Figure 1: Own plot of four-week moving average deaths per week 2018 compared to the average of all weeks in 2016‑2019. Data from Federal Statistical Office (Destatis), 2023, “Sterbefälle – Fallzahlen nach Tagen, Wochen, Monaten, Altersgruppen, Geschlecht und Bundesländern für Deutschland, 2016‑2023“ Retrieved January 27, 2023.3
The results of these simple evaluations are consistent with a study from South Africa on relative mortality risk by temperature and age group. An increased risk of death is found not only at higher ages, but also particularly strongly among the youngest (the 0 to 4 age group), while in the middle age groups neither heat nor cold – as we know it – has a significant effect on the relative risk of death.4
Influenza influence
A logical next step after investigating rising temperatures and the resulting heat mortality, is to also look at the flipside, cold mortality. Can the increased mortality during heat waves be offset by reduced cold mortality? To answer that question we must distinguish between cold mortality and mortality during the cold season.
One major contributor to mortality during the cold season in Germany is influenza. While there is a correlation to cold temperature, it is not exclusive and the overall influenza activity is ultimately determined by many additional factors. Although seasonal influenza occurs in winter in both the northern and southern hemispheres, factors such as seasonal variations in host immune response, changes in influenza strains, and environmental factors such as humidity and UV radiation also influence influenza activity5 and, indirectly, influenza mortality. So even if the winters did become milder with climate change, influenza activity might still be significant.
Figure 2 shows that overall mortality per 1.000 inhabitants in Germany is higher in winter e.g., January, but the correlation between temperature and mortality appears much weaker than it does in summer e.g., August. While the analysis lacks an age-standardization and should therefore be handled with care, it clearly hints towards a stronger relationship between summer and heat deaths as against winter and cold deaths, where influenza activity might play an active role in dispersing the picture.