Virtual Summit Shorts: Mental health, COVID-19 and excess mortality

Across the opening two weeks of the 2021 All-Actuaries Virtual Summit, two health-related Concurrent sessions looked to enhance the audience’s understanding of the health implications stemming from the COVID-19 pandemic, with deep dives into mental health and excess mortality.

The sessions, titled ‘Mental Health and COVID’ and ‘Excess Mortality in 2020’, each delved into how the COVID-19 pandemic and associated lockdowns will potentially affect health both now and into the future, as well as figures from the Australian Bureau of Statistics around the spikes in deaths from pneumonia, diabetes and stroke at the same time as the first wave of COVID-19 in Australia.

In ‘Mental Health and COVID’, held on Thursday 29 April, Kirsten Armstrong and Matt Dabrowski, both of Taylor Fry, explored the impact of COVID-19 on Australia’s mental health.

They led the audience through an examination of publicly available data from multiple mental health services and examined psychological distress among different groups of people and locations.

The use of mental health services has increased significantly particularly among young people, who continue to experience significantly higher levels of psychological distress compared to other groups. Among those aged 15-24 and 25-34 years, the number of mental health plans in the three quarters to December 2020 was 12% and 9% higher, respectively, than the same time in 2019.

Thus far, these higher levels of distress haven’t resulted in higher levels of suicide, and Kirsten surmised that may be because increases in suicide tend to lag economic “shocks” by 12 to 18 months. The plethora of suicide prevention services that now exist may also have played a part.  

On a state-by-state basis, in New South Wales, death by suicide was 5% lower in 2020 than in 2019, while Queensland and Victoria also recorded fewer suicide deaths.

Despite the severe lockdowns in Victoria, there has been only a 1% increase in GP mental health plans, the smallest of all the states. However, at its peak there was a 62% uptake in telehealth services in Victoria, compared to 10-20% elsewhere.

The data has revealed early warning signs that need monitoring, particularly the continuing psychological distress among young people.

‘Excess Mortality in 2020’, held on Tuesday 4 May investigated the impact of COVID-19 on mortality around the world and in Australia, and also touches on long term illness resulting from COVID-19.

Richard Lyon, Head of Actuarial (Transformation and IFRS) at TAL, examined excess mortality rates throughout the world. Australia had low COVID-19 deaths and lower overall mortality than previous years’ trends. Countries that have suffered more from COVID-19, such as Britain and the United States also had excess mortality well above the reported COVID-19 deaths. Richard surmised this could be due to both ‘missed’ COVID-19 deaths as well as more deaths from other causes.

Lockdowns and other measures introduced in Australia to control COVID-19 have reduced mortality rates from other causes, according to actuary Karen Cutter. All respiratory diseases, including the flu, have had much lower deaths than predicted as a result, and road deaths in 2020 were also lower than the previous year.

However, it is possible that some COVID-19 deaths were missed early in the pandemic when testing was less available. Deaths from mid-March through April 2020 were higher than expected, with increases reported for pneumonia, diabetes, dementia, and cerebrovascular disease.

Karen questioned whether these may in fact have been ‘missed’ COVID-19 deaths. Diabetes, dementia and cerebrovascular disease were also higher than expected in Victoria’s second wave.

Jennifer Lang, non-executive director and actuary, found that people discharged after catching COVID-19 have a much greater chance of multi-organ disfunction than the general populace.

Both presentations expressed frustration at the lags in accessing important data. Australian mortality data was three months behind most other countries in the mortality comparison, and Australia-wide hospital and suicide data for 2020 aren’t yet available. Policy-makers and stakeholders need timely data to make effective decisions and some national data sets are frustratingly slow.   

Read further Actuaries Digital coverage of the 2021 All-Actuaries Virtual Summit.

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