Marian Harkin (Sligo-Leitrim, Independent)
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454. To ask the Minister for Health if any analysis has been undertaken to explain the significant increase in deaths in Ireland in the period from July to September 2021 (details supplied); and if he will make a statement on the matter. [21853/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The data referred to were sourced from the Central Statistics Office (CSO) quarterly Vital Statistics release for Quarter 3 2021 (issued on 16 March 2022).  The CSO’s quarterly Vital Statistics releases report on births, deaths and marriages registered in Ireland within a quarter.  It is important to note that this data refers to the quarter in which the event was registered with the General Register Office (GRO), and this may not be the same quarter in which the event occurred. Therefore, not all deaths registered within a quarter would have occurred in the same quarter.  Legally in Ireland a period of three months is allowed to register a death.

On 14 May 2021, the Health Service Executive (HSE) IT systems suffered a major ransomware attack.  As a result of this, civil registrations with the GRO (including death registrations) could not be processed for a period of approximately five to six weeks.  This resulted in a significant reduction in registrations recorded in Quarter 2 2021 (April-June).  The CSO’s Vital Statistics release for Quarter 2 2021 (issued 26 November 2021) reported that the number of births registered in Quarter 2 decreased by 1,976 (14.6%) compared to the same period in 2020 and that the number of deaths registered decreased by 1,882 (21.9%).

The backlog of civil registrations created by the cyber-attack disruption resulted in some registrations which should have occurred in Quarter 2 being delayed to Quarter 3 2021 (and given the significance of the disruption, may also impact on registrations recorded for Quarter 4 when that data is reported). The CSO’s Vital Statistics release for Quarter 3 reported that the number of births registered increased by 2,270 (15.7%) compared to the same period in 2020 and the number of deaths registered increased by 1,054 (14.8%).   

Total deaths registered in Ireland in Quarter 2 and Quarter 3 2021 combined (14,865) was 5.3% lower than the same period in 2020 (15,693) and almost the same as the number of deaths registered in Quarter 2 and Quarter 3 of 2019 (14,877).

In response to a query on this issue, the CSO has stated that ‘On 14 May 2021, the Health Service Executive (HSE) of Ireland suffered a major ransom ware cyber-attack which caused all of its IT systems nationwide to be shut down. The General Register Office (GRO) is the central repository for records relating to births, stillbirths, adoptions, marriages, civil partnerships and deaths in Ireland. The GRO systems were also affected by this cyber-attack and consequently, the availability to register life events such as births, deaths and marriages was severely restricted and unavailable for a period of time. As a result, the number of births, deaths and marriages registered in Q2 2021 was lower than what it otherwise would have been had such a cyber-attack not occurred. This unavailability in Q2 2021, ceteris paribus, resulted in a spillover of registrations for such life events in Q3 2021.’

The significant delay caused in civil registrations due to the impact of the cyber-attack was debated in the Oireachtas on a number of occasions during 2021 (primarily in relation to birth registrations).

Due to the impact of the cyber-attack on registration of deaths, analysis of mortality in 2021 will need to be based on data on deaths by date of occurrence. The CSO publishes annual data on deaths by date of occurrence.  The latest data available at present is for 2020, however when 2021 data is published this will be analysed by the Department of Health.

Data and trends in mortality in Ireland, including the direct and indirect impacts of COVID-19, are closely monitored by the Department of Health including analysis of excess mortality.  Excess mortality is an epidemiological indicator which can provide information on the burden of mortality potentially related to the COVID-19 pandemic. Several studies examining excess mortality in Ireland in the context of the COVID-19 pandemic have been published since 2020.

A number of analyses of excess mortality have indicated that Ireland appears to have experienced lower excess mortality during the COVID-19 pandemic than many other countries in Europe and globally.

- An April 2022 analysis by HIQA (Descriptive analysis of COVID-19 epidemiological indicators and associated contextual factors in European countries) estimated that there were 2,019 excess deaths in Ireland between 2 March 2020 and 28 November 2021. The excess deaths occurred during a seven-week period from late March to mid-May 2020 and an eight-week period from early January to late February 2021. The two distinct peaks in excess mortality experienced by Ireland broadly corresponded with the peaks observed for recorded COVID-19 deaths. Throughout the study period, there was substantial variability in the magnitude and duration of peaks in excess mortality across European countries. Between mid- and late-2021, the excess mortality in Ireland was observed to be amongst the lowest in Europe. The analysis of excess mortality contained in the report was based on the data and approaches of EuroMOMO (a European mortality monitoring activity), which provides a long-standing and robust approach to the measurement of excess mortality.

- A study published in the Lancet in March 2022 (Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21) indicated that rates varied substantially in western Europe, with estimated rates in some countries almost as high as those for countries in other global regions. Ireland was among several European countries (including Iceland, Norway, and Cyprus) which had some of the lowest rates in the world, at less than 50 excess deaths per 100,000 population. Based on the Lancet publication, which does include a number of methodological caveats, Ireland had the third lowest estimated excess mortality rate amongst western European countries for the relevant study period (1 January 2020 to 31 December 2021).

- A number of factors may have contributed to lower excess mortality in Ireland, which include, but are not limited to, timely and appropriate institution of population-level public health protective measures, effective communication and buy-in of individuals to non-pharmaceutical interventions, the prioritised roll out, and uptake, of vaccination amongst those in the population most vulnerable to severe outcomes from COVID-19, as well as, potentially, demographic differences, such as the younger population in Ireland compared to other European countries.

The Department of Health and its agencies will continue to closely monitor data in relation to mortality and excess mortality in Ireland.  The Department also engages with international organisations in their ongoing analysis of the direct and indirect impacts of the COVID-19 pandemic on population health, including mortality.