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

In this week’s blog we explore the latest data on weekly deaths, which for the first time for four weeks were below seasonal norms. COVID-19 deaths have continued to fall, with deaths in the latest reported week the lowest since COVID-19 first appeared in the UK in early March. In addition, non COVID deaths have fallen 13% compared to the previous week. This may in part be due to timing of the August Bank Holiday in the UK (except Scotland). However, the fall in weekly deaths is more than we would typically see in a week with a Bank Holiday. After the upwards trend seen in recent weeks, this fall is welcome, although care should be taken in considering figures for an individual week.

The past week has seen a number of additions to the PHE ‘watchlist’ of areas of concern in England, as well as local lockdowns being introduced for the first time in Northern Ireland, while local lockdowns remain in force in both Scotland and Wales. In addition, national restrictions on numbers gathering together have been tightened in England, Wales and Scotland this week. Our recent blog post explored the rising case numbers across the UK, as well as highlighting areas which may be at risk of requiring more direct interventions in the near future. It will be important to keep a close eye on case numbers in the weeks ahead.

Weekly deaths drop back below seasonal levels

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 4th September. 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 latest data shows that the total registered deaths in the last reported week have fallen below the average for the time of year.  The numbers of both COVID-19 and non COVID-19 deaths are down on the previous week, while the seasonal average for the latest week is higher than the previous week.

The weekly death figures are based on date of registration (rather than date of death) so can be impacted by events such as Bank Holidays, when registration offices are typically closed.  Further, death registrations are collated according to the week of the year in which they occur (with the weeks always ending on a specific day e.g. a Friday in England). The actual dates these week span can differ slightly from year to year, and events such as bank holidays can appear in a different “week” from year to year. For example, the end of August bank holiday celebrated in England, Wales and Northern Ireland fell this year in week 36, the last week shown in the chart above. In contrast it had fallen in the preceding week in four of the five previous years.  This contributes to the average (dashed) line on the chart appearing to dip down, before increasing in the most recent week.

Similarly, this goes some way to explaining why the weekly deaths (bars) also dip down in the final week shown. However, the fall in deaths is more significant than we would typically expect to see due to bank holiday effects (as although the registration offices may have been closed on the Monday, there is usually time to ‘catch up’ before the Friday).

Non COVID-19 deaths fall sharply

Non COVID-19 deaths saw a sharp rise around the same time as the pandemic started to impact in the UK in April (what we termed ‘missed’ deaths, shown in red in the chart below), but had returned to the early 2020 trend of being below seasonal levels. However, in more recent weeks non COVID-19 deaths have been creeping steadily up (as seen in the decreasing purple bars) and had been higher than average for three successive weeks (noting that timings of the August Bank Holiday may have impacted the last red bar). In light of concerns for COVID-19 related reductions in the availability and uptake of medical care to result in a rise in non COVID-19 deaths, this pattern was concerning. The latest week showing a marked fall below seasonal levels is a welcome development.  

There is inevitably some volatility in these weekly deaths, as well as the impact of events such as bank holidays, so some caution is required in interpreting them over short periods. After a period of steady increases over the previous seven weeks, one week of lower than average deaths, while welcome, does not reduce the risk that we may yet see the feared increase in non COVID-19 linked deaths, and it is something we will continue to keep a close eye on. 

What is the position for the year to date?

Cumulative deaths in the UK rose rapidly as a result of the pandemic, following a relatively light start to the year. 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 years, before stabilising over recent weeks (the solid line in chart below).

The chart reminds us of the sudden and dramatic emergence of COVID-19 and its impact on UK mortality, with excess deaths of the order of 10% of the typical annual total for the UK. There are several warning signals fuelling concerns that we could be entering a fresh phase of rising excess deaths in the weeks ahead, including:

While deaths have fallen in the most recent week, the upwards trend in non COVID-19 death figures relative to average levels over the preceding few weeks also highlights the broader health impacts arising from the pandemic.

As efforts continue to restart the economy, we continue to walk a delicate tightrope between reopening services and focussed localised interventions in order to contain the direct and indirect loss of life from COVID-19.

“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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