Deaths due to COVID-19, influenza and RSV in Australia - 2022 - September 2024

The ABS have reported extensively on deaths involving COVID-19 during the pandemic. The ABS mortality data is sourced from the Registry of Births, Deaths and Marriages and is separate from the National Notifiable Disease Surveillance System. While the registration-based deaths data takes longer to receive and process this dataset has provided important supplementary information to the surveillance system data. 

As the pandemic has progressed, there has been a re-emergence of other acute respiratory diseases. To reflect this, the ABS now reports on the number of monthly deaths due to COVID-19, influenza and respiratory syncytial virus (RSV). In this article, these viral diseases will be referred to collectively as deaths due to acute respiratory infections. Due to the higher number of deaths due to COVID-19 more detailed analysis will be included for this cause. 

All data presented in this article is provisional. It is expected that numbers of deaths due to these causes will increase for more recent time periods as more death registrations are received by the ABS. 

The table below shows the number of acute respiratory associated deaths reported on a medical certificate of cause of death by month and year. An acute respiratory associated death is one where the viral disease has either directly caused the death (the virus has caused terminal complications such as pneumonia) or the person has died with the virus (a person has died from another cause but the viral illness still contributed significantly to death). 

• COVID-19 has been the leading cause of acute respiratory infection mortality across 2022-2024. 
• After lower numbers of deaths between February and April, deaths involving COVID-19 started to rise in May and June before falling in July and August. Deaths due to acute respiratory infections are typically lower in Australia in warmer months. Between January and July 2024, deaths involving COVID-19 were 17.5% lower than in 2023 and 59.3% lower than in 2022.
• Deaths involving influenza in July and August were at similar levels in 2024 to those recorded in 2019 (241 and 247 deaths respectively), but remain well below the levels of August and September in 2017 (525 and 661 deaths respectively). There were 810 deaths involving flu between January and August 2024, which is above the same period in 2023 (416) and 2022 (402), 2017 (730) but below 2019 (1,005 deaths). Influenza deaths are for 2017 and 2019 are included in this analysis as they are considered to be years with high numbers of deaths due to flu. 
• For the first six months of 2024, deaths involving RSV were higher in each month of 2024 than either of 2022 or 2023. In July the number of deaths was comparable to 2023. Between January and July 2024, deaths involving RSV were 51.9% higher than in 2023 and 203.9% higher than in 2022.

The ABS codes an underlying cause of death (UCOD) for all deaths in the national mortality dataset. The underlying cause of death is defined as the disease, condition or external event that started the chain of events leading to death. International coding rules are applied to disease and conditions appearing on the medical certificate of cause of death (MCCD) to assign the UCOD. A disease or condition must be certified on the MCCD to be coded by the ABS. If COVID-19, influenza or RSV is listed as the underlying cause of death, the death is considered to have been caused by the virus. 

The following table shows the number of deaths due to acute respiratory diseases since 2022.

• The number of deaths from COVID-19 have been much lower in every month of 2024 than the same month in 2022. Deaths from COVID-19 between June and August 2024 have been higher than the same months in 2023, but over the year to August there have been 325 (9.4%) fewer deaths in 2024 than 2023.
• The 72 deaths due to influenza in the first three months of 2024 were much higher than in either 2022 or 2023, but slightly lower than pre-pandemic average levels. For example, in 2019 there were 86 influenza deaths recorded in the first 3 months. In the second quarter of 2024 (April, May and June) there were a further 171 deaths due to influenza which was comparable to 148 deaths recorded in 2023 but below levels for this period in 2019 (350). In July and August 2024 there have been 402 deaths due to influenza, comparable to the 391 deaths in 2019. 

The table below shows the number of acute-respiratory associated deaths where the person has died with the virus (a person has died from another cause but the viral illness still contributed significantly to death).

• COVID-19 and Influenza are more likely to be assigned as the underlying causes of death rather than a contributing factor (i.e. a person died with the virus). The opposite is true for RSV - it is more likely to be listed as a significant contributor to death. To wholly monitor the effects of RSV on mortality, deaths with RSV should be taken into consideration. 
• There have been more deaths with RSV in each of the first six months of 2024 than in the corresponding months of 2022 or 2023. Deaths with RSV in July 2024 were comparable to July 2023.
• There have been fewer deaths with COVID-19 in each of the first six months of 2024 than in the corresponding months of 2022 or 2023. The 181 deaths with COVID-19 in July and August 2024 have been comparable to the same months in 2023 (175 deaths).

• More males have died from COVID-19 compared to females across 2022-2024. The reverse has been true for influenza and RSV.
• Those aged over 90 years are the only age group to consistently record more deaths of females than males from COVID-19. Nearly two thirds of Australia's population of persons aged over 90 years are female.
• More females (355) than males (319) have died from influenza in 2024.
• All three of these acute respiratory infections are more likely to cause death in older age groups than younger age groups. 

• As the most populous state, New South Wales generally records the highest numbers of deaths for acute respiratory infections. 
• Queensland has recorded the highest number of deaths due to RSV in 2024.
• COVID-19 has caused more deaths than influenza and RSV across 2022-2024 in all jurisdictions. 

Aboriginal and Torres Strait Islander peoples are at heightened risk of more severe outcomes from acute respiratory diseases. There are several reasons for this, including higher rates of socioeconomic disadvantage, higher rates of chronic diseases and limited access to culturally safe health care.

This section presents three tables which includes information on Aboriginal and Torres Strait Islander people who have died from acute respiratory diseases. The first two tables focus on COVID-19 mortality only due to the higher numbers of deaths from the virus. The third table presents numbers of deaths and age-standardised death rates on deaths associated with COVID-19, influenza and RSV. For most of the analysis deaths include those where the acute respiratory disease was listed on the medical certificate of cause of death. This includes deaths where the acute respiratory disease caused death and those where the acute respiratory disease contributed to death. Data is presented in this way largely due to the small numbers of deaths from these diseases in Aboriginal and Torres Strait Islander people.  

There have been deaths recorded in all jurisdictions of Aboriginal and Torres Strait Islander people. However, the rest of this analysis focusses on deaths registered in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory only. Currently, these five states and territories have evidence of a sufficient level of Indigenous identification and high enough numbers of Aboriginal and Torres Strait Islander deaths to support mortality analysis.

There were 62 deaths of Aboriginal and Torres Strait Islander people involving COVID-19 in the first eight months of 2024. This is lower than the first eight months in both 2023 (92 deaths) and 2022 (204 deaths).

There were 436 Aboriginal and Torres Strait Islander people who had COVID-19 certified as a cause of death across the five jurisdictions. Of these people:

• 281 died due to COVID-19. This is where the virus caused complications that led directly to death. A further 155 people died with COVID-19. This is where another disease caused the terminal complication causing death but COVID-19 was a contributing factor.
• The age-standardised death rate for deaths from COVID-19 is slightly higher for Aboriginal and Torres Strait Islander females than males. The reverse is true for deaths with COVID-19. For non-indigenous people, males have a higher age-standardised death rate than females for both deaths from COVID-19 and with COVID-19.
• Of those who died from or with COVID-19, a higher proportion of Aboriginal and Torres Strait Islander people died with COVID-19 as a contributing factor compared with non-Indigenous people (35.6% compared with 25.4%).
• The mortality rate from COVID-19 is 1.5 times higher in Aboriginal and Torres Strait Islander people compared to non-Indigenous people.
• For Aboriginal and Torres Strait Islander females, the rate of mortality with COVID-19 is 2.3 times higher than that of non-Indigenous females.

For Aboriginal and Torres Strait Islander people who died by an acute respiratory disease: 

• COVID-19 caused more deaths than both influenza and RSV across each year in 2022-2024. 
• The mortality rate for COVID-19 and influenza related mortality for Aboriginal and Torres Strait Islander people was higher than non-Indigenous people across each year in 2022-2024. 
• The mortality rate for influenza related mortality is higher in both Aboriginal and Torres Strait Islander and non-Indigenous people in 2024 compared to 2022 and 2023.