A summary of plenary 2 at the IFoA Conference (26 to 27 June 2023). The session had the topic of ‘Life after Covid: how will it impact our work and the skills we need?’
Stuart McDonald began by describing major mortality trends in the decade leading up to Covid. There was increasing inequality, with life expectancy ranging from 68 in one district of Blackpool to 95 in Kensington and Chelsea. Mortality improvements were stagnating in this period.
In the aftermath of Covid, the pandemic continues to have an impact on mortality. There are 4 important examples.
First, in 2022 the usual seasonal pattern of falling mortality in the spring did not occur. Rates in 2023 started high because of a very bad flu season. There have also been several waves on a similar scale to a typical flu season. This is a challenge for the NHS since it has little spare capacity.
Second, ambulance response times worsened considerably in 2022, reaching 90 minutes in December against a target of 18 minutes. Also that month, McDonald estimates that 500 extra deaths per week were caused by delays as people waited for treatment in accident and emergency.
Third, diagnoses for other conditions fell during Covid. Although the rate has recovered, this has not addressed the group that went undiagnosed.
And fourth, waiting lists increased from 4 million to 7 million between 2018 and 2022.
McDonald talked about the work of the Actuaries Response Group (ARG) during Covid. The group encompassed a range of skills: he was not one of the technical leaders, but he did have strong media contacts. ARG’s outputs were picked up by a range of organisations. Those included the Wall Street Journal, Radio 4’s More or Less programme, the Department of Health and Social Care, and the government’s SAGE committee. The government’s Chief Medical Adviser Chris Whitty also referenced its work in a televised briefing.
McDonald referred to the group’s ability to analyse scenarios and alert people to incorrect lines of argument. For example, an article in the Financial Times that claimed half the population had Covid and, at the other extreme, a naïve model that predicted Covid deaths would be 5,700 at most.
McDonald ended his opening remarks with some more general views on actuaries’ future role. He said AI posed a challenge to define the value actuaries could add. Climate change is an immediate issue. Inequality is another area where actuarial analysis can be valuable. He also thought Covid has led to a changing public view on the role of experts. People now expect them to express their views on issues.
There was a lively question and answer session with Stuart McDonald after his initial comments.
One question was about which skills were most important for ARG’s success. He mentioned understanding and analysing data, and particularly sense checking it, together with simplifying the material and presenting it for an audience.
When asked what lessons can be learned for the future, McDonald said actuaries have a bigger public profile than before Covid. They are seen as experts. ARG and the Continuous Mortality Investigation (CMI) are still doing great work. ARG’s approach was to discuss ideas in private, and if they couldn’t resolve disagreements, to move on. ARG had lost a few opportunities to comment on economic impacts of Covid – in retrospect the team, which included life and health actuaries, could have been more diverse. In general, he said it is important to follow the media’s focus, and timing is key.
Covid also highlighted the importance of local variations. For example, some ambulance teams developed their own solutions, creating makeshift ‘wards’ while waiting to admit patients to the busiest hospitals.
One questioner asked which was more important for communication: nimbleness or rigour. McDonald said both are needed, but there are different emphases. So while the CMI focuses on rigour, ARG was seeking to contribute to the debate by stating its views based on current conditions.
McDonald was asked for his views on prospects for a cure for cancer. He noted the many varieties of the disease but believed AI will help identify warning signs. Pandemic vaccines are likely to have a preventative impact on cancer. But the overlap with Covid meant this would probably have only a minor effect on life expectancy.
Regarding the coming winter, McDonald expected both Covid and flu to be significant. It will take years to address NHS funding so that ambulance response times and waiting lists can be significantly reduced.
You can purchase and watch all the conference plenaries on our Virtual Learning Environment.
