Re-emerging Indicators of Excess Mortality in Ireland

Postings to RIP.ie indicated excess mortality in northeast Laois hit double normal levels in summer—immediately prior to the county’s regional lockdown.

Gerard D McCarthy https://www.maynoothuniversity.ie/icarus/our-people/gerard-mccarthy , Rebecca L Dempsey https://www.maynoothuniversity.ie/geography/ , Amin Shoari Nejad https://www.maynoothuniversity.ie/hamilton/our-people/amin-shoari-nejad , Pádraig MacCarron https://www.ul.ie/dafinet/p%C3%A1draig-mac-carron , Andrew Parnell https://hamilton-institute.github.io/docs/
08-31-2020

At the height of the COVID-19 crisis in Ireland, the death notices website RIP.ie provided a useful, open, and near-realtime indicator of excess mortality associated with the disease. With late summer seeing a rersurgence in cases in Ireland, we ask whether postings to RIP.ie have risen in certain localities.

There is growing unease and concern in Ireland about the recent increase in cases of COVID-19 in Ireland. Three counties—Laois, Offaly, Kildare (LOK)—endured renewed lockdown, clusters have been identified in meat processing plants and Direct Provision centres, generational divisions are sharpening, with the perception that young people are flouting the rules, and, against this backdrop, schools are returning. Some consolation perhaps is that while case numbers have risen, fatalities associated with the disease are not rising at comparable levels. But could this be a false sense of security? Using postings of death notices to RIP.ie, we identify the Eircode regions that have shown high levels of posting through the summer. The highest by far is in the heart of the LOKdown counties: the Porlaoise Eircode (R32), where posts reached almost double their normal levels at the start of July.

The Portlaoise Eircode (beginning R32) experienced excess postings to RIP.ie in April 2020 when posts topped 70 in a 28-day total, almost double the normal levels of approximately 45. A second peak occurred near the start of July. This time posts topped 60, when normal levels would typically drop to below 35 for this time of year. These levels were the highest ever recorded in the Portlaoise Eircode for this time of year. The 2020 postings (solid line), previous maxima (dotted line) and mean posts (dashed line) are based on 28-day centered tallies of posts to RIP.ie.

Figure 1: The Portlaoise Eircode (beginning R32) experienced excess postings to RIP.ie in April 2020 when posts topped 70 in a 28-day total, almost double the normal levels of approximately 45. A second peak occurred near the start of July. This time posts topped 60, when normal levels would typically drop to below 35 for this time of year. These levels were the highest ever recorded in the Portlaoise Eircode for this time of year. The 2020 postings (solid line), previous maxima (dotted line) and mean posts (dashed line) are based on 28-day centered tallies of posts to RIP.ie.

Explore for yourself the number of postings to RIP.ie in your area, by using the drop-down list below:

While we note postings to RIP.ie showed peaks above previous maxima in Northwest Cavan (focused around Belturbet), West Mayo (F28, F23), Westmeath (Athlone (N37) and Mullingar(N91)), Carlow (R93, R21), Kilkenny (R95), and Dublin West (D15, K78 LUCAN, D22, D24), the question of whether these increased postings are statistically significant indicators of excess mortality is one we continue to work on. Excess postings to RIP.ie also does not mean that deaths were associated with COVID-19. However, we live in days of suspicion rather than rigour, which is why we present these findings now.

Did postings to RIP.ie increase in summer?

At a national and county level, the answer is ‘No’. National levels of posting to RIP.ie have remained at a normal level. At county level, the picture is much the same. A number of counties have shown an upturn in the numbers of notices posted. However, this upturn is in a normal range in comparison with previous recent years.

The initial spread of COVID-19 in Ireland, as elsewhere, was explosive and resulted in 11 of 26 counties in the Republic posting the highest number of death notices for any April—for 7 of these counties, April 2020 was the month with the highest postings to RIP.ie ever. The unprecedented measures introduced to combat the spread were effective and by May the tide of excess postings had ebbed.

A resurgence of the disease was always going to appear differently from this initial wave. Clusters were always likely to re-emerge and the battle against the resurgence will take the form of skirmishes, dependent on tracking and tracing. And clusters of cases have re-emerged. Most notably in Laois, Offaly, and Kildare—the counties that were locked down again during July (so-called LOKdown). A pattern of new cases stretching through Laois and Kildare along the N7/M7 emerged during the summer, with Edenderry being the centre of the Offaly outbreak—see map by David Higgins here.

We have looked at the notices posted to RIP.ie in the EirCodes of the LOKdown regions to investigate any evidence for excess postings relative to the time of year. Excess postings to RIP.ie were a potent indicator of the deadliness of COVID-19 in the first wave of the disease at county level but, given the more random and localised nature typical of a resurgence, we wanted to investigate finer scale geographies. We consider the 3-digit Eircodes as a relatable geography. These do not have much geographic fidelity, by which we mean they do not match existing administrative boundaries, such as county bounds, nor do they encompass a consistent areal or population unit. However, they are societally relateable as everyone knows (or can find) their Eircode.