Wednesday, August 31, 2022

Point of Order: Long Covid: less about health, more about politics?

Covid doesn’t grab British headlines these days. Recent coverage instead picked up on heat-related deaths from July’s scorching weather.

Shame that there wasn’t more probing into that data set. Because there was some good news. The – deep breath now – age standardised mortality rates for England and Wales in the year to date are at almost their lowest-ever level.

That seems worth a bit of celebration, even if it is what you might expect with the pandemic’s passing.

But hang on, the Financial Times’s diligent John Burn-Murdoch has been able to dig a little more out of the government statistician’s recent mortality data.

He notes that excess deaths (i.e., those which exceed historically-based expectations), which were overwhelmingly attributable to Covid during the pandemic, are now increasingly non-Covid related.

“Between July and December 2021, England recorded 24,000 more deaths than in a typical year, but only two-thirds of these could be attributed to Covid. And this year, less than half of the 10,000 excess deaths accrued since May were Covid-related. In total, there have been just over 12,000 additional non-Covid deaths across the two periods.”

Astute readers will no doubt be struggling to reconcile low and falling mortality rates with continuing excess deaths. Among other things, it might have something to do with using the best years for the baseline.

Burn-Murdoch is particularly interested in the possible correlation between non-Covid excess deaths with growing A & E waiting times.

All seems to be going well, until he leaps – perhaps a little too quickly – to a familiar villain, namely the government’s “… failure to address the failings of a chronically under-resourced and overburdened system”.

To be sure, the Socialist Worker was fulsome in its praise. And quick to argue for strikes in Britain’s National Health Service as a final solution to the excess-death problem (this might be sounding a little more relevant to New Zealand readers).

But really, has there ever been a time when a free health system has not been “chronically under-resourced” and overburdened by its patients.

Before drawing a single striking conclusion from statistically-based calculations during an abnormal public health event with data attribution challenges, it might just be sensible to look a little more closely at the flexibility of the health system’s response in switching resources during and after the pandemic; and examining just how much of the continuing excess mortality is due to the delay and even cancellation of other treatments during the pandemic. Burn-Murdoch has an honourable record in this line of work.

It might be that the health business is one of many in which degraded service quality is symptomatic of policy-driven lack of flexibility and loss of productivity.

Which would have worrying implications for everyone.

In times of rising living standards – like those pre-Covid years – we all too easily forget that this benign state of affairs depends on us all getting more productive in our job; or, if we don’t, losing it and getting another; and then making sure our children get even more productive jobs than we had.

In most places, it seems to be dawning that something went wrong with this during the pandemic.

The next shoe to drop is that adjustment to the new reality is necessary. And it’s not feasible in the long run for the government to pay us for work we have not done and compensate us for changes we need to tackle ourselves.

Sadly, Burn-Murdoch’s article also reminds us that no government has had much success applying this analysis to the health sector. Even so, the gradations of failure are quite important.

New Zealanders facing some whopping price / quality adjustments (for example, those desperate to get out of the country) might also wonder if their government has been slower than most in twigging the need for adjustment. Better hope the Ukraine war does good things for commodity prices to support the always “chronically under-resourced” health system.

Point of Order is a blog focused on politics and the economy run by veteran newspaper reporters Bob Edlin and Ian Templeton

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