Tag: pandemic

Excess mortality in England

Mary Pat Campbell

Link: https://app.powerbi.com/view?r=eyJrIjoiYmUwNmFhMjYtNGZhYS00NDk2LWFlMTAtOTg0OGNhNmFiNGM0IiwidCI6ImVlNGUxNDk5LTRhMzUtNGIyZS1hZDQ3LTVmM2NmOWRlODY2NiIsImMiOjh9

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The numbers of expected deaths are estimated using statistical models and based on previous 5 years’ (2015 to 2019) mortality rates. Weekly monitoring of excess mortality from all causes throughout the COVID-19 pandemic provides an objective and comparable measure of the scale of the pandemic [reference 1]. Measuring excess mortality from all causes, instead of focusing solely on mortality from COVID-19, overcomes the issues of variation in testing and differential coding of cause of death between individuals and over time [reference 1].


In the weekly reports, estimates of excess deaths are presented by week of registration at national and subnational level, for subgroups of the population (age groups, sex, deprivation groups, ethnic groups) and by cause of death and place of death.

Author(s): Office for Health Improvement and Disparities

Publication Date: accessed 10 Aug 2022

Publication Site: Public PowerBI dashboard

Book Review: A Global History of the Black Death

Mary Pat Campbell

Link: https://undark.org/2022/07/29/book-review-a-global-history-of-the-black-death/

Excerpt:

James Belich’s new book, “The World the Plague Made: The Black Death and the Rise of Europe,” shows the depth and longevity of the controversy over the sources and impacts of an era-defining scourge. Belich, an Oxford University historian, suggests that what is now known as the Black Death was so consequential that its effects equal those of the Enlightenment, the Reformation, the Industrial Revolution, and the Renaissance. It’s a staggering implication, but he makes a decent case for it in this bold, tremendously researched work. From illustrating the plague’s effects globally to showing how central it was to Europe’s ascension, Belich demonstrates that the medieval pandemic influenced many aspects of human life.

Once called the Great Death or the Great Plague, the pandemic lasted hundreds of years and was so deadly that it is still popularly referred to simply as the Plague. “The Black Death Pandemic, beginning in 1345, persisted for more than three centuries and involved about 30 major epidemics in all,” writes Belich. What’s more, it “did not always behave like the modern pandemic,” he writes further on. “It killed far more people, for one thing.” Belich’s book implicitly underscores that, compared to the devastation of the plague, Covid-19 is relatively insignificant.

Just how many deaths was the Black Death responsible for? Despite centuries of debate on the subject, there is no consensus. The common belief is that the first wave killed between 25 percent and 33 percent of Western Europeans. (The historian Barbara Tuchman advanced the one-third estimate in her best-selling 1978 book about the 14th century, “A Distant Mirror.”) Belich suggests that the number was far higher. In the first strike alone, the population of Western Europe was cut in half, he writes, citing studies about the death rates in England, France, Italy, and Scandinavia. Many places didn’t return to their pre-plague population levels for some 250 years. (Despite his claims, the true extent of the toll is still widely contested.)

….

In Belich’s view, what made the plague different from other major historical events and catastrophes was that, while it decimated the human population, it left the material world untouched. It “doubled the average amount per person of everything,” from horses to housing, he writes. For a time, this meant more resources for survivors and greater access to luxury goods, better living conditions, and higher wages for workers.

Author(s): Jordan Michael Smith

Publication Date: 29 July 2022

Publication Site: unDark

Think You’ve Never Had Covid-19? Think Again

Mary Pat Campbell

Link: https://www.wsj.com/articles/think-youve-never-had-covid-19-think-again-11658741403

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Dr. Ding is a member of a shrinking club of people who are pretty sure they have never been infected with SARS-CoV-2, the virus that causes Covid-19. Geneticists and immunologists are studying factors that might protect people from infection, and learning why some are predisposed to more severe Covid-19 disease.

For many, the explanation is likely that they have in fact been infected with the virus at some point without realizing it, said Susan Kline, professor of medicine at the University of Minnesota Medical School. About 40% of confirmed Covid-19 cases are asymptomatic, according to a meta-analysis published in December in the Journal of the American Medical Association.

More than two years into the pandemic, most people worldwide have likely been infected with the virus at least once, epidemiologists said. Some 58% of people in the U.S. had contracted Covid-19 through February, the Centers for Disease Control and Prevention has estimated. Since then, a persistent wave driven by offshoots of the infectious Omicron variant has kept daily known cases in the U.S. above 100,000 for weeks.

Yet some people haven’t gotten sick or tested positive.

Author(s): Julie Wernau

Publication Date: 25 Jul 2022

Publication Site: WSJ

Covid-19 Impact on the South African Life Insurance Industry: What Can we Learn?

Mary Pat Campbell

Link: https://www.soa.org/sections/international/international-newsletter/2022/july/isn-2022-07-hoberg/

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The impact of Covid-19 in South Africa in terms of excess deaths was substantial, when considering the reported excess deaths as published by the South African Medical Research Council (SAMRC).[4] Please note that in this article we will not further consider whether all excess deaths can be directly attributed to Covid-19, however, as per the article “Correlation of Excess Natural Deaths with Other Measures of the Covid-19 Pandemic in South Africa,”[5] it is estimated that 85 percent to 95 percent of excess natural deaths are attributable to Covid-19.

Based on the SAMRC excess deaths, taking the expected plus excess deaths as Actual and expected natural deaths as per their methodology as Expected, we observe an Actual versus Expected (AvE) ratio of 116 percent in 2020, a ratio of 131 percent in 2021, and a ratio of 113 percent in 2022 up to May 1. When we look at the AvE for each wave, we can see that the 2nd wave (predominantly Beta variant) and the 3rd wave (predominantly Delta variant), had the most severe impact on the general population (see figure 2 and figure 3)

Author(s): Idelia Hoberg

Publication Date: July 2022

Publication Site: SOA International News

A Framework for Defining a Role for Insurers in “Uninsurable” Risks: Insights from COVID-19

Mary Pat Campbell

Link: https://content.naic.org/sites/default/files/JIR-ZA-40-10-EL.pdf

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RETHINKING UNINSURABILITY While many have viewed insurability as a binary choice with respect to a risk (i.e., insurable or uninsurable), insurability is more appropriately considered on a continuum, ranging from easy-to-insure, such as automobile or life insurance, to difficult-to-insure, such as pandemic, loss of the electrical grid, and other extreme catastrophic risks.

FRAMEWORK The role of private and public sectors in dealing with risks that are difficult-to-insure should be to develop strategies that enable a greater degree of insurability. To do so, the framework suggests that policymakers consider three fundamental options in dealing with the insurance industry:

Status Quo (SQ) –This option (SQ) contemplates a similar dynamic to that experienced with COVID-19, wherein businesses, nonprofits, and local governments found limited (if any) insurance coverage for their losses and ex post relief programs funded by the government.

Service Provider (SP) – This option (SP) contemplates an administrative, non-risk-bearing role for the insurance industry while the entire cost of claims would be publicly financed.

Service and Risk (SR) –In addition to its role as a service provider as characterized by SP, this option (SR) would expect insurers to commit capital – in an amount that does not threaten their financial viability – to cover a specified layer or other defined element of losses.

Author(s): Howard Kunreuther, Jason Schupp

Publication Date: 2021

Publication Site: NAIC

Millions retired early during the pandemic. Many are now returning to work, new data shows.

Mary Pat Campbell

Link: https://www.washingtonpost.com/business/2022/05/05/retirement-jobs-work-inflation-medicare/

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Roughly 2.4 million additional Americans retired in the first 18 months of the pandemic than expected, making up the majority of the 4.2 million people who left the labor force between March 2020 and July 2021, according to Miguel Faria-e-Castro, a senior economist at the Federal Reserve Bank of St. Louis.

The percentage of retirees returning to work has picked up momentum in recent months, hitting a pandemic high of 3.2 percent in March, according to Indeed. In interviews with nearly a dozen workers who recently “un-retired,” many said they felt comfortable returning to work now that they’ve gotten the coronavirus vaccine and booster shots. Almost all said they’d taken on jobs that were more accommodating of their needs, whether that meant being able to work remotely, travel less or set their own hours.

“This is primarily a story of a tight labor market,” said Bunker of Indeed, who added that there was a similar rebound in people returning from retirement after the Great Recession. “For so much of last year, the big question in the labor market was: Where are all the workers? This year we’re seeing that they’re coming back.”

Author(s): Abha Bhattarai

Publication Date: 6 May 2022

Publication Site: WaPo

U.S. Births Increase for First Time Since 2014

Mary Pat Campbell

Link: https://www.wsj.com/articles/u-s-births-increase-for-first-time-since-2014-11653364861

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U.S. births increased last year for the first time in seven years, according to federal figures out on Tuesday that offer the latest indication the pandemic baby bust was smaller than expected.

American women had about 3.66 million babies in 2021, up 1% from the prior year, according to provisional data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. It was the first increase since 2014. The rebound spanned age groups, with birthrates rising for every cohort of women age 25 and older.

Births still remain at historically low levels after peaking in 2007 and then plummeting during the recession that began at the end of that year. The total fertility rate — a snapshot of the average number of babies a woman would have over her lifetime — was 1.66 last year, up from 1.64 the prior year, when it fell to the lowest level since the government began tracking it in the 1930s.

Author(s): Janet Adamy and Anthony DeBarros

Publication Date: 24 May 2022

Publication Site: WSJ

Inflation: Return of a Plague

Mary Pat Campbell

Link: https://www.city-journal.org/inflation-return-of-a-plague

Excerpt:

Experience has once again verified Friedman’s and Lucas’s theories, reducing to nothing the naïve propositions of Modern Monetary Theory, a recent delusion of the American Left. According to this unscientific, ahistorical theory, legislatures can control the production of money and distribute it in a way that satisfies all needs, with no destructive consequences from expanding the money supply. The question of reimbursing a gigantic public debt is not supposed to arise, because no one can force the government to pay what it owes. But this magical solution, adopted in part by Joe Biden, ignores the fact that public debt produces inflation and that a debt that is not repaid, as in the case of Argentina, eventually ruins the currency. All this was well known, at least by economists, so it is surprising that governments in America and Europe had not taken it into account of late. They have short memories. From the 1980s until recently, inflation had been constrained thanks to public policies inspired by Friedman—but policymakers had forgotten its threatening presence, as if it belonged only to the past. We can liken inflation with pathogens: smallpox has disappeared, but vaccination is what made it disappear; stop vaccinating, and the evil can return. In the 1980s, central banks helmed by Friedman’s disciples, such as Paul Volcker in the United States or Jean-Claude Trichet in Europe, raised interest rates and defeated inflation by reducing the money supply. Today, economic policymakers will need to apply the same remedy as in 1980. Central banks are working on this, but their conversion comes late; they have waited for inflation to establish itself before responding, a delay that will make the remedy more painful.

Author(s): Guy Sorman

Publication Date: 14 Jun 2022

Publication Site: City Journal

What happens when the public health emergency associated with COVID-19 ends?

Mary Pat Campbell

Link: https://contingencies.org/the-great-unwinding/

Excerpt:

The ongoing COVID-19 pandemic has now spanned three years. A lot has changed and will continue to change once society and every industry, especially health care, adjusts to the new post-COVID world. With the pandemic, a federal public health emergency (PHE) was declared, and legislation was then passed that had a major impact on how health care is administered from both an operational and financial perspective. Many temporary provisions were put into place that mostly impact Medicaid but ultimately affect all health insurance payers. As we look ahead to a point at which the PHE ends, those temporary provisions start to end in what many in the industry are calling the “unwinding of the PHE.” This article aims to provide an overview of the flexibilities that have been offered as a result of legislation tied to the PHE, examine the impacts of increased Medicaid enrollment, and assess how the risk profile of covered lives for all health insurance payers has changed.

The PHE that has been in effect because of the virus SARS-CoV-2 (which causes the disease COVID-19, or simply COVID), was declared on March 12, 2020, retroactively effective as of Jan. 31, 2020. 

….

Where does this leave us now? At the time of this writing, the PHE is under its ninth renewal (90-day extensions) and is set to expire July 15, 2022. HHS has previously informed states that at least 60 days’ notice will be provided, which means the end of the PHE will occur July 2022 or later. States receive the additional FMAP bump through the end of the quarter in which the PHE ends, which is slated to be Sept. 30, 2022. Before the omicron wave, many thought the PHE would end in early 2022. Popular opinion seems to have shifted to a later time period, with mid-to-late 2022 being the likely end of the PHE. Any continued uncertainty with the pandemic, such as another wave of cases, is likely to extend the PHE.

As we get close to the end of the PHE though, the focus shifts from case counts and test kits to the virus becoming endemic and moving past the PHE. This puts, front and center, the unwinding of all of the operational and financial elements that have been tied to the PHE since FFCRA was passed. When the unwinding starts, it will radically change the risk profile of Medicaid and all other health payors. Measuring and mitigating against this changing risk profile is where the nature of our profession as actuaries becomes critical. The biggest driver in the changing risk profile is the enrollment growth that has occurred with Medicaid since the pandemic began, as a number of these new members are at risk of losing their coverage.

Author(s): Colby Schaeffer

Publication Date: May/June 2022

Publication Site: Contingencies

A Resilient Future

Mary Pat Campbell

Link: https://theactuarymagazine.org/a-resilient-future/

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If we consider how risk events unfold in reality, they usually occur through a sequence of interacting factors (see Figure 1). For example: A control does not quite work as intended because the usual supervisor is not available, and coincidentally a staff member has unintended access to a system from which they are able to extract personal information. On any other day, those conditions might have been different and resulted in another outcome. The reality, therefore, is that risks emerge as a result of a complex series of interactions among a large number of factors, and small changes in conditions can lead to significantly different risk outcomes.

Risk events also often involve active participants who learn and adapt their behaviors accordingly. Cyber is a good example—the attacker generally is trying to outthink their adversary and stay one step ahead. All of this means that past performance is not necessarily a reliable predictor of the future. There are too many things that can be subtly different, leading to hugely different outcomes.

Author(s): Neil Cantle

Publication Date: May 2022

Publication Site: SOA

The pandemic’s reported death toll will soon reach 1 million people in the United States.

Mary Pat Campbell

Link: https://www.washingtonpost.com/opinions/interactive/2022/how-many-people-died-covid-united-states-1-million-graphic/

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The pandemic’s death toll in the United States will surpass 1 million people in the coming days. Conveying the meaning or the magnitude of this number is impossible. But 1 million deaths is the benchmark of an unprecedented American tragedy.

Consider this comparison: The population of D.C. is about 670,000 people. Try to imagine life without every person, in every building, on every street, in the nation’s capital. And then imagine another 330,000 people are gone.

To attempt to put the 1 million deaths in context, we plotted its damage over more than two years and compared the continuing death toll with the tolls from previous catastrophes in our history.

Author(s): Sergio Peçanha and Yan Wu

Publication Date: 12 May 2022

Publication Site: Washington Post

COVID-19 Deaths Cause More Than $700M in Q1 Claims

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/05/09/covid-19-deaths-continue-to-hit-life-insurers-hard/

Excerpt:

Reinsurance Group of America — a Chesterfield, Missouri-based reinsurer — said its U.S. COVID-19 individual life claims fell to $260 million in the latest quarter, from $340 million a year earlier.

“Our U.S. individual mortality results are very consistent with what we are seeing in the general population this quarter,” Jonathan Porter, RGA’s global chief risk officer, said Friday, during a conference call with securities analysts. “We saw a reduction in our claim cost per 10,000 general population deaths as compared to the third quarter and fourth quarter of 2021. This improvement, we believe, is in part due to the lower proportion of deaths in working ages.”

Here’s what happened to U.S. COVID-19 claim statistics at some other life insurers, including some that are known mainly for group life:

MetLife: $230 million in world group life claims this quarter, down from $280 million a year earlier.

Hartford Financial: $96 million before taxes this quarter, down from $185 million a year earlier.

Unum: 1,400 deaths at an average of $55,000, or $77 million, down from 1,725 deaths at an average of $65,000, or $112 million, a year earlier.

Lincoln Financial: $53 million in group life claim claims and $18 million in group disability claims this quarter, down from $83 million in group life claims and $7 million in group disability claims a year earlier.

Voya: $35 million in group life claims this quarter, up from $29 million a year earlier.

Primerica: $16 million in life claims this quarter, down from $21 million a year earlier.

Author(s): Allison Bell

Publication Date: 9 May 2022

Publication Site: Think Advisor