Funeral directors have seen great crowds since Christmas. Monuta in Apeldoorn has had hundreds of extra funerals for weeks. “It really takes all hands on deck to complete the planning,” says Director Funeral Care at Monuta Corné Mulders. Funeral centers are full, it’s shifting the planning to get the services done.
Mortality is upset
All this has to do with excess mortality: more people are dying than expected. “The mortality is a bit upset,” says CBS researcher Ruben van Gaalen. “Since the spring of 2022 there has been excess mortality again. In the last four weeks of 2022 it was even remarkably high: 15,819 people died, a quarter more people than normal.”
CBS over oversterfte in 2022
Statistics Netherlands reports on the basis of provisional annual figures that 170,000 people died last year. That is 14,500 (9.3 percent) more than expected. Mortality was higher in every age group. The excess mortality in 2022 was slightly lower than in 2021 and 2020, but much higher than in years with severe flu waves, such as in 2015 and 2018. There was no excess mortality in the first three months of 2022, but there was from the end of March. Since that time there has been excess mortality in almost every week.
“We’ve had waves like this before, but high mortality over such a long period is not common,” says researcher Van Gaalen. The suspicion is that corona plays a major role. But corona may not explain everything.
The excess mortality (in the first nine months of 2022) was in numbers greater than the deaths from the virus.
Thoroughly wrong
Member of Parliament Pieter Omtzigt has long argued for a broad independent study of excess mortality, which also specifically looks at 2022. “Normally, an excess or under-mortality of a few thousand people is normal. During the two corona years (2020, 2021) that was 15,000 people per year. years. Extremely high. And that excess mortality remained extremely high in 2022: about 14,500 people.”
There is currently no conclusive explanation for the persistent excess mortality, says researcher Van Gaalen. In addition to corona, other, as yet unproven effects may also play a role. Like the delayed care. During the corona pandemic, a lot of care, for example cancer care, has been postponed due to the high pressure on hospitals. Researchers and members of parliament are therefore increasingly pressing for research into the phenomenon.
More than ten studies are already underway, but there is not yet an unequivocal answer.
Vaccinations
Because the lack of clarity about the remarkably high mortality in our country is food for speculation. Corona skeptics argue that it would be because of the corona vaccinations.
CBS strongly opposes this. “We see quite the opposite. In countries where many people have been vaccinated against corona, such as New Zealand, we do not see any excess mortality at all. Vaccinations actually have a positive effect on people’s health to prevent illness or death.”
“Speculation about the causes of excess mortality happens enough on this file,” says MP Omtzigt. He wants to expand research to the year 2022. “CBS investigated whether vaccinations led to death in the two months after vaccination in 2021 and found no indications for this. Now you also have to extend that research to 2022 and also provide the data to scientists for available to those who wish to conduct research.
Cancer research
PVV MP Fleur Agema agrees. The fact that ‘normal treatments’ were postponed due to corona care may cause additional deaths. “We see a lot of excess mortality in the group aged 50 to 65. Isn’t that striking? If there is more mortality in this group because these people did not receive regular care due to the government’s corona approach, for example cancer care, then we have to really something.”
Agema finds it incomprehensible that it is not possible to urgently find out how large the effect of the years of life lost due to delayed care is. Omtzigt: “If the excess mortality is because cancer screenings have been halted, the government will have to allocate considerable extra money to make up for all missed screenings very quickly. And if lung covid is the reason, then we know that much more money is needed in research into corona must be stopped.”
Minefield
But this requires access to all public data, which has been anonymized in such a way that results cannot be traced back to individuals, emphasizes Omtzigt, who calls the research a ‘minefield’. RIVM and CBS keep track of the data, but not everything is released and shared in connection with privacy. For example, specific data about underlying suffering, hereditary diseases and living context.
Excess mortality working group
The fact that sharing data is so difficult bothers MPs. Agema: “I don’t understand why they can’t just make two groups: vaccinated and unvaccinated. And research the excess mortality within those two groups. Then we will get answers.”
The House of Representatives has had a working group on excess mortality for several months. Wieke Paulusma, member of parliament of D66, is a member of this. In our country, compared to other countries, it is relatively difficult to exchange health data, she says.
“We have all kinds of databases where patient data is stored, but they are separate parts. We have to look at how we can exchange data and data better, within the limits of what is possible. Of course we have to be careful and work within the rules, but sharing data is very important to get facts on the table and to promote the health of the Netherlands.”
To exchange
Paulusma even advocates exchanging data at European level in order to gain much better insights. “Not only to explain the excess mortality, but also to make our health care better,” she says. “Scandinavian countries, for example, know that certain chronic diseases are relatively common in some parts of the country thanks to the sharing of health data. Important, you can then make policy on that.”
At the end of April, the working group will present the first results and a debate will follow.
Cooper response
Minister of Health Ernst Kuipers calls the high excess mortality ‘a very important subject’. He points to the many studies that are being done and says to wait and see. He cannot yet say when those results will be available. “It will take a while, these are complex investigations.”
Kuipers does call the linking of different data files together, which has been successful, an important step. “That was already complex in itself, but we have taken clear steps in that.”
Follow-up research
Kuipers is currently reluctant to include the year 2022 in the studies, as MP Omtzigt, among others, wants. “I think it’s very important that we first look at 2020 and 2021. Previous research has been done into this and you want to be able to compare the data from different studies,” says Kuipers. “Let’s just finish that first. And then we’ll see what kind of follow-up research that requires. And a follow-up study may also focus on 2022.”
When asked what Kuipers himself thinks is the cause of the high excess mortality, he points to the corona outbreak and the deaths that resulted. In addition, according to him, there could be all other possible causes.
“This may concern delayed care in times of corona. This may concern population screening for cancer that has been temporarily halted. And there are other causes that you have to take into account, but for that it is extremely important not to speculate, but first careful research.”
