Why is North’s Covid death rate almost seven times higher than that of Republic?

Five more deaths and 1,771 new positive cases of Covid-19 in Northern Ireland were reported on Wednesday.

The death rate in Northern Ireland from Covid-19 is currently almost seven times higher than it is in the Republic. The number of people who have died from the illness in the last seven days in the North is 49, the equivalent of 122 in the Republic adjusted for population.

It seems a shocking comparison but there are explanations, according to the North chief scientific adviser, Prof Ian Young.

The most obvious one, he said, is that when you have a high number of positive cases it naturally follows that after a lag time you will have a high number of deaths.

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Northern Ireland’s case numbers have been much higher than the Republic in recent weeks. The North’s health department’s Covid dashboard features a graph comparing daily international death rates based on a seven-day rolling average. It compares Northern Ireland with seven countries – the Republic, the UK, the US, Italy, Japan, South Korea and China.

Last Saturday, the North topped the list at 0.44 deaths per 100,000 of population, which at the time was more than 10 times the death rate of the Republic at 0.04 deaths per 100,000.

Second was the US with 0.33 cases per 100,000; the UK as a whole at 0.15 cases; Italy 0.08; the Republic at 0.04; Japan at 0.03; South Korea at 0.02; and China at zero.

Recent upsurge

“Although the numbers at the moment are relatively high, they are still actually low compared to other stages of the epidemic,” Prof Young said.

He said that prior to the recent upsurge the number of cases were “significantly higher” in the Republic than in the North, which pressed ahead earlier and more rapidly with vaccinations. “But now the Republic has overtaken us in terms of vaccinations and that is a significant factor in terms of the difference in case rates.”

And there were other factors, he suggested. For example, there is evidence that immunity among the vaccinated “wanes with time”. And because the North’s the vaccination programme was rolled out ahead of the Republic there was evidence that this “waning of immunity” was happening there first.

Prof Young also pointed out that lockdown measures were eased in the North significantly ahead of the Republic. Indoor hospitality was permitted north of the Border from May 24th while it did not happen in the Republic until two months later on July 26th.

This meant there was much more indoor mixing in the North with the added factor that thousands of visitors from the Republic availed of the earlier easing to cross the Border for city weekends or holidays .

Different behaviours

He said there may be the issue of “different behaviours North and South, although it is difficult to get reliable information on that”.

But anecdotally, there are plenty of reports that since the earlier relaxing of lockdown people in the North have not been observing the rules as stringently as those in the Republic.

Prof Young said he believed the North was very close to reaching peak cases and deaths. “I expect there will be a slight reduction in the next two to three weeks,” he said.

But they could rise again when the schools return after the summer holidays, particularly as students aged over 12 are not being vaccinated in the North as they are in the Republic.