Berlin Demography Dialogue • 02.03.2021Higher (Excess) Mortality in Germany Due to COVID-19?

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The question of whether the corona pandemic has caused excess mortality in Germany is being widely discussed at present. In order to make a realistic assessment, it is necessary to look at the total number of deaths, as statistician Dr. Felix zur Nieden from the Federal Statistical Office pointed out. Such data, in contrast to COVID-19-related mortality, are not dependent on how causes of death are defined and recorded. There are considerable differences between individual countries in this respect.

What Does Excess Mortality Actually Mean?

Excess mortality is not a concretely defined scientific concept, as there are different approaches to recording it. “Basically, excess mortality means increased mortality over a period of weeks or months rather than calendar years,” the statistician explained. Excess mortality is when there are more deaths than expected. This can be gauged, for example, from the deviation from previous years in the average number of deaths for certain weeks or months. “However, there are also more complex approaches to eliminating previous excess mortality periods seen in earlier years,” the scientist said. Basically, it is crucial which definition of excess mortality is used and which time period is referred to.

Development of Death Counts 2020/2021

It is difficult to make direct comparisons with figures from previous years, as the way in which the mortality figures are interpreted must take into account the measures taken and the changes in behaviour since March 2020. At the beginning of 2020, for example, there were significantly fewer flu deaths than in the years before – the mortality was thus significantly below average.

The increase in COVID-19 numbers during the first wave then saw deaths increase significantly, with 10 per cent more deaths being recorded than the average in previous years. After a decline, the average number of deaths increased again during the heat wave in summer 2020. By the beginning of October 2020, the death rates had returned to the average range. They then systematically climbed to above the average again as the COVID-19 numbers rose. “As the figure stands today, we had just under 985,000 deaths in 2020, 5 per cent up on the previous year’s average,” the statistician summed up.

Does COVID-19 Have Any Effect on the Death Count?

It is difficult to determine what influence coronavirus had on the number of deaths, as many effects are involved. If the figures from April to December are considered in isolation, then these were 9 per cent above the previous year’s average. In January 2021, death rates were still significantly elevated – overall they were 20 per cent higher than the previous year's average. In February, the figures returned to the average range, although a relevant number of COVID-19 deaths were still being reported.

Overall, it can be stated that coronavirus has led to a strong increase in the death count in Germany. This is especially true for the end of last year, although there were regional variations in the impact, as the statistician summed up. In relation to the calendar year as a whole, however, it can be stated that there was no significant excess mortality in Germany. However, this again depends on how excess mortality is defined and what is included.

Excess Mortality? Comparison between Germany and Other Countries

How has (excess) mortality developed in other countries? BiB researcher Dr. Sebastian Klüsener has been looking at this question. Countries that have performed slightly better than Germany include Norway, which has so far recorded no excess mortality in 2020 and 2021. In South Korea, too, the pandemic has only had a minor impact on mortality to date.

In the USA, the pandemic has had more serious consequences than in Germany or Sweden. However, it should be noted that the American population is younger on average. “This means that the occurrence of a high number of infection cases does not automatically lead to high excess mortality.” For example, the excess mortality rate in the USA is not as high as in some other countries which have received much less attention.

Overall, the findings show that coronavirus can quickly lead to high excess mortality if the pandemic is not contained, the researcher concluded. This also applies to the initial phase of the pandemic, when the mutations which are currently spreading rapidly did not yet exist.

What Contribution Can Health and Mortality Data Make to Managing the Pandemic?

In the second part of his talk, Dr. Klüsener described the extent to which sufficiently detailed health and mortality data are collected in Germany and are available quickly enough to contribute to successful management of the pandemic.

Some Data Are Now Available More Quickly, Due in Part to the Pandemic

The speed at which the data are made available plays an important role here. Dr. Klüsener pointed out that considerable progress was made in some areas last year thanks to the great commitment of employees at the Robert Koch Institute (RKI) and the Federal Statistical Office. However, there are still areas with potential for improvement. Cause of death statistics are a case in point. From the research perspective, there is a great need to improve the access to detailed data in the research data centres.

What Improvements Can Be Made to Research into the Consequences of the Pandemic?

It is also important to have information on the place of death (hospital or nursing home, for example). This would make it possible to gauge where the mortality is concentrated. “In addition, it would be desirable to have data that permit better recording of social differences in mortality,” Dr. Klüsener demanded. It is also important to raise the quality of the cause-of-death data and their collection, for example with the help of a mortality register. “In general, we need to change over to fully electronic recording of all health and death data,” the demographer stated.