COVID-19: The latest picture as at 13th October 2020

In this week’s blog we explore the latest data on total weekly deaths, which currently sit above average seasonal levels even if we strip out deaths where COVID-19 has been mentioned on the death certificate. As for deaths directly attributable to COVID-19, we continue to see the upward trend observed in recent weeks.

In the week since our last update, there has been further movement towards more stringent restrictions across the UK. In Scotland hospitality restrictions have been introduced – limiting opening hours to 6 a.m. - 6 p.m. (or 10 p.m. outside if you can brave the autumn Scottish wind!). Additional mini ‘circuit-breaker’ restrictions have been enforced in the more populous central Scotland, where pubs and restaurants are closed outright, and tight restrictions placed on meeting other households continue. Elsewhere in the UK, the government has outlined plans for a new “three-tier” system of local restrictions from Wednesday 14th in an attempt to limit transmission at a more local level and avoid a national lockdown.

At this stage, we have not seen excess deaths rise dramatically following the jump in the number of cases seen across the UK (as outlined in our latest cases blog). However, as both total deaths and those directly attributable to COVID-19 continue to steadily rise, concerns remain that we could be entering a fresh phase of the pandemic as we head into winter.

Continuing increase in COVID-19 deaths

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 2nd October. In particular, they identify deaths where there is any mention of COVID-19 on the death certificate. Combining this information with similar data from the corresponding statistical bodies in Scotland and Northern Ireland, we can examine emerging patterns in the data. 

The gradual increase in COVID-19 deaths over the past weeks continues – although we are still far from the levels observed at the start of the pandemic. The steady increase in deaths may indicate the beginning of a rising trend which is unsurprising given the high case growth seen across the country. The fact that deaths are not (yet) showing the dramatic increase seen in March and April may suggest that those now contracting the virus are perhaps younger, fitter and more resilient to the effects of the virus, or that improvements in medical treatments have reduced the mortality rate.

As more stringent restrictions are implemented, we will be keeping our eyes on the data to see whether we see a slowing of the trend in case rates and deaths in the weeks ahead.

Weekly deaths are above average seasonal levels

Last week, total deaths were in-line with the average seen over the past 5 years. Unsurprisingly, given the further uptick in COVID-19 deaths seen this week, total deaths are now slightly above the 5-year average. This movement is in part due to COVID-19 however, as can be seen from the graph below, this above average level is still observed even if we strip out deaths where COVID-19 has been mentioned on the death certificate.

The bars shaded in red indicate weeks where deaths not directly attributable to COVID-19 brought total deaths above average seasonal levels, even before including the COVID deaths.

This effect was observed to the greatest extent through the months of April and May and was investigated as ‘missed’ deaths in our earlier blog. The additional level of mortality could be due to a range of different factors, such as an under-reporting of true COVID-19 deaths or wider impacts on the health service - whether that be disruptions in treatments for terminal illnesses or simply a reluctance amongst some people to seek medical assistance during the pandemic. The latest increase in ‘non-COVID’ excess deaths could be statistical noise, but it may once again be a sign of these ‘missed’ deaths and it will be important to see how this evolves as we head into winter. 

Possible drivers for the increase in COVID-19 deaths?

As discussed, COVID-19 cases across the UK have been high and climbing for several weeks but deaths have not experienced the same jump that was observed in the earlier stages of the pandemic. It has been suggested that this is due to younger generations being behind the increase in cases as schools, colleges and universities returned and older generations, who are more likely to face complications, thus far managing to avoid transmission of the virus.

Below shows COVID-19 deaths split by age for England & Wales over the past few months:

For most causes of death, we would expect to see higher numbers of deaths in older populations reflecting their relative frailty, and research thus far shows COVID-19 is no different in this regard. However, recent weeks have seen a sharp increase in deaths for those above 75 whilst deaths in younger generations have remained relatively constant. This has followed an earlier rise in case numbers amongst older age groups and it this rise which particularly concerned Chris Whitty (Chief Medical Officer of England) in Monday’s press briefing when he said (paraphrasing): Rising cases amongst older generations lead intertribally to rising hospitalisations and in turn to deaths.

The emerging data suggests that our older generations now being exposed to the virus in higher numbers once again, and in turn the mounting concern of the pressures our health service will face over forthcoming weeks. Sadly, it seems likely that we will see more weeks of excess mortality during the final quarter of the year.

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