From the beginning of September to the beginning of October, the overall mortality rate rose to a level recently observed in the 1990s, when life expectancy was about four years lower. Overall, the excess mortality rate in Israel is lower than expected according to the age structure and patterns of infection of Israelis with the corona virus. The result is a two-month decline in life expectancy at birth and a nearly three-month decline in life expectancy at age 65.
The high rates of infection and mortality among the ultra-Orthodox and Arabs will lead to a more significant increase in excess mortality in these populations and a sharper decline in their life expectancy.
Identifying corona-related mortality is a rather challenging task, as it is difficult to know whether the virus was the leading cause of death, a contributing factor or background characteristic, and whether the patient was on the verge of death or in the absence of corona would have lived for many years. Another challenge is to distinguish between the direct effects of the virus on mortality and its indirect effects – such as diverting most of the resources of the health system to treat the plague and deducting the resources intended for the treatment and prevention of other medical conditions.
Among the waves of the Corona epidemic – the overall mortality rate in Israel has been the lowest in recent years
In a study by the Taub Center, Prof. Weinreb examined the differences in mortality rates for all reasons between 2020 and the years preceding it, and trends in mortality rates by age groups. The study shows that although mortality has been declining over many years, in recent years there has been a slowdown in decline, most likely as a result of an increase in common health conditions such as diabetes and obesity.
At the beginning of 2020, however, the picture is completely different: during the first two months of the year, the lowest mortality rates in Israel ever – less than 11 deaths per 100,000 inhabitants per week – decreased by 7% compared to the same period in 2017-2019. The effect of the corona on mortality rates began to be felt from the end of March, and especially from the beginning of July to the end of September. It is important to note that between the waves, mortality rates returned to lower levels than they were in 2017–2019.
Corona plague has led to an increase in the excess mortality rate, but a marked decrease in the mortality rate of people under the age of 30
Between 18 March and 31 December 2020, the number of deaths was 7% higher than in the corresponding period in previous years, taking into account only the increase in population. However, even taking into account the expected reduction in mortality rates in the absence of corona, estimates of excess mortality are rising.
Examining age groups, Prof. Weinreb found that in age groups over 55, mortality rates were particularly low in the first two months of the year, especially among those aged 65 and over. Mortality rates in these groups rose from mid-March to mid-July to levels that were in 2017–2019, and then continued to rise to uncharacteristic highs, particularly among those aged 65–74.
Among young people, the picture is different: among people aged 0–19, mortality during 2020 was 23% lower than in 2017–2019, and among people aged 20–29 by about 4%. These trends confirm the claim about the continuing decline in mortality in the general population, in contrast to the patterns observed in the U.S., where non-Corona-related mortality rates in 2020 were high and there was no decline in mortality in any age group.
“The total number of corona deaths in each age group consists of the rate of infection by age, the probability of dying from corona by age, and the number of people in each age group. The risk of mortality varies between age groups, so it is affected by society’s ability to maintain a low infection rate.” Explained Prof. Weinreb.
Since the outbreak, the verified patients have been mostly from the 20-55 age group. As for adults, the rate of verified patients among those aged 80 and over at the time of the first wave was 40% higher than their rate in the population, until September it dropped to about 60% of their rate in the population, in October it rose again, then fell again. A similar trend was observed among those aged 60 and over. These trends indicate some success in protecting adults from infection. If the infection rates matched the age structure in Israel, there would be 31% more deaths in Israel. If the rates of infection matched the age structure in OECD countries, the number of deaths would have doubled.
Another result of the excess mortality rate in Israel for 2020 is the effect on life expectancy: life expectancy at birth is expected to decrease by about two months among men and women alike. This means that the excess mortality associated with corona had a heavier weight than the sharp declines in mortality rates among younger ages. However, given the high rates of infection among young people, the decline in life expectancy is lower than expected.
Mortality rates have risen, but less than expected. Most of the victims are Arabs and ultra-Orthodox
The corona plague has led to a significant excess mortality rate in Israel. At the end of December, the official death toll from Corona was 3,338. In the absence of corona, Says Prof. Weinreb, And given a 7% reduction in mortality during the first 11 weeks of the year, there was a decrease of about 2.5% throughout the year compared to levels in 2017–2019. Instead, from the end of July to the beginning of October, excess mortality in Israel rose to a peak of 30%, raising the overall mortality rate to an level not observed this season since the 1990s, when life expectancy in Israel was four years lower than today.
Given the rate of population growth alone, this wave of deaths in the corona era increased the number of deaths by about 7%, but if one also takes into account the expected reduction in mortality in the absence of corona, the plague increased the death toll by about 10%. Although this is a significant increase, it is lower than in other countries (for example, 18% in the United States, where mortality rates were higher than in Israel even before the corona plague).
“It should be remembered that the flu pandemic in 2015 also reduced life expectancy in most European countries by more than three months, even in countries with good health systems,” he said. Explained Prof. Weinreb. “A two-month decline in life expectancy in 2020 due to the corona is a relatively moderate decline, but it is not yet known what is expected in 2021, as the mortality rate in the last two months has been unusually high. However, it is important to understand that wearing masks and maintaining social distance helps reduce disease transmission. Others, as evidenced by the very low number of cases of influenza this winter. “
Existing data do not make it possible to accurately estimate the effect by population groups throughout the year, but they show that about half of all those infected among those aged 65 and over by mid-October were from the ultra-Orthodox population, and coronary heart mortality rates were four times higher than the general population. Thus, the decline in life expectancy can be expected to be disproportionately concentrated in ultra-Orthodox areas. Even among the Arab population, the excess mortality may be higher, but not because of particularly high rates of infection but because of background diseases, especially diabetes and heart disease that are more common among this population.
“The corona plague has far-reaching effects on all areas of life, and it has significantly increased excess mortality in Israel. A two- to three-month decline in life expectancy, as Prof. Weinreb found, is significant but smaller than the decline observed in other countries, thus recording some success for Israel.” , Said the president of the Taub Center, Prof. Avi Weiss.
The Taub Center for Social Policy Research in Israel is an independent and non-partisan research institution that deals with economics and society. The center provides policy makers and the public with research and data on some of the most important issues Israel faces in the areas of education, health, welfare, the labor market and economic policy, in order to influence decision-making processes in Israel and improve the well-being of all residents.