Social distancing isn't just for COVID

 Social distancing isn’t just for COVID-19!

Back in April, we in Pandemicia forecast that there would actually be a drop in respiratory deaths this year, because social distancing and lockdown would lessen the seasonal influenza mortality. The first results are in and the fall in deaths is more impressive than we anticipated!

There have been two important phases. As elsewhere in the world, there was an unexplained spurt in pneumonia deaths at the same time as COVID-19 deaths. Between 17 March and 14 April there were 56 COVID deaths. At the same time there were 95 pneumonia deaths more than the usual historical average. During this early, panic phase of the epidemic, there is a good chance that many of these were unrecognised COVID deaths.

During this earlier period there were also significantly more diabetes deaths than usual. From 11 February to 19 May there were 228 (19%) more diabetes deaths than usual. This is possibly because of unwillingness of sufferers to seek medical attention, as they are at high risk and might have been avoiding possible exposure. There may have also been an unrecognised COVID contribution.

 However, as Australia moved toward winter things changed. Deaths no longer rose, they fell in comparison with past years. 

From 19 May to 28 July there were 59 deaths in the second COVID ‘blister’, However, deaths from other causes began to fall – or failed to rise as they usually do in winter in Australia. During the period there were 1935 less deaths than usual – about 6%, well out of the normal range. The fall in deaths by cause is particularly interesting.

Cause of death	Deaths below average	Fall %
Ischaemic heart disease	640	18%
Cerebrovascular	236	11%
Respiratory	720	24%
Includes Pneumonia/influenza	193	30%
TOTAL	1598

Source: Calculated from “Provisional mortality statistics Jan-July 2020. Australian Bureau of Statistics.”

The 24% fall in respiratory deaths was probably due to limitations in the spread of colds and influenza during the early winter months, because of social distancing and mask-wearing. The fall in pneumonia/influenza mortality was particularly striking at 30%. The extra medical attention paid to all forms of respiratory complaints may also have affected this outcome.

Is going to work bad for you? The reduction of mortality from heart disease and strokes, while significant, does not have so obvious a cause as the reduction in respiratory deaths, but it may well be due to reduced stress due to working from home and limitations on travel.

Deaths from cancer and dementia were at normal levels during the whole period. 

How many COVID-19 deaths did Australia’s response prevent in the same period? One might compare with other countries at the same time. Australia's death rate from COVID-19 was 2.4 per million over the 10 weeks, about 60 deaths. USA and Sweden had about 160 deaths per million, while Brazil had 333 per million. A direct comparison with Sweden, where controls were minimal, would suggest there might have been 4220 COVID deaths in the period if Australia had followed their policy. If Australia had followed the chaotic path of Brazil, 8500 deaths might have occurred. 

Using the US/Swedish counterfactual, the breakdown of lives saved in the ten-week period from all causes is shown in the Figure. There are significant savings of lives from non-COVID sources, but the scale of lives saved from COVID alone is nearly triple that of other conditions, This does give the lie to claims by detractors it is ‘just another flu’.

Lives saved, 19 May to 28 July

That social distancing and partial lockdown has saved lives not just from COVID-19 but from other causes as well has not been previously observed, though it is to be expected. The gain in lives from eliminating COVID not once but twice in Australia is an ongoing blessing, of the order of 400 lives per week. The accompanying fall of about 160 deaths per week from other conditions is a welcome addition. The trend will doubtless continue in subsequent periods.