At the prompting of a Tweep (thanks Michael), I’ve revisited my September 2024 post “In Australia, COVID-19 deaths may have stopped decreasing” to see the latest Australian Bureau of Statistics (ABS) provisional numbers which add some of 2025’s COVID-19 deaths, complete the 2024 calandar year and update the 2023 tally by 14 deaths.

Back in September, I concluded a post by saying, based on the 2022 to partial 2024 ABS data to hand, “for now, the numbers say that we are settling into a baseline of death and harm due to this respiratory virus“. That was then. Now that we have new, complete provisional numbers, what more can we say about 2024 and the trend so far?

Complete 2024 COVID-19 death numbers

Just to note the definition provided bye the ABS: An acute respiratory associated death is one where the viral disease has either directly caused the death (the virus has caused terminal complications such as pneumonia) or the person has died with the virus (a person has died from another cause but the viral illness still contributed significantly to death)

According to the newly released numbers, 2024 included 1,169 fewer acute respiratory-associated deaths (directly + with virus) than 2023. A definite drop from a total of 6,188 in 2023 to 5,019 in 2024.

Among those who died due to COVID-19, a drop of 731 was recorded between 2023 (4,609) and 2024 (3,883).

You could argue that we haven’t spent enough years with COVID-19 yet to be sure that 731 deaths isn’t within normal fluctuation between a good (fewer deaths) and a bad year (more deaths).

Summer 2024/25 recorded fewer COVID-19 deaths than summer 2023/25, while winter 2024 recorded more than winter 2023. This degree of year-to-year variation in deaths can also be observed during the peak periods of influenza and respiratory syncytial virus (RSV) activity.

We can’t accurately extrapolate the size of the next COVID-19 peak from the last one when dealing with what are considered more well-established respiratory viruses, as they exhibit significant variability. The same is apparent for SARS-CoV-2. That difference is actually a familiarity.

All that is to say that these ABS data support a continual decline in COVID-19 deaths in Australia from 2022 to 2023 to 2024. This likely reflects improved immunity, patient treatment, and management.

But to be very clear, COVID-19’s addition into our society brings with it an all-new cause of direct and indirect death and a poorly described burden of chronic diseases.

COVID-19, the newly added killer

There’s nothing new emerging from the circulation or features of SARS-CoV-2 infections. Even though severe outcomes are in the minority, new variants continue to reliably evolve and spread worldwide, facilitated by travel from where they expand in all other jurisdictions. Just as we experience with other, more well-established respiratory viruses.

SARS-CoV-2 mutates under immune pressure; our successful immunity, either from vaccination or infection, has pushed out old variants only to see them replaced by new and suitably different ones. There’s a caveat here, and that’s where old variants have continued to replicate in immunocompromised individuals for long periods. They may then come back in a new form in the future. The proposed issue of variants jumping from animals (anthroponosis) to humans (via a zoonosis) and then back to animals to cause havoc does not seem to have been a major driver of new surges to date.

The epidemics we do have appear to have a biannual peak close to summer and winter in Australia, fed by novel variants that hop onto the global travellator.

COVID-19’s murder ranking among the many other endemic respiratory viruses hasn’t changed either – SARS-CoV-2 infection outcomes still cause more deaths than those due to influenza viruses, RSV, human metapneumovirus, rhinoviruses, parainfluenzaviruses, human coronaviruses, adenoviruses, enteroviruses, bocaviruses or parechoviruses each year. Its target population is older people (over 70 years of age) and males in almost all age groups, except those over 90 years.

Aboriginal and Torres Strait Islander deaths have consistently declined from 2022 to 2024, but the mortality rate is 1.5 times higher than that among non-Indigenous people.

As many of you know, labelling SARS-CoV-2 as endemic has nothing to do with the disease it causes, but instead that it’s always present in a given jurisdiction. We know now that SARS-CoV-2 is going to keep killing and circulating and mutating for the foreseeable future while we continue to do nothing significant to interfere with that. This is the contract we’ve agreed to – without ever actually having a serious conversation about it.

What can we say about the future?

Will 2025 see a further decrease in COVID-19-related acute respiratory-associated death?

We’d be guessing – again – (as I was in September) to say we knew. But let’s hope so.

“Hopium” is a great term for a fictional addictive drug that could easily have played a huge part in this part of the book of COVID-19. This chapter describes the world’s responses after the waning tsunami of infections, illnesses, chronic disease, and deaths left behind its destructive imprint. And yes, it did leave it behind – it’s stopped delivering novelty and surprises. But the water hasn’t all dried up, and we’re left with an ongoing level of death and disability due to COVID-19. We no longer track it, try to prevent it, or discuss it as we used to.

Hopium is a poor ingredient in the recipe for success against a life-threatening infectious disease. But looking both around (at the world) and back (at our absent plans for any next steps), it’s an ingredient that perfectly explains the meal we’ve sat down to. We failed to plan for the transitional phase between pandemic and “living with COVID-19”, and so our plan was to fail. Which we’ve done. Instead, we played politics, spread lies and misinformation, created fear, pointed fingers, expressed frustrations, grew bored, stopped talking, and gave up. Not all of us, but most of us. And all of those we entrusted to lead us.

References

1. In Australia, COVID-19 deaths may have stopped decreasing
   https://virologydownunder.com/in-australia-covid-19-deaths-may-have-stopped-decreasing/
2. Deaths due to COVID-19, influenza and RSV in Australia – 2023 – May 2025
   https://www.abs.gov.au/articles/deaths-due-covid-19-influenza-and-rsv-australia-2023-may-2025