Peadar Tóibín (Meath West, Aontú)
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650. To ask the Minister for Health the reason the excess mortality rate in Ireland has been spiking so high in recent months; the reason there were 25.4% more deaths in Ireland in December 2022 than the average for the same month from 2016 to 2019; the reason that the excess mortality rate in Ireland has been higher than the EU average for the past 12 months apart from July 2022; and if there is a formal investigation being carried out by any State organisation into the reasons for these excess deaths. [33438/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Department of Health does not produce estimates of excess mortality. However, the Department works closely with the Health Protection Surveillance Centre (HPSC) and other stakeholders to monitor estimates of excess mortality. Excess mortality refers to the number of deaths from all causes during a period of time above and beyond what we would have normally expected to see.

A number of different methodologies have been developed by organisations and academics internationally to try to estimate levels of excess mortality. It is important to note that estimation methods vary, for example in the years used to estimate a baseline, in how they estimate the level of expected deaths, the data source used for ‘actual’ deaths and whether statistical significance tests are applied before reporting deaths as excess. There is therefore no single source of data on estimated excess mortality.

Internationally work is currently underway to improve methods to estimate excess mortality including moving the baseline years used to calculate expected deaths forward from pre-pandemic years. The gap between the current period and the baseline period is relatively wide and growing. The gap is greater than would have been normal practice previously, which impacts on comparability between the current period and the period used to estimate ‘expected’ deaths.

In addition, most estimation methods, including Eurostat and EuroMOMO, do not currently take account of demographic changes such as population change or ageing which may have occurred since the baseline period and which can have a large impact on mortality. EuroMOMO has received four-year funding to further develop their model, including the incorporation of demographic change.

The recent Census 2022 summary results released by the CSO have shown that the number of persons in Ireland aged 65 years and over increased by 22% between 2016 and 2022. Within this category, the highest increases were among those aged 75-84 years (28%) and 85 years and over (25%). Over the same period, the total population only increased by 8.1% with declines in some younger age groups e.g. 25-39 years and those aged under 10 years.

The 22% increase in the population aged 65 years and older in Ireland between 2016 and 2022, was more than double the 10% increase which occurred for the EU27 over the same period. For the 75-84 years age category the difference was greater, with a 3% increase across the EU27 compared with a 28% increase in Ireland.

As persons in older age groups account for the majority of deaths (in 2019 82% of all deaths which occurred in Ireland were among persons aged 65 years and over), the substantial increase in the number of persons in these age groups within the population would be expected to increase the absolute number of deaths occurring in Ireland, compared with the number which occurred in 2016-2019. Compared with the most recent year included in the baseline (2019) the number of persons aged 65 years and over in Ireland was 12% higher in 2022 and for 75-84 years, it was 17% higher (based on CSO estimated 2019 population).

The Health Protection Surveillance Centre (HPSC) has monitored excess mortality in Ireland since 2009, using registered deaths data reported to HPSC on a daily basis from the General Register Office (GRO). HPSC participates in EuroMOMO for Ireland, a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. EuroMOMO publish a weekly update of estimates of excess mortality for all participating European countries www.euromomo.eu/graphs-and-maps.

The latest HPSC excess mortality analysis of all registered deaths in Ireland for the 2022/2023 winter period, using the standardised European EuroMOMO algorithm, has shown:

• Excess all-cause mortality over five consecutive weeks (week 51 2022 – week 3 2023), reaching moderate levels of excess during weeks 51 and 52 2022 and week 2 2023.
• Excess Pneumonia and Influenza mortality over four consecutive weeks (weeks 51 2022 – week 2 2023), reaching moderate levels of excess during week 52 2022. Pneumonia and influenza deaths refer to deaths where pneumonia and/or influenza were listed as one of the causes of death on the death certificate.