Undermines belief that excess mortality is due to unavailability of services: Mortality rates have risen primarily due to COVID-19

Specialists and members of Seimas discussed this at a meeting of the Seimas Health Affairs Committee (SSC) on Wednesday.

Government data analyst Aistis Šimaitis pointed out that the increase in mortality of Lithuanians last year is mainly related to the number of COVID-19 cases.

“As the COVID-19 case curve increased, so did mortality. <...> As the number of cases increased, so did the number of deaths, and so did the number of deaths, ”he noted.

Although the management of the COVID-19 pandemic has reduced access to other medical services and resulted in a surplus of other deaths, it is said to be less significant and the increase in mortality is mainly due to coronavirus infection.

The excess deaths were mainly due to COVID-19.

A. Šimaitis explained that deaths related to a pandemic are defined in two ways: those deaths whose direct cause is indicated as COVID-19, and deaths related to the coronavirus. In the second case, a positive case of coronavirus is confirmed in the deceased, but he dies from comorbidities.

As the COVID-19 case curve increased, so did mortality.

Not as many other deaths were reported.

“A positive COVID-19 diagnosis accelerates human death, whether or not it is directly caused,” the analyst said.

Another aspect related to the coronavirus is the decrease in the availability of services, but we will see the consequences later, said A. Šimaitis.

“When there are high cases of COVID-19, the resuscitation beds are occupied and in fact, you have to place the assistance scheduled for operations because there is nowhere to put the patients.

When we stopped all medical services in the spring, elective surgery was stopped for a couple of months, then gradually recovered, but the real effect was seen in the fall because there was no decision to suspend health services, the government encouraged people to request health All autumn and winter services, but we see by the number of COVID-19 cases, those services coincided, “said the specialist.

According to him, in this case, the psychological factor of the people also works, they do not necessarily want to go to medical institutions themselves.

However, the risk of dying from a coronavirus is greater than that of dying without medical care.

“The chance of dying doubles if it was you who had a positive coronavirus test,” he said, according to an analysis by other institutions.

“Only 10-15%. People in Lithuania were infected with COVID-19. If the lack of medical care during that period were the cause of their deaths, we would probably see an excess mortality between 5 and 7 times higher than now, because the people who did not have covid He also did not receive medical services, “he said.

The chance of dying doubles if you were the person who had a positive coronavirus test.

“Failure to provide services will have consequences, but it seems that we have not seen those consequences yet, we will see them in the future. Šimaitis.

We are not very different from other countries.

Professor Vytautas Kasiulevičius, Vice Dean of the Vilnius University (VU) Medical Faculty, spoke in committee that we do not stand out from other countries in the context of excessive deaths.

“There is an excellent review from the third Oxford Evidence-Based Medical Center in March, which looked at excess mortality and standardized 100,000. population in a week, we can see that the surpluses of those countries that have roughly the same number of registered COVID-19 cases for 2020 are quite similar.

For example, the Netherlands is a country where the number of cases per million inhabitants is similar to that of Lithuania. Here, the weekly surplus is 5.4 percent, and in the Netherlands it is 7.2 percent, in Israel, which also has a similar number, 6.5 percent, ”commented V. Kassievievičius.

According to him, similar indicators are found in other countries of the European Union (EU): Poland, Slovenia, Slovakia, the Czech Republic, Croatia and others.

Furthermore, he said, in countries that were quarantined throughout the year, such as Australia, there were fewer than 5,000 deaths per year and 2,000 in New Zealand.

“We didn’t have that kind of quarantine, we had quarantine episodes and it was very mild compared to those countries. But for both, it is up to politicians to constantly politicize and escalate that issue. They will continue to do so because it has to do with the votes of the electorate, ”said the doctor.

Here the weekly surplus is 5.4 per cent, while in the Netherlands it is 7.2 per cent.

According to him, even if all the specialists had worked only “live” all the time, the residents themselves would not have appeared in medical institutions.

“Probably some of those patients would not have come because we have seen the whole half year, the flow of patients has decreased so much that they did not reach the prevention programs, we can blame the GPs for not doing something in the prevention programs, but physically those patients were not, they did not, they agreed to speak on the phone, “said V. Kasiulevičius.

Some exacerbate the situation artificially

Odeta Vitkūnienė, director of the Department of Personal Health of the Ministry of Health (SAM) reached a similar conclusion.

According to her, the most threatening at the moment is the coronavirus, which still needs to be fought.

Of 4 thousand. More than half of the excess deaths in 2021 were caused by the coronavirus, while other deaths were related to diseases of the heart and circulatory system, as well as the digestive system.

“It just came to our knowledge then kovidas it resulted in us dying excessively. The main objective remains to continue the fight against the epidemic, ”said O. Vitkūnienė at the committee meeting.

When talking about the research, Romualdas Gurevičius, head of the Health Information Center of the Institute of Hygiene, pointed out that the institutions or analysts that calculate excess deaths often use different methodologies, so there is a risk that the results are not identical .

“Some use a different methodology to artificially worsen this indicator because they choose the basis of comparison for one year, that is, 2019, when there was the lowest number of deaths, <...> You get fifteen hundred more excess deaths.

Therefore, great care must be taken when comparing data from different researchers. “We suggest that you should not be able to manipulate the statistics, select and compare at least a three-year average of what Eurostat compares,” he said.

The availability of services is increasing

According to O.Vitkūnienė, the proportion of remote and direct services is improving this year, remote services are mainly provided to coronavirus infected patients who are sick at home.

According to her, the level of provision of primary services for diseases of the circulatory system in 2019 is almost reached in 2019. In March, the number of visits to family doctors by cancer patients increased and exceeded the number in 2019

“And with the hospital, there is also a trend of improvement due to the efforts of all participants in the health system,” he said.

Conservative member Jurgita Sėjonienė said that during the first quarantine, artificially limited scheduled services were still negatively evaluated.

“I don’t think it has added any benefit to either patients or health facilities, and I’m glad it doesn’t apply,” the politician said.

He was also pleased that recent studies have allayed fears that COVID-19 is less dangerous and that the death toll is due only to unavailability of services.