Covid-19 mortality: the Proportionality Hypothesis

Abstract We introduce and provide evidence to support the Proportionality Hypothesis which states that Covid-19 infection fatality rates are approximately proportional to all-cause death rates by age and subgroup (e.g., socio-economic class). We also show that vaccination played a very significant role in preventing people infected with Covid-19 from needing to be hospitalised, since it reduced the average severity of an infection. Death rates involving Covid-19 were very significantly lower for people in the fully vaccinated group compared to the unvaccinated group. During the pandemic, death rates from other causes were in some cases reduced (e.g., flu and pneumonia), in some cases unchanged (e.g., lung cancer) and in some cases elevated (e.g., heart disease). We discuss the implications of our findings both for potential adjustments to extrapolative mortality models which allow for future pandemics in a way that is consistent with the Proportionality Hypothesis and for insurance companies in terms of both modelling extreme scenarios and the design of mortality catastrophe bonds.