COVID-19: The latest picture as at 12th May 2020

In their latest weekly update on emerging COVID-19 statistics in the UK, Conor and Steven explore how the total loss of life, indirect and direct, may now exceed 65,000. They highlight how the deaths may now be slowing, and explore the differing levels of COVID-19 deaths in the community within the home nations.

The “missing” deaths…

Last week we reported how changes in the methods underlying the daily numbers being reported in the media from the official government site had reduced the issue of ‘missing’ COVID-19 deaths by including deaths “in the community” who had been diagnosed with COVID-19 in the English figures. However, as these figures still exclude those with symptoms of COVID-19 but for whom no test was carried out, issues with ‘missing’ deaths remained.

The latest statistics from the ONS include detailed breakdowns of COVID-19 deaths registered in England & Wales up to 1st May, alongside basic information on numbers dying each day for registrations since then. This enables us to explore the patterns in the deaths where there is a mention of COVID-19 somewhere on the death certificate, regardless of location.   

Focussing in on the 1st May we can compare what we now know had happened in terms of deaths with the official statistics published the following day.  Although subject to some under-reporting for registrations yet to happen, this provides an indication of the level of “missing” deaths. 

“We estimate that the official figures may understate direct COVID-19 deaths by around 35%-40%, equivalent to some 11,400 -13,100 missing deaths, which could bring the total UK death toll to over 45,000.”

The “missed” deaths…

The other issue to consider is the un-seasonally high levels of non COVID-19 deaths seen over recent weeks. These “missed” deaths make no mention of COVID-19 on the death certificate but may well be indirectly related to COVID-19. 

We estimate that the total ‘missed’ deaths, allowing for experience over the last few days, may now be as high as 20,000.  This estimate is largely unchanged since our previous blog, reflecting how the week to 1 May saw a dip in non COVID-19 deaths, with some 2,000 ‘extra’ deaths compared to seasonal norms (down from around 3,000 ‘extra’ deaths per week in the prior weeks).  In making our updated estimate we have assumed a continuation of these ‘extra’ deaths closer to the 2,000 deaths per week level, hopeful that we have also passed an initial peak in non COVID-19 related excess mortality.

The tragic direct and indirect loss of life…

“Combining these 20,000 “missed” indirect deaths with the potential 13,100 “missing” deaths not counted in official COVID-19 statistics, suggests that the combined direct and indirect loss of life from COVID-19 could now be over 65,000 lives across the UK”

Sadly, the ongoing rise of COVID-19 cases in the UK, and the large number of active cases both in hospitals and care homes, mean that we expect this grim toll to continue to rise for some time yet, even if we had remained in full lockdown. 

These additional deaths already represent around 12% of the deaths we would expect in an entire year. For those setting assumptions for future longevity of pension scheme members, this will clearly be significant and require careful thought as to how to allow for. We have convened an international panel of experts to discuss the implications in our webinar on 19th May

However, the most recent data also offers some glimmers of hope, in terms of having passed the initial peak of deaths and working our way out of the first wave of the pandemic. The total weekly death registrations have now started to fall, which is clearly very welcome news. This information will no doubt have contributed to starting the process of easing some lockdown restrictions.

We note that while the fall in COVID-19 deaths makes the headlines, the non COVID-19 deaths are falling too. Of course, this may be noise in the data, but it may also be early signs of a return towards ‘normal’ death levels.

How do different countries in the UK compare?

This week has also seen the first significant differences in lockdown approaches across the constituent countries of the UK. As such it’s interesting to compare their COVID-19 experiences thus far. 

The charts below look at the breakdown of COVID-19 related deaths split by location (hospital / care home / home / other) for each of the home nations.

We see some marked differences between the countries.  In particular, the proportion of COVID-19 deaths occurring in care homes is significantly higher in Scotland than in England. This raises the question of whether there are fundamental differences in either the relative populations of individuals in care homes, the approach to hospitalisation of suspected COVID cases in care homes, or the methods for recognising COVID-19 on the death certificates for care home deaths. 

We can explore this further by comparing the total deaths, both with and without COVID-19 on the death certificate, in care homes and hospitals, for Scotland and England.

For each of the weeks shown, the overall split of deaths between non COVID-19 and COVID-19 attributed deaths across both settings (combining hospitals and care home deaths) has been very similar for Scotland and England. However, the split clearly differs within the settings.

COVID-19 deaths have formed a noticeably higher proportion of total deaths in Scottish care homes than in England; but a lower proportion of hospital deaths in Scotland. This could be suggestive of differing practices in the hospitalisation of COVID-19 cases in English and Scottish care homes. 

Despite these differences, it is also reassuring to see that, for both England and Scotland, the numbers of both COVID-19 and non COVID-19 deaths are beginning to fall. Hopefully this is a sign of things to come as efforts to control the virus start to impact; and that any easing of lockdown does not see these numbers spike back up.

“All of the team at Club Vita wish to extend our condolences to anyone who has personally been touched by bereavement in recent weeks. We know that these deaths leave behind people who are missing loved ones. Our thoughts are with you…”
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