Recently, there has been considerable commentary by politicians and others that Australia has done well in managing the COVID-19 pandemic.
‘Australians are world beaters. We have one of the highest vaccination rates in the world, lowest mortality rates in the world and one of the strongest economic recoveries in the world.’
But with respect to mortality rates and economic performance, this argument is flawed. The success of the Government must consider not just the present data but how mortality rates and economic growth evolve over time.
Sweden is an interesting comparison. We had substantial lockdowns whilst Sweden had none. (In doing so, note that there are many differences between Australia and Sweden; their population density is lower, they are perhaps more likely to comply with government rules/recommendations, their atmospheric temperatures are lower than here and so on.)
Let’s first consider mortality rates.
As of 4 April this year, Australia had recorded 6,418 deaths attributed to COVID-19. This corresponds to a mortality rate of 246 deaths per million people. In contrast, Sweden has experienced a COVID mortality rate of 1,795 per million people. If Australia had the same mortality rate as Sweden, there would have been 46,831 deaths in Australia.
Some have argued that Australia has “saved” 40,000 lives. Another type of analysis, excess mortality, finds that Australia “saved” 45,000 lives and we use that figure going forward.
A 2022 paper in BMC Public Health found that the years of life lost (YLL) of those who died from COVID between January and August 2020 was 2.7 years (note the median age at death is over 80 years). It would seem conservative to allocate 3 YLL for every person who died of COVID. Those 45,000 deaths, as calculated in the previous paragraph, correspond to 135,000 YLL.
How significant is 135,000 YLL lost in the whole scheme of things? In two words, not very. Based on 2018 figures from the Australian Institute of Health and Welfare, 68.2% of all annual YLL are due to cancers and cardiovascular, neurological and respiratory diseases. Of the total 2,400,000 YLL in a year, this equates to 1,637,000 YLL.
This is the crux of the flaw with the “Australia has done well” argument. Lockdowns, other government decisions and messaging led to the suspension of screenings for things like cancer and cardiovascular disease, and deferral of non-urgent diagnostic work/intervention. Anyone who died from cancers and the diseases mentioned above in the last two years and in, say, the next five years may have been or may be impacted by these medical delays.
Compared to Sweden, we have saved 135,000 YLL, but we have exposed to risk 11,459,000 YLL. An increase of these 11,459,000 YLL of just over 1% will mean that Australia has not done well at all.
A cursory look through the research shows that the increase in YLL might be higher than 1%. For example, a study in Lancet Oncology regarding England (which had substantial lockdowns as in Melbourne and Sydney) concluded that ‘substantial increases in the number of avoidable cancer deaths... are to be expected’.
So far, we have only considered cancers and cardiovascular, neurological and respiratory diseases. Dying from suicide leads to significant loss of years of life in the age groups 15-24 and 25-44 years old. We don't yet know if lockdowns will increase the suicide rate going forward.
There are also indirect routes to losing years of life. Lockdowns may have increased mental health issues and reduced educational outcomes. This is very concerning in its own right. But they can also lead to increased poverty, incarceration rates and homelessness, and ultimately increased mortality.
One could argue that without lockdowns, our hospitals would have been overwhelmed with COVID-19 cases and this would in turn lead to an increase in YLL. In a decade or two, epidemiologists might have the answer. But what is clear is that “Australia has done well” is not supported by anything other than flawed logic and marketing spin.
When we turn to consider our economic growth performance, the logic of “Australia has done well” is again flawed. And for the same basic reason. We need to consider what happens in the future. Short term economic growth can largely be controlled by governments spending more money. But this comes at the cost of higher debt going forward.
Sweden had no lockdowns. According to the International Monetary Fund, its debt to GDP ratio has increased by only 4.7 percentage points from 2019 to 2021. Australia’s debt to GDP has increased over three times more (15.5 percentage points).
On Australia’s GDP of about $1.9 trillion, the extra 10.8 percentage points equate to $205 billion. And that $205 billion may rise in this year as the IMF forecasts that in 2022 our debt to GDP ratio will grow more than Sweden's. The $205 billion eventually has to be paid, with interest. And that means less money for hospitals or roads or defence. Our governments have achieved the present economic growth but at a future cost to us, our children and our grandchildren.
A true story, or myth according to who you believe, says that in 1972, Chinese Premier Zhou Enlai was asked about the impact of the French Revolution. “Too early to say,” he replied. When people say Australia has done well, it is also too early to say.
Dr Randell Heyman has degrees in Actuarial Studies and Pure Mathematics. He is currently a university academic focusing on number theory research.
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