COVID-19: The latest picture as at 21st January 2021

In this week’s blog we explore the latest weekly deaths data for the UK, covering the first week of 2021. Deaths increased sharply, however, as noted in last week’s blog, the impact of the Bank Holidays (and associated closures of registration offices) over the Christmas period is likely to have resulted in some ‘catch-up’ in death registrations over the first week of the new year. As a result, these latest figures should be treated with some caution.

While concerns remain about capacity in our hospitals given recent increases in admissions, there are some encouraging signs of daily case numbers falling recently - which may be a result of the tightened nationwide restrictions now in place across the UK beginning to have the desired effect. As the vaccination programme continues to be rolled out, there will hopefully be more positive news to come.

COVID-19 in the UK: Current position

COVID-19 case numbers continue to grab the headlines. While many cases show only relatively mild symptoms, and some are entirely asymptomatic, there will unfortunately be a proportion who will require hospital treatment and potentially intensive care. Sadly, while medical treatments continue to improve, 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 (averaged over the 7 days to the date shown to smooth out variations, such as weekends and bank holidays). We have focussed on the figures for the past few months, given the very low levels of COVID-19 seen over the summer months.

We can see how COVID-19 cases in the UK (purple line, left hand axis) increased steadily from early September, fell somewhat in late November, following a tightening of restrictions, before increasing rapidly since the start of December, potentially due to the new more transmissible variant and a (slight) loosening of restrictions for the festive period. New, more stringent, nationwide restrictions were brought in after Christmas, and it is encouraging to see that case numbers have now started to fall more recently, suggesting they may be having the desired effect. We would also hope to start to see the impact of the vaccination programme over the weeks ahead.   

There will not always be a direct correlation between cases and hospitalisations (solid green line, right hand axis), for example due to changing rates of infection across different age groups, who are likely to have differing levels of hospitalisation. However, hospitalisations (green line, right hand axis) have broadly followed case numbers (with some anticipated time lag) in the chart.  While numbers remain high, which is clearly a concern as hospitals are typically busier at this time of year, there are also signs that daily admissions may be levelling off.

COVID-19 deaths (dashed green line, right hand axis) are also following similar patterns, although the rate of increase since early December is less dramatic and closer to that seen over November. Note that, unlike in the rest of this blog, these death figures are based on date of death rather than date of registration. We are also seeing signs that deaths may also be levelling off somewhat, which is welcome news.

Weekly deaths are significantly above average seasonal levels

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 8th January 2020. Combining this information with similar data from the corresponding statistical bodies in Scotland and Northern Ireland, we can examine emerging patterns in the data.

As discussed in last week’s blog, the final two weeks of 2020 were impacted by the timing of the Christmas and New Year Bank Holidays, so were unusually low. The first week of 2021 was therefore expected to have some element of ‘catch-up’ in deaths. If we look at the average over the latest three weeks, we get a figure of just below 15,000 deaths, which is closer to (albeit higher than) the weekly figures from earlier in December.

Note that the ‘average’ line shown is for the corresponding weeks over 2015 to 2019 (rather than 2016 to 2020 for 2021). This approach will therefore exclude the impact of the pandemic (later in the year) and instead compare to what we would previously consider an ‘average’ value.

Deaths directly attributable to COVID-19 have increased sharply

We focus on deaths where there is any mention of COVID-19 on the death certificate in the chart below. 

The number of registered deaths which mention COVID-19 on the death certificate has increased sharply, being almost double the previous week’s figure. Some of this increase is likely to be due to catch-ups in death registrations from the festive period, as mentioned above, so should be treated with some caution. However, it is worth noting that the last few weeks of 2020 did not see the same ‘dip’ that we saw in deaths which had no mention of COVID-19.

Deaths excluding those linked to COVID-19 are below average levels (again comparing to 2015-2019) 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.

As noted above, the figures for the last three weeks should be treated with some caution, given variations in the timing of festive bank holidays. We have illustrated how the chart may have looked had week 52 had 2 rather than 1 Bank Holiday, with a catchup in week 53, in dashed lines (similar to the approach taken when illustrating the potential impact of the Friday Bank Holiday in May).

What will 2021 bring?

2020 saw an unprecedented increase in deaths in the UK. After a relatively light start to the year, the pandemic resulted in a sharp increase in deaths over April and May, followed by fairly average death rates over the summer, and a resurgence in deaths at the end of the year. The excess deaths figure for the year was around 83,000. Given a typical year sees UK deaths of around 600,000, this illustrates the scale of the impact of the pandemic, despite the significant social distancing measures put in place.

As noted above, 2021 began with deaths signifcantly higher than average, in part due to a catch-up from the festive period. While cases are starting to show signs of falling, they remain high, as do level of hospitalisations. We are likely to see further tragic COVID-19 deaths in the weeks ahead, and there remain concerns that the impact of disruption to healthcare services during the pandemic may have consequences in the short to medium term. Offsetting that, the hope is that the continued rollout of vaccinations will help stem both the case levels and ultimately deaths.

We will be keeping a close eye on the emerging statistics in the weeks and months ahead.

“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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