeks of the year. The graph shows in the weeks ending 3 March, 24 March and 31 March 2020 the number of deaths are shown to be above the maximum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Cancer is the rapid growth and multiplication of abnormal cells, which can then spread to surrounding body parts and organs. Cancer includes malignant neoplasms encompassing carcinomas, sarcomas and lymph and blood cancers.

• 11,646 deaths from cancer occurred between 1 January and 31 March 2020.
• The average number of deaths for the same time period from 2015-2019 was 11,404.
   

The graph below shows the number of provisional doctor certified deaths due to cancers that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows that the number of deaths due to cancer fluctuates for the first quarter of 2020 when compared with the five year average. The graph shows in weeks ending 18 February and 25 February the number of deaths are shown to be above the maximum range for the last five years. In the week ending 10 March it is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Diabetes includes both Type 1 diabetes and Type 2 diabetes. The majority of diabetes deaths are from Type 2 diabetes.

• 1,056 deaths from diabetes occurred between 1 January to 31 March 2020.
• The average number of deaths over the same period from 2015 and 2019 was 1,012.
• The week with the highest number of diabetes deaths in 2020 was the week ending 31 March with 99 deaths recorded.
   

The graph below shows the number of provisional doctor certified deaths due to diabetes that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows that the number of diabetes deaths is relatively stable against the baseline between weeks 4 and 12 of the year. The graph shows in the weeks ending 7 January, 25 February and 31 March 2020 the number of deaths due to diabetes are shown to be above the maximum range. The graph shows in the weeks ending 14 January and 21 January number of deaths due to diabetes in 2020 is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Dementia, including Alzheimer disease, is the second leading cause of death in Australia and counts 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.

• 3,474 deaths from Dementia, including Alzheimer disease occurred between 1 January and 31 March 2020.
• The average number of deaths for the same period from 2015 to 2019 was 2,979.
• The week with the highest number of dementia deaths was the week ending 31 March 2020.
• Deaths due to dementia were above the five year average for all weeks in the first quarter of 2020.
   

The graph below shows the number of provisional doctor certified deaths due to dementia including Alzheimer's disease that occurred on a weekly basis in the first quarter of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is also presented as a shaded outline. The graph shows that the number of deaths in 2020 due to dementia including Alzheimer disease was above the maximum range for the last five years in every week except the weeks ending 18 February and 17 March. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Each death registration in the national mortality dataset has 3 dates:

• The date on which the death occurred.
• The date on which the death was registered with the jurisdictional Registry of Births Deaths and Marriages (RBDM).
• The date on which the death was lodged with the ABS.
   

The time between the occurrence of a death and registration can vary although in general deaths certified by a doctor are registered sooner. Coroner certified deaths undergo extensive investigative processes which can delay registration times, and for this reason they are excluded from the provisional mortality reports.

When looking to measure change over time, the completeness of data for the most recent period is important. When data are received each month by the ABS, the lag between the date of death and date of registration means that only 40-50% of those registrations are deaths that occurred in the month being reported. The remainder are deaths that occurred in earlier months. After a second month of reporting, approximately 95% of doctor certified registrations have been received. This is considered sufficiently complete to enable meaningful comparison with historic counts.

This pattern of registration and reporting is highlighted in the table below, which also shows the slight variation in reporting timelines by cause of death. This should be considered when comparing 2020 data to the 2015-2019 baseline data.

Updates to this report will be released on a monthly basis. Tracking of all doctor certified deaths and deaths by specified causes will continue throughout 2020.

Each new report will include those deaths that have been registered and reported to the ABS since the previous report. As some of those deaths will have occurred in time periods covered in previous reports, the counts of deaths for those time periods will change from one report to the next.

Numbers cannot be aggregated across months to calculate a quarter or annual number as some deaths may not be registered until more than 3 months after the end of the reference period.