Provisional Mortality Statistics

Provisional deaths data for measuring changes in patterns of mortality during the COVID-19 pandemic and recovery period

• 55,047 doctor certified deaths occurred between 1 January 2020 and 26 May 2020 and were registered by 30 June. This compares to a baseline average of 53,361 over the past 5 years.
• The numbers of deaths returned to historical averages in the first two weeks of May and were below those averages for the last two weeks (ending 26 May). Care should be taken when interpreting data for the last two weeks of May as additional deaths will be registered for that period and included in future reports. See the Timeliness and Completeness of Data section in this article for further information on changes in counts of death through 2020.
• The highest numbers of deaths were recorded in the weeks ending 31 March (2,808), 7 April (2,778), 12 May (2,723) and 14 April (2,713).
• Deaths due to influenza and pneumonia fell below historical averages in May.
   

Counts of deaths for the period from 1 January to 28 April 2020 will differ from those in the previous report, with additional deaths that occurred in that period being registered and reported between the end of May and the end of June. Changes will occur as each new report is released, with data for the most recent weeks being most affected.

This report will be updated monthly throughout 2020. Reports will only include data in full weeks. As such, data for May includes information for the four weeks from 29 April to 26 May but data for 27-31 May are not included. The next report will include deaths that occurred up until 30 June and were registered by the end of July.

Excess mortality is an epidemiological concept typically defined as the difference between the observed number of deaths in a specified time period and the expected numbers of deaths in that same time period. Estimates of excess deaths can provide information about the burden of mortality potentially related to the COVID-19 pandemic, including deaths that are directly or indirectly attributed to COVID-19.

Throughout this report, counts of deaths for 2020 are compared to an average number of deaths recorded over the previous 5 years (2015-2019). These average or baseline counts serve as a proxy for the expected number of deaths, so comparisons against baseline counts can provide an indication of excess mortality. The minimum and maximum counts from 2015-19 are also included to provide an indication of the range of previous counts. Minimums and maximums for any given week can be from any of the five years from 2015-19.

Tracking the number of doctor certified deaths against historic averages provides an indication of when excess deaths may occur. In 2020, this is of particular relevance because of the many potential public health impacts of the COVID-19 pandemic.

The number of COVID-19 infections by week in Australia is highlighted alongside total deaths to enable a comparison of the timelines for the pandemic with changes in numbers of deaths. Over the period from 1 January through to 26 May, peak numbers of COVID-19 infections in Australia were recorded from mid-March to mid-April. This period is of particular interest for mortality analysis. Patterns of mortality beyond that peak infection period may also provide insights into the delayed effect of COVID-19 infections (including for the small proportion of people who died from COVID-19) and other indirect effects of measures in place to reduce infections (i.e. the temporary cessation of elective surgery, changes in access arrangements for medical services).

• 55,047 doctor certified deaths occurred between 1 January 2020 and 26 May 2020 and were registered by 30 June. This compares to a baseline average of 53,361 over the past 5 years.
• Over the four weeks from 18 March to 14 April there were a total of 10,974 deaths, 841 more than the historic average for 2015-19.
• Counts of deaths were close to historic maximums over the last three weeks of April and were close to historic averages in the first half of May. In the last two weeks of May counts fell below historic averages. Counts of deaths in May (especially in the last two weeks) will increase as additional registrations are finalised and reported to the ABS over coming months. See the Timeliness and Completeness of Data section in this article for further information on changes in counts of death through 2020.
   

Note: This analysis does not include coroner referred deaths. Any changes in patterns of coroner referral could affect counts of doctor certified deaths. Some conditions have higher coroner referral rates (ischaemic heart disease, cerebrovascular diseases and to a lesser extent respiratory diseases and diabetes) so counts for those conditions would be more likely to be affected by such changes.

The graph below shows the number of provisional doctor certified deaths that occurred on a weekly basis in the first five months of 2020 (red line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (orange line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. A dark blue line represents the number of COVID-19 infections in Australia during the time period. The graph shows the number of deaths is above the 5 year average for all weeks until the week ending 19 May when it fell below the average. The number of deaths for the week ending 26 May was below the minimum of the 5 year range. In the weeks ending 28 January, 11 February, 10 March, 24 March, 31 March, 7 April and 28 April, the number of deaths was above the maximum of the 5 year range. The graph shows that the peak number of COVID-19 infections during this time period occurred in the week ending 31 March and this coincided with the peak number of deaths for the same period. Data for mortality presented in this graph are available in the data cube in the Data downloads section of this publication.

Ischaemic heart disease is the leading cause of death in Australia. The category includes acute conditions such as myocardial infarction and chronic conditions such as coronary atherosclerosis.

• 5,175 deaths occurred from ischaemic heart disease between 1 January 2020 and 26 May 2020.
• The average number of deaths recorded for the same period between 2015 and 2019 was 5,649.
• Counts of heart disease deaths were slightly above the historic average in the weeks ending 28 April and 5 May, but fell below historic averages for the remainder of May.
   

The graph below shows the number of provisional doctor certified deaths due to ischaemic heart diseases that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows the number of ischaemic heart disease deaths is below the 5 year average for all weeks of 2020 except in the week ending 18 February when deaths were slightly above the 5 year maximum, and the weeks ending 28 April and 5 May when deaths are slightly above average. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Cerebrovascular diseases refers to a number of conditions such as stroke, cerebral aneurysms and stenosis that affect blood flow and circulation to the brain.

• 3,497 deaths from cerebrovascular diseases (including strokes) occurred between 1 January and 26 May 2020.
• The average number of deaths recorded for the same period between 2015 and 2019 was 3,761.
• The highest number of deaths from cerebrovascular diseases was recorded in the week ending 7 April (200). This was equal to the maximum recorded for that week in the previous 5 years.
   

The graph below shows the number of provisional doctor certified deaths due to cerebrovascular diseases that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows the number of cerebrovascular disease deaths is below the 5 year average for all weeks 2020 except in the week ending 11 February where deaths were slightly above the 5 year average, the week ending 31 March when deaths were equal to the 5 year average, the week ending 7 April when deaths were above the 5 year maximum, and the week ending 14 April when the number of deaths was slightly above average. In the majority of weeks, deaths due to cerebrovascular are below the minimum range for the last five years. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Respiratory diseases include causes of death such as pneumonia, influenza, and chronic lower respiratory diseases (including emphysema and chronic bronchitis). Deaths due to COVID-19 are not included in this category. COVID-19 deaths are captured using WHO issued emergency codes U07.1 and U07.2 and are not currently grouped with any other diseases, though they are included in the total number of deaths.

• There were 4,886 deaths from respiratory diseases between 1 January 2020 and 26 May 2020.
• The average number of deaths for the same period between 2015 and 2019 was 4,758.
• Over the four weeks from 18 March to 14 April there were a total of 1,037 respiratory disease deaths, 146 more than the historic average for 2015-19.
• Since the week ending 21 April, the weekly number of respiratory deaths has remained below the historic average for 2015-19 and at times has fallen below 5 year minimums.
   

The graph below shows the number of provisional doctor certified deaths due to respiratory diseases that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows the number of respiratory disease deaths is above the five year average for all weeks of 2020 other than the weeks ending 11 February, 10 March and all weeks from 21 April. The number of respiratory disease deaths are above the maximum range in the weeks ending 21 January, 4 February, 3 March, 24 March, 31 March and 14 April. In the weeks ending 11 February, 21 April, 28 April and 19 May it is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Chronic lower respiratory diseases include chronic bronchitis, emphysema, asthma and chronic obstructive pulmonary diseases (COPD). Chronic lower respiratory diseases are a sub-group of respiratory diseases (J00-J99).

• There were 2,654 deaths from chronic lower respiratory diseases from 1 January to 26 May 2020.
• The average of number of deaths for the same period from 2015 to 2019 was 2,636.
• The number of deaths from chronic lower respiratory diseases decreased relative to baseline averages during April, and was below the minimum range throughout May.
   

The graph below shows the number of provisional doctor certified deaths due to chronic lower respiratory diseases that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows the number of chronic lower respiratory disease deaths fluctuates for the first six weeks of 2020 when compared with the five year average. From the week ending 18 February until the week ending 14 April it is above the five year average, while from the week ending 21 April through until the week ending 26 May it is below the minimum range apart from being above average in the week ending 28 April. Deaths due to chronic lower respiratory diseases were above the 5 year maximum in the weeks ending 21 January, 4 February, 18 February, 3 March, 24 March and 31 March. Chronic respiratory disease deaths were below the 5 year minimum in the weeks ending 28 January, 11 February, 21 April and each of the last four weeks. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Influenza and pneumonia are acute respiratory diseases often grouped together when compiling leading causes of death. They are two distinct diseases: influenza is a viral infection, while pneumonia can be caused by a virus, bacteria or fungi. Influenza is a common cause of pneumonia.

Influenza deaths are highly seasonal and most commonly occur in Australia between the months of May and September. The timing, length and severity of the influenza season varies considerably from year to year. Influenza and pneumonia are a subset of respiratory diseases (J00-J99).

• There were 974 deaths due to influenza and pneumonia recorded from 1 January to 26 May 2020.
• The average number of deaths recorded over the same period from 2015 to 2019 was 954.
• Counts of influenza deaths have remained very low throughout 2020 so deaths in this category are almost all from pneumonia.
• Between 1 April and 26 May there have been fewer than 5 deaths due to influenza. The average number of influenza deaths based on historic counts is approximately 5 per week in April and 10 per week in May.
• Over the four weeks from 18 March to 14 April there were a total of 263 influenza and pneumonia deaths, 90 more than the historic average for 2015-19.
• Numbers of deaths due to influenza and pneumonia decreased towards the end of April, falling below historic averages. Numbers remained below baseline averages throughout May.
• As historic counts of influenza and pneumonia deaths are heavily influenced by seasonal influenza deaths during winter months, these causes will be separated in future reports.
   

The graph below shows the number of provisional doctor certified deaths due to influenza and pneumonia that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows that the number of influenza and pneumonia deaths is relatively stable against the baseline for the first 8 weeks of the year. In the week ending 3 March, and from the week ending 24 March until the week ending 14 April it is above the five year maximum range, before falling below average for the week ending 21 April and below the minimum for the week ending 28 April. During May deaths have fluctuated around the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Cancer includes malignant neoplasms encompassing carcinomas, sarcomas and lymph and blood cancers.

• 18,959 deaths from cancer occurred between 1 January and 26 May 2020.
• The average number of deaths for the same time period from 2015-2019 was 18,457.
• Cancer deaths have been generally higher than baseline averages through 2020.
   

The graph below shows the number of provisional doctor certified deaths due to cancers that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows that the number of deaths due to cancer fluctuates during 2020 when compared with the five year average but is above average more often than not. The graph shows in weeks ending 18 February, 25 February, 31 March, 7 April and 12 May the number of deaths are shown to be above the maximum range for the last five years. In the weeks ending 10 March and 26 May it is below the minimum range. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Diabetes includes both Type 1 diabetes and Type 2 diabetes. The majority of diabetes deaths are from Type 2 diabetes.

• 1,856 deaths from diabetes occurred between 1 January to 26 May 2020.
• The average number of deaths over the same period from 2015 and 2019 was 1,671.
• Over the six weeks from 25 March to 11 May, diabetes deaths were above 5 year maximums. A total of 617 diabetes deaths were recorded during those 5 weeks, 149 more than the historic average for 2015-19.
• Deaths from diabetes declined slowly from mid April, returning to historical averages from the week ending 12 May.
   

The graph below shows the number of provisional doctor certified deaths due to diabetes that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows that the number of diabetes deaths is above the maximum range in the week ending 7 January, before falling below minimum range for the following two weeks, remaining below average until the week ending 4 February. From the week ending 11 February until the week ending 24 March it is generally between the average and maximum range, and from the week ending 31 March until the week ending 5 May it is above the maximum range. In the weeks ending 12 May and 19 May it is around average before falling near the minimum in the week ending 26 May. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Dementia, including Alzheimer disease, is the second leading cause of death in Australia and counts of deaths from dementia have increased steadily over the past 20 years. This increase should be taken into consideration when comparing 2020 counts against baseline averages.

• 5,794 deaths from dementia, including Alzheimer disease, occurred between 1 January and 26 May 2020.
• The average number of deaths for the same period from 2015 to 2019 was 5,026.
• Deaths due to dementia were above historic averages in all weeks from January through to the end of April. Numbers of deaths decreased in May, with counts falling below 5 year averages in mid-May. It is likely counts of dementia deaths for May will increase as additional deaths are registered and included in future reports.
• Over the four weeks from 18 March to 14 April there were a total of 1,198 deaths, 223 more than the historic average for 2015-19.
   

The graph below shows the number of provisional doctor certified deaths due to dementia including Alzheimer disease that occurred on a weekly basis in the first five months of 2020 (orange line). A baseline representing the average of 2015-2019 deaths for the same period is also shown (dark blue line). The minimum and maximum range of deaths that occurred in this same period is shown as a shaded outline. The graph shows that the number of deaths in 2020 due to dementia including Alzheimer disease was above the maximum range for the last five years in every week except the weeks ending 18 February and 17 March until the week ending 28 April. From the week ending 5 May until the week ending 26 May, it has fairly closely tracked the average. Data presented in this graph are available in the data cubes in the Data downloads section of this publication.

Each death registration in the national mortality dataset has 3 dates:

• The date on which the death occurred.
• The date on which the death was registered with the jurisdictional Registry of Births Deaths and Marriages (RBDM).
• The date on which the death was lodged with the ABS.
   

The time between the occurrence of a death and registration can vary although in general deaths certified by a doctor are registered sooner. Coroner certified deaths undergo extensive investigative processes which can delay registration times, and for this reason they are excluded from the provisional mortality reports.

When looking to measure change over time, the completeness of data for the most recent period is important. When data are received each month by the ABS, the lag between the date of death and date of registration means that only 40-50% of reported registrations are of deaths that occurred in the month being reported. The remainder are deaths that occurred in earlier months. After a second month of reporting, approximately 95% of doctor certified registrations have been received. This is considered sufficiently complete to enable meaningful comparison with historic counts, noting that the level of completeness will be higher for the start of any given month than the end of that month.

This pattern of registration and reporting is highlighted in the table below, which also shows the slight variation in reporting timelines by cause of death. This should be considered when comparing 2020 data to the 2015-2019 baseline data.

This graph below shows how the discussed pattern of lagged registrations for doctor certified deaths has affected the information presented in the Monthly Provisional Mortality Reports. Data on deaths published in July and August shows increases on information published in June for the first quarter of the year. These increases are most notable for deaths that occurred in March. Data for May should be treated with caution as it is expected that the number of deaths will increase with published data in September and October.

Updates to this report will be released on a monthly basis. Tracking of all doctor certified deaths and deaths by specified causes will continue throughout 2020.

Each new report will include those deaths that have been registered and reported to the ABS since the previous report. As some of those deaths will have occurred in time periods covered in previous reports, the counts of deaths for those time periods will change from one report to the next.

Numbers of deaths cannot be aggregated across months to calculate a quarterly or annual count of deaths, as additional deaths for any given reference period can be registered and reported many months after the date on which they occurred.

This release previously used catalogue number 3303.0.55.004