Australians are still dying at higher rates than before the pandemic, reflecting how Covid-19’s lingering effects may be driving a sustained increase in death and disease around the globe.

Excess mortality - the increase above the expected toll had the pandemic not occurred - was 5% for Australia in 2023, the Sydney-based Actuaries Institute said in a report Monday, significantly higher than the 1%-2% excess seen in years of crushing seasonal influenza epidemics.

The elevated toll in a country with high Covid vaccination rates reveals the long tail of a pandemic that not only caused the most deaths in a century, but left many survivors with lingering ailments, and disrupted medical care for patients with other conditions. More than four years on, hospitals are still grappling with an unexpected increase in coronary artery disease.

“Covid will continue to have an impact for some years to come,” actuary Karen Cutter, a spokesperson for the institute’s mortality working group, said. “The ‘new normal’ level of mortality is likely to be higher than it would have been if we hadn’t had the pandemic.”

The Australian findings support growing evidence that Covid-19 worsened health across populations, especially the elderly and marginalised racial and ethnic minority groups, resetting the baseline for expected mortality.

The health impact across the US may be felt for years, said Robert Anderson, chief of the statistical analysis and surveillance branch of the Centers for Disease Control and Prevention’s National Center for Health Statistics, who is trying to calibrate a new measure of excess mortality in the wake of the coronavirus.

“We know that it has done damage to people who’ve survived the virus,” he said in an interview. “Should we expect mortality to be exactly like it was pre-pandemic? I don’t think so.”

The Australian report provides one of the most detailed analyses of excess mortality since the pathogen emerged, making it valuable for researchers trying to understand the macro health landscape now.

The report looked at deaths directly and indirectly caused by Covid-19, which remains a top-10 killer in the country.

Over 6,100 Australians died of Covid in 2023, making it the nation’s ninth leading cause of death, the report said. Even though each successive wave has so far resulted in fewer deaths than the previous one, the coronavirus is likely to remain a significant cause of death in the future, especially for people who haven’t received the recommended vaccinations and boosters.

Ongoing mutations in the coronavirus mean that a new variant is sparking a Covid wave every four or five months, said David Putrino, an Australian neuroscientist who has been studying the pandemic’s health effects at the Icahn School of Medicine at Mount Sinai in New York since early 2020.

“Contrary to popular opinion, this is always going to be worse than influenza for the vulnerable,” Putrino said. “We need to put infection prevention measures out there.”

Over the period 2020 to 2023, the report found that Australia’s excess mortality was capped at 5% due to its aggressive measures to stem the coronavirus’ spread before vaccines became available at the end of 2021. Many other places saw a bigger death toll averaged across the four-year period: about 20% excess deaths in Latin America, 14% in Eastern Europe, and 10% in the US, the report said.

“The first two years of the pandemic determined whether a country ended up better or worse overall,” Cutter said. “That has to do with how countries protected their populations before the vaccines were widely available.”

  - Bloomberg