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Australians who have died from Covid-19 have lost more years of their expected lifespan, on average, than those dying from the country’s three leading causes of death, a new study suggests.
The Australian Institute of Health and Welfare (AIHW) report, released on Thursday, makes it clear that coronavirus is not just dangerous for the chronically ill and elderly.
The two-yearly report card analyses recent health data to create a picture of the nation’s health in 2020. While much of the information in the report, including data on obesity and chronic health conditions, is not new, it does contain data on the first fourth months of the Covid-19 pandemic in Australia, covering the period from 25 January to the end of May.
The AIHW deputy chief executive, Matthew James, said there was a perception that the majority of Australian Covid-19 deaths were among people who did not have many years of life left prior to developing the disease. “However, the Australians who died lost more years of their expected lifespan on average than those who died of our three leading causes of death: coronary heart disease, dementia and stroke,” he said.
The Covid-19 data was compiled for the AIHW by an infectious disease specialist at the Australian National University, Associate Professor Sanjaya Senanayake, who then conducted a preliminary analysis of that data. Senanayake wrote that the median age at death for Covid-19 was 80 years, slightly lower than that for all causes of death in 2018 (81 years).
“It is also somewhat lower than many other leading causes of death that commonly occur in older age,” the report said. “The median age at death for Covid-19 was lower than the three leading causes of death – coronary heart disease (84 years), dementia (88 years) and stroke (86 years) and it was also lower than the median age of deaths from pneumonia (89 years) and influenza (82 years).”
A way to examine the impact of age at death is to measure years of life lost, which counts the number of years between the age at death and life expectancy at that age. There has been speculation that years of life lost are low for Covid-19 because it mostly kills the elderly, who may not have a long life expectancy prior to developing the virus due.
But preliminary calculations for Australia found the average years of life lost per person was 17 years for men and 14 for women (including deaths up to 31 May).
“These higher estimates in Australia indicate a lower proportion of deaths in older people, possibly due to fewer outbreaks in aged care facilities than have occurred in other countries,” the report found. “This suggests there is a strong possibility that the Covid-19 deaths were among people that, on average, would not have been expected to die soon, particularly when taken alongside [other research which has found] comorbidity did not greatly reduce years of life lost”.
Comorbidities include diseases such as diabetes, obesity and lung disease. The report found the latest available data showed that in 2017–18, 66.4% of Australians aged 18 and over were overweight or obese, up from 61.1% in 2007–08. Overall, 47% of Australians, or more than 11 million people, have a chronic condition such as heart disease, cancer, stroke, diabetes, arthritis, asthma or a mental health condition.
“Many – but not all – chronic conditions are largely preventable by addressing risk factors such as tobacco smoking, high blood pressure and high blood cholesterol, insufficient physical activity, poor diet and nutrition and overweight and obesity,” James said.
The report found the majority of Covid-19 cases in Australia were mild to moderate in severity and were managed at home. However, a small proportion of people developed more severe disease.
“By 24 May, 13% of diagnosed cases had been admitted to hospital,” the report found. “Hospitalisation usually indicates more severe disease, though in the early stages of the epidemic in Australia some mild cases were admitted to hospital to enhance isolation procedures in order to minimise the chance of further transmission. The median age for hospitalised cases was older than for all cases (61 years compared with 47 years).”
People’s use of other types of healthcare had changed during the pandemic, the report found. Initially, lower priority elective surgery was cancelled, and the report said it is not yet known what the impact of the consequential delay will be for the health of the population.
“There has also been concern that people may delay their usual care (such as management of chronic conditions) to avoid exposure to the virus,” the report said. However, for the period between 1 January to 30 April, total GP visits including telehealth services were higher than the same period last year: increasing by 3.9%.
“The large scale changes to society that were required to contain this virus also have a number of potential adverse health and welfare effects, although there are interventions that can be put in place to reduce the risk of these,” the report found. “At this stage we are still likely to be experiencing the earlier effects of the Covid-19 epidemic, but clearly these longer-term effects will need to be monitored into the future.”
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