COVID-19: The latest picture as at 15th December 2020

In this week’s blog we explore the latest weekly COVID-19 data in the UK where COVID-19 deaths remain high but saw a slight reduction, whilst non COVID-19 deaths hold steady and remain below average levels for this time of year. This somewhat positive news is set against the backdrop of a resurgence in cases and hospitalisations at the UK-wide level, perhaps signalling that this pause in rising COVID-19 deaths may be short-lived.

Since last week’s blog National and devolved governments have reacted to changing regional COVID-19 levels:

  • England has seen a sharp increase in cases in the South-East, with Greater London, parts of Essex and Hertfordshire moving to the highest level of restrictions
  • Scotland has slightly relaxed restrictions for those previously placed on the highest tier, whilst increasing restrictions in Aberdeen, and East Lothian from Friday 18th December
  • Wales took the decision to move secondary schools and colleges to online learning for the final week of term this week

COVID-19 in the UK: Current position

While case numbers grab most of the headlines, we know that many people infected with COVID-19 have relatively mild symptoms, with some cases being entirely asymptomatic. However, there will unfortunately be a number of more severe cases which require hospital treatment and, in the most serious cases, intensive care facilities. Sadly, while medical treatments have improved markedly since the start of the pandemic, a number of those admitted to hospital will tragically die. The progression from first infection, to developing serious symptoms requiring hospitalisation, to death occurring typically takes a number of weeks.

It is therefore very useful to look at the numbers of COVID-19 cases, as an indicator of imminent hospitalisation requirements, and to look at hospitalisation figures themselves as an indicator of future rises in COVID-19 linked deaths.

The chart below compares these three figures for the UK as a whole (with averaging over 7 days applied in each case to smooth out variations, such as that occurring at weekends and bank holidays). We have focussed on the figures for the past few months, given the very low levels seen over the summer.

We can see how COVID-19 cases in the UK (purple line, left hand axis), having increased fairly rapidly since early September, fell relatively sharply in November following increased restrictions from all 4 home nations. However, in the most recent week cases have started to increase once again at a national level and currently show a strong growth rate.

There will not be direct correlation between cases and hospitalisations (solid green line, right hand axis), for example impacts may depend on the changing rates of infection across different age groups, who are likely to have differing levels of hospitalisation. However, hospitalisations have broadly followed cases as expected (with the anticipated time lag) and are too showing a return to the higher levels seen in November.

The decreasing case numbers and hospitalisations seen in November have translated to a levelling-off and small reduction in COVID-19 deaths (dashed green line, right hand axis). However, given the relationships discussed, if case numbers and hospitalisations continue to increase, this reduction in deaths may be brief, with a possible return to higher levels in coming weeks.

Slight reduction in deaths directly attributable to COVID-19

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 4th December. 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. 

Following twelve straight weeks of increasing deaths which mention COVID-19 on the death certificate, the latest week of data shows a welcome reduction. Although a relief from the continued increases seen in recent weeks is encouraging, COVID-19 deaths remain high at 3,615 deaths and account for 23% of total deaths this week.

As discussed above, this respite in rising deaths may be due to the lower cases and hospitalisations in November translating to lower deaths, and given the trends seen in recent weeks it will be important to monitor COVID-19 deaths in the coming weeks.

Weekly deaths remain above average seasonal levels

The small reduction in deaths mentioning COVID-19 on the death certificate, combined with steady non COVID-19 deaths, equates to a small reduction in total deaths in the most recent week. As expected for this time of year, the 5-year average is trending upwards – despite this, total deaths remain above the 5-year average for the thirteenth consecutive week.

Deaths excluding those linked to COVID-19 continue to be below 5-year average levels as can be seen from the chart below.

The bars shaded in red indicate weeks where total deaths were above average seasonal levels. This effect was particularly evident at the same time as the COVID-19 pandemic first hit the UK over April and May and was explored as ‘missed’ COVID-19 linked deaths in our earlier blog. Since then weekly non COVID-19 deaths have been much closer to, and for the most recent weeks below, seasonal levels.

Given the statistical ‘noise’ in weekly death figures, caution is required when looking at this data over relatively short periods. However, the continued below-average levels seen over the past few weeks is nonetheless welcome, particularly at a time of high COVID-19 deaths. It will, however, be important to monitor how these figures evolve over the next few months, where deaths would be expected to increase in any given year over the winter.

What is the position for the year to date?

After a relatively light start to the year, cumulative deaths in the UK rose rapidly over April and May, and by mid-June cumulative deaths for the year to date were almost 60,000 higher than the corresponding weekly average values over the past 5 year (the solid line in chart below). For much of the summer the cumulative excess mortality was relatively stable, as weekly deaths were close to average levels. 

The combined effects of COVID-19 deaths and below seasonal average non COVID-19 deaths can be seen in the below chart.

COVID-19 and non COVID-19 deaths continue the divergence seen in recent weeks as COVID-19 deaths continue to rise amid lower than seasonal average non COVID-19 deaths. As we enter the last few weeks of the year, the picture by the end of the year may still worsen and it will be important to assess the final position as we begin 2021.

As we enter the festive period, this will be our last blog of 2020. We will return in early January to resume monitoring the ever-changing effect of COVID-19 on mortality in the UK.

Merry Christmas, and a happy New Year from everyone at Club Vita.

“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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