COVID-19 Actuaries Response Group

The Covid-19 Actuaries Response Group came together on the weekend of 7-8 March 2020, as the Lombardy region in Italy was being shut down. As a group of concerned actuaries, epidemiologists and longevity specialists, they recognised a global crisis of epic proportions and committed to working together quickly, meaningfully and thoughtfully.

The Actuaries Response Group’s purpose:  

• To help actuaries in thinking and responding to the COVID-19 crisis.
• To create a community and forum for actuaries and others to learn, educate, inform and influence the unfolding events in a positive and constructive way.
• The group aims to bring credit to the actuarial profession, and support and enhance our profession’s commitment to societal and public interest.

The Covid-19 Actuaries Response Group’s principles and full range of Covid-19 bulletins can be found on its website.

Recent publications

• 100 – Our Hundredth Bulletin - In our 100^th bulletin, an achievement we’re very proud of, we trace our experience of the pandemics many twists and turns to date. Authored by Matthew Edwards, 02 February, 2020.   
   
• Friday Report – Issue 34 – Our regular Friday update with a summary of the key papers and articles that we’ve looked at recently. 
   
• Estimating up-to-date COVID-19 incidence - COVID-19 Tracker seeks to help improve and tailor measures to impede transmission of the virus, aiming to be as real-time as possible. Authored by Andrew Pijper & Jonathan Pearson-Stuttard, 20 January 2021.
   
• How soon will we see the benefits of the vaccine rollout? We will soon see a meaningful reduction in the number of cases, hospitalisations and deaths. But how soon? Authored by John Roberts, 15 January 2021. 
   
• Vaccine priorities - Nine groups in the UK have been prioritised to be vaccinated in the first phase. In this bulletin, we consider the logic of the priority order by examining the deaths to date in each group where COVID-19 was mentioned on the death certificate. Authored by Yifei Gong and Stuart McDonald, 7 December 2020

2020 highlights

• A tale of two variants -  This bulletin discusses the emergence of two new variants of SARS-CoV-2 in the UK and South Africa. Mutation of SARS-CoV-2 is common and has been under ongoing monitoring by scientists since the first genome was sequenced and released in January 2020. However, the two new variants, which share a common mutation, show cause for concern. Scientists studying these variants believe increased transmission risk is plausible but are not yet clear on the impact on severity of the disease, reinfection risk and importantly, the efficacy of vaccines. Authored by Louis Rossouw, 20 December 2020

• The Friday report, issue 31 - COVID-19 is still one of the hottest topics for scientific papers and articles. The COVID‑19 Actuaries Response Group provides a regular Friday update with a summary of the key papers and articles that we’ve looked at recently. Authored by Matt Fletcher, Nicola Oliver & John Roberts, 11 December 2020.

• Wave 2 non-pharmaceutical intervention responses - Over the last couple of months there have been different approaches adopted by the four nations within the UK to combat the second wave of COVID-19 infections. In this bulletin we explore whether the difference in approach enable us to demonstrate the relative effectiveness of restrictions. We conclude that all restrictions, with the exception of Tier 1, have a material beneficial impact on rates but that duration and behaviour before and after restriction can alter effectiveness. Authored by John Roberts, 10 December 2020.

• SARS-COV-2 and seasonal flu - Seasonal influenza is a material killer although focus has of course been elsewhere. This bulletin looks at the Southern Hemisphere's recent winter experience of flu and draws lessons from that. This Northern Hemisphere winter may be mild as far as flu is concerned. But the risk of a ‘double hit’ remains. Flu vaccination has some effect against COVID-19, and so the flu vaccine could also provide a form of protective ‘counter double hit’ – as would the social distancing that has already become routine for many. Authored by Stephen Kramer, 9 December 2020.

• Commentary on Bulletin Risk Uncertainty Psychology and Judgement - Tan Suee Chieh, IFoA President, spoke to 600 actuaries in South East Asia (Malaysia, Singapore, Thailand, Indonesia, Vietnam, Khmer, Laos, Myanmar and the Philippines) in four separate Zoom meetings (27 March to 10 April) on Risk, Uncertainty, Psychology and Judgement. Using his background and interest in actuarial science, psychology, culture, change dynamics and other disciplines, he has woven a personal narrative on the unfolding COVID-19 crisis.  Mr Tan spoke on risk, uncertainty, the psychology of risk preferences in different contexts in the COVID-19 crisis, and how good judgment can, and need to be brought to bear.  He also said that in an increasingly uncertain world, where risks cannot be modelled on a probabilistic basis, actuaries will increasingly need to develop, use and rely on judgement A summary of his presentation has been written up for the IFoA Pandemics Hub and a complete set of slides attached.
   
• What degree of compliance do we need? - For the UK reproduction number R to fall below 1, there must be a vast improvement in public compliance with quarantine. This bulletin discusses the merits of different strategies in containing the spread of SARS-CoV2. Authored by Gordon Woo, 11 November 2020.
   
• The risks of social isolation  - The material mortality impact of social isolation has been under-appreciated, but needs to be considered in planning any form of lockdown strategy. Authored by Matthew Edwards 28 October 2020.
   
• False positives: Misleading results or false narratives - COVID-19 case numbers in the UK have been increasing significantly, leading to conjecture that this increase may reflect a large number of “false positives” (people who are not infected but who test positive for COVID-19). In this bulletin we consider the issue, and conclude that the vast majority of positive tests represent real COVID-19 cases. Authored by Matt Fletcher, 21 October 2020.
   
• Overdispersion – How superspreading drives the pandemic - In this Bulletin we explore how superspreading is an important contributor to R. Broad strategies can be successful at reducing R but may come at a high economic cost. Strategies which focus on reducing superspreading may – if successful – lead to suppression of the virus at a lower economic cost. Authored by James Sharpe, 19 October 2020.
   
• Tracking the mutation potential of SARS-COV-2 - In this article, we explore the mutation potential of SARS-CoV-2 in the face of selective pressure. Authored by Dan Ryan, 15 October 2020.
   
• Long COVID - “Long covid” is a term used to describe illness in people who have either recovered from COVID-19 but are still report lasting effects of the infection, or have had the usual symptoms for far longer than would be expected. This bulletin highlights the range of symptoms and potential future burden of morbidity. Authored by Nicola Oliver, 24 September 2020.
   
• Monitoring and interpreting excess mortality statistics - The focus on understanding the extent to which the pandemic has affected different countries has thrown a spotlight on the concept of excess mortality. However, care is needed when interpreting the data and results to ensure that an objective view is obtained as to what is being seen in the data. This note sets out some of the key considerations in attempting to come up with the best view on excess mortality. Authored by John Roberts, 1 September 2020.
   
• Deaths, excess deaths and statistics - In this bulletin we note the recent news about the unreliability of daily COVID-19 death figures in England, and re-state our belief  that excess deaths are the most reliable way of gauging the pandemic’s impact. Hence, nothing has changed – it remains the case that over 60,000 have (very likely) died from COVID-19. We have analysed the difference between ONS and PHE-reported deaths, tracing the growing difference over time. Although the figures are different, the total erroneous reporting to date changes nothing. We are concerned that reduced public trust in the numbers, or Government advice, may have unwarranted consequences. Authored by John Roberts and Matthew Edwards, 19 July 2020.
   
• Are we getting better at treating COVID-19? - Comparing COVID-19 deaths against hospital admissions shows that the in-hospital mortality of COVID-19 patients roughly halved from April to June. We discuss the possible drivers for this, and conclude that the improvement comes from a combination of hard-earned understanding leading to better treatment, and better staff-to-patient ratios. This great improvement will, we hope, help in any second wave. Authored by John Roberts and Matthew Edwards, 16 July 2020.
   
• Is COVID-19 seasonal - Common coronaviruses are highly seasonal, with cases peaking in winter months. As we move out of lockdown and through the summer months in the Northern hemisphere, an obvious question is whether COVID-19 exhibits seasonality, as this will have a direct impact on the timing and level of any second wave of infection. This bulletin considers the factors typically involved in seasonality of diseases, and the research on the likely seasonality of COVID-19. Authored by Matthew Fletcher – 9 July 2020.
   
• Longer term mortality and morbidity impacts of the pandemic - This Bulletin considers the plausible mortality and morbidity consequences in respect of economic shock, physiological impacts on ‘severe symptoms’ survivors, behavioural changes, and mental health. We conclude that the sum total of these is likely to be material and negative, although we do not try to quantify the impact. Authored by Matthew Edwards and Andrew Gaches, 24 June 2020.
   
• Care homes- Forgotten by us, not by COVID - Care homes have become a controversial topic in the pandemic, for the saddest of reasons - a very high COVID-19 mortality rate, caused to some degree by poor policy (analogous to what happened in other countries, Italy for example). In this bulletin, Dan Ryan and Adrian Baskir summarise the experience to date - with around 1 in 7 care home residents dying - and draw out lessons for the future. Authored by Dan Ryan and Adrian Baskir, 17 June 2020.
   
• Estimating R for the UK - The reproductive rate R is fundamental in studying the spread of the coronavirus.  In this Bulletin, Stuart McDonald uses ONS and NHS data to estimate how R has moved over recent months. Authored by Stuart McDonald, 12 June 2020.
   
• Facemasks for public use - The use of facemasks by the public has been recommended or mandated in many countries, while the UK has remained ambivalent. This bulletin reviews the evidence for mask wearing by the public. Most of it points in the same direction: masks reduce transmission. Authored by Nicola Oliver, 4 June 2020.
   
• Mortality impacts of the pandemic – future investigations - In our first bulletin looking at the impact of the pandemic on mortality, we considered what could reasonably be inferred now about the likely post-pandemic mortality of survivors. In this second bulletin, we explore the question of mortality from the perspective of how best to use data once we are ‘post-pandemic’. This will be a challenge for pension schemes and insurance (and reinsurance) companies. Authored by Andrew Gaches, 3 June 2020.
   
• Mortality impacts of the pandemic – survivor mortality - COVID-19 mortality is associated with risk factors such as obesity and diabetes that imply higher ‘normal’ (all-cause) mortality. In this Bulletin, we consider how this may lead overall mortality of the post-pandemic ‘survivor pool’ to be lighter than it was pre-pandemic. We conclude that the effect will be low other than in subgroups with a high proportion of COVID-19 deaths (which is what you would expect). This is the first of three bulletins looking at 'post-pandemic' mortality - next we look at mortality analyses post-pandemic, and then the impact on mortality improvements. Authored by Matthew Edwards, 27 May 2020.
   
• ‘A tale of two Covids’ – South Africa and the UK - In 'A tale of two Covids', Louis Rossouw provides a comparison of how the pandemic is unfolding in South Africa and the UK. Although there are some similarities (almost simultaneous lockdown), the differences have been greater – timings of cases, population age profiles, health systems (and existing common conditions), and economic strength. Of these, it is the economic situation that leaves South Africa with less room to move, but a careful exit from lockdown is also required - or infections and deaths could accelerate rapidly and undo the good work done to date. Similar issues to those facing other countries. Authored by Louis Rossouw, 20 May 2020.
   
• Risk Factors for COVID-19 - Very little ‘multivariate’ analysis has been done to quantify the effect of COVID-19 risk factors simultaneously. Hence there is potential to misunderstand the operation of risk factors because of confounding – where the effect of one risk factor is distorted by the effect of another. Understanding risk factors better can help with understanding the underlying pathogenesis, and with evaluating strategies to move beyond lockdown. Authored by Matthew Edwards, 1 May 2020.
   
• How COVID-19 kills - This bulletin summarises how COVID-19 kills. COVID-19 damages the lungs, causing death. The joint culprits are the virus and an over-reacting immune system. Authored by Joseph Lu, 27 April 2020.
   
• COVID-19 – Will the health insurers be the unlikely winners? In this 18th bulletin, Adrian Basker, Chief Actuary of International Markets at Bupa and a member of IFoA Health and care board explores if health insurers will be the unlikely winners in the COVID-19 crisis. This unprecedented crisis is a significant disruption to the healthcare supply chain with unexpected consequences.  Health insurance typically affords its customers access to quicker and in some cases, perceived better quality of care. But public healthcare has become the only option for Covid-19 treatment in some of these countries.  In the UK, independent hospitals are currently re-provisioned to the NHS, so access for non-urgent non-Covid-19 treatment is temporarily reduced. In other countries, lockdown measures, rather than re-provisioning, would reduce access to non-Covid-19 treatment. Authored by Adrian Baskir, 22 April 2020.
   
• Are this year’s COVID-19 victims already ‘on death row’? Although many COVID-19 deaths involve those with chronic health problems (e.g. diabetics), such health problems are normal at high ages. People with managed conditions such as diabetes, even in the presence of adverse risk factors (e.g. obesity, smoking) would generally have several years of life expectancy at high ages. The contention that the majority of this year’s COVID-19 victims would have died this year absent the coronavirus is incorrect. Furthermore, it is a dangerous message as it could easily lead to an ‘it doesn’t matter’ attitude to the health crisis, and in particular, could weaken the case for social distancing. Authored by Matthew Edwards, 7 April 2020.
   
• COVID-19 in numbers: Ten times worse than seasonal influenza? In this bulletin, we look at the Case Fatality Rate of COVID-19 and compare it with that of seasonal influenza. We conclude that it is around 5-10 times more lethal than normal flu for people in the 50+ age range. This comparison excludes the question of infectiousness, but the Coronavirus seems to be more infectious (higher R0) than other well-studied influenzas. Taking that into account exacerbates the above comparison in terms of overall mortality impact. Authored by Matthew Edwards, 2 April 2020.
   
• Modelling and the COVID-19 pandemic - Fighting this COVID-19 pandemic requires a good grasp on how the virus spreads, impacts health care demand and could be managed. This bulletin highlights some examples of how mathematical modelling has contributed to the understanding and intervention of this pandemic, “the health crisis of a generation”. Authored by Joseph Lu, 1 April 2020.
   
• What is a Coronavirus? - This bulletin addresses what the coronavirus is biologically, how it spreads and causes the disease COIVID-19, the disorders it creates and it’s course. Authored by Nicola Oliver 27 March 2020.