NZ’s Covid-19 statistics will become more accurate as the Ministry of Health starts reporting deaths where the virus is
the underlying or contributing cause.
The Ministry previously recorded all deaths within 28 days of a positive test, plus any death that was attributed to
Covid-19 after medical review. The new reporting system shows the virus has been an underlying or contributing factor to
somewhere between two-thirds and three-quarters of deaths after a Covid-19 infection.
The SMC asked experts to comment.
Professor Michael Baker, Professor of Public Health, University of Otago, Wellington, comments:
“It is good to see this upgrading of Covid-19 mortality reporting. New Zealand has followed the international reporting
standard specified by the World Health Organisation which is important as it allows for meaningful comparisons across
different countries and time periods. However, this standard needs some revisions, which our Ministry of Health is now
making.
“All health agencies and researchers want health statistics that are valid, i.e. that measure what they intend to
measure. This change will therefore increase the confidence we have that deaths attributed to Covid-19 are valid. I am
pleased to see that all of our Covid-19 mortality data will be revised to incorporate this change, including current and
previously reported numbers.
“It is likely that reporting of Covid-19 deaths will continue to underestimate numbers. Covid-19 infection can cause
death from heart attacks and strokes and other causes that may not be attributed to this condition. We know that deaths
from other infections such as influenza have always been hugely underestimated. Only about 5% of deaths linked to
influenza have this infection recorded as the cause of death. This problem is partly because of the way that mortality
reporting focussed on the underlying cause of death, so tends to default to any major chronic illnesses that a patient
had, rather than acute infections that contributed to their death at that time.
“The Covid-19 pandemic is shining a light on the complexity of ensuing that health data are as valid as possible, and
the need to keep improving our methods.”
No conflict of interest.
Associate Professor Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington
Pacific Office, and Associate Professor, Dean’s Department, University of Otago Wellington, comments:
“The spread of Omicron is continuing to place added burden and strain onto families, communities, our vulnerable,
schools, workforces and our health and other support systems in Aotearoa New Zealand.
“Daily Covid-19 case figures remain high with hospitalisations continuing to increase, and hospitals, primary and
community care overwhelmed, and with the actual Covid-19 community case figures likely much higher than those being
reported currently.
“Approximately 100 Covid-19 related deaths have been reported each week over the past months – with sympathies and
condolences respectfully extended to all family, whānau, kāinga, aiga and friends impacted and affected.
“Previously, Covid-19 associated deaths were reported in the daily Covid-19 updates as all those who’d passed away
within 28 days of a Covid-19 infection.
Now, additional deaths associated with Covid-19 will continue to be reported in the daily updates, along with the total
Covid-19 deaths being categorised based on whether Covid-19 is either the (1) underlying cause or a (2) contributing
cause of death, and where these deaths can be wholly, or partly ‘attributed’ to Covid-19. Another category will
constitute (3) those deaths still under investigation.
“It has been indicated by the Ministry of Health that the median time taken between a death occurring and then being
reported publicly is two days with approximately 10% of deaths taking more than a week before being reported publicly.
The information relating to the majority of reported deaths will be processed by the Ministry of Health’s Mortality
Coding team usually within a couple of days, however incomplete death records and those deaths referred to the coroner
will take much longer.
“With more people having now been exposed to the virus, and with the emergence of the Omicron variant and subvariants,
reinfections are increasing in a way not seen with earlier variants. Waning immunity, Omicron’s higher transmissibility
and ability to evade immune protection are contributing factors. The risk of reinfection remains, especially for
vulnerable communities.
“Ongoing work will be needed to understand more about whether re-infections for Omicron and all its subvariants are more
or less severe, when compared to the primary infection. In the meantime however, it is still important that those who
may have already had a Covid-19 infection, strengthen their immunity with vaccination/boosters as well.
“While issues with unequal global Covid-19 vaccine coverage, availability, accessibility and distribution persist, and
remain unaddressed, new variants of the SARS-CoV-2 virus will continue to emerge, develop and spread. Addressing health
inequities and current inequities in society will be critical steps moving forward.
“There is still much work to be done at this time with significant immunity gaps in Aotearoa New Zealand right now.
Masks, Covid-19 vaccines and proper ventilation within the education setting remain important for protection,
particularly for children, tamariki and tamaiki aged 5-11 years and those still needing to be vaccinated against
Covid-19. Many adults also still need their Covid-19 boosters as well.
“During the Covid-19 pandemic, there has been limited exposure to other viruses such as the influenza virus here in
Aotearoa New Zealand, and there is potential risk of upcoming influenza outbreaks moving into winter. We now have more
of the influenza vaccines here in Aotearoa New Zealand being made available for people – these are important.
“Regular childhood vaccine schedules (non- Covid-19) for children tamariki and tamaiki in Aotearoa New Zealand have been
significantly affected by the Covid-19 pandemic. As a result, there is potential risk of outbreaks for whooping cough,
measles and other illnesses that could be prevented. A resurgence of influenza and the respiratory syncytial virus (RSV)
could also possibly occur.
“Although Covid-19 has been a key focus over the past two years, it is important to remember that all vaccinations are
still important.”
No conflict of interest declared.
Dr Bodo Lang, University of Auckland Business School, comments:
“Being more precise in the classification of deaths will be useful to illustrate the seriousness of Covid. As a side
benefit, having this new classification will also be useful to address one of the criticisms from anti vaxxers and Covid
doubters: how many deaths are really caused by Covid? The evidence will now be clearer on this, possibly resulting in a
reappraisal of Covid’s seriousness by those who were least likely to follow Covid guidelines.”
No conflict of interest.