COVID-19: The latest picture as at 2nd June 2020

In this week’s blog we explore the latest data on weekly deaths, which continues to trend downwards towards average levels. In addition, we examine how registered deaths varied by location, highlighting some noticeable differences between countries of the UK, and in the drop-off of deaths between those in the hospital and care home settings.

Weekly deaths continue downwards trend 

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 22nd May. 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. It is encouraging to see that the latest data shows a reduction in the weekly death registrations; and deaths which mention COVID-19 on the death certificate have continued to fall.

Weekly figures for Scotland use a different definition of weeks, running from Monday to Sunday rather than Saturday to Friday. The chart above is based on using the Scottish data for the week ending on the Sunday immediately after the date shown on the horizontal axis.

The light mauve bar in the chart above is the deaths which do not mention COVID-19 on the death certificate. After the increase in the weekly data published last week, caused in part by registration delays because of the VE day holiday, these deaths have fallen back below the average for the latest reported week.  

The correlation of the surge, and subsequent fall, in non-COVID deaths with those attributed to COVID is quite clear in the data. While we are not medical experts, there are several potential drivers for this pattern:

  • A reluctance to visit medical facilities, particularly at the initial stages of the pandemic when there was much uncertainty, leading to delays in diagnosis and treatment.
  • Reductions in level of healthcare provision, for example house visits by GPs, resulting in ‘preventable’ deaths.
  • Patients who were already severely ill unfortunately passing away.
  • Missed diagnoses of patients who had been infected with COVID-19 but were not recognised as such – again particularly early in the pandemic when the pathology was less well understood.

For any medical or health-care experts reading this, we would love to hear your views as to what might be driving this. (I can be contacted at Conor.OReilly@clubvita.net.)

We estimate that the total death toll from COVID-19 in the UK, including both the direct and the indirect deaths (i.e. the unseasonably high excess weekly deaths shown by the red bars above), is currently around the 65,000 level.

This experience of indirect deaths is not unique to the UK.  However, it appears that the UK has amongst the highest levels of ‘excess’ deaths per capita in the world. 

Hospitals, care homes or in the home? 

We continue to see different patterns of the location of COVID-19 deaths between the different constituent countries of the UK. This is illustrated in the charts below which consider where individuals were (i.e. hospital, care home etc..) when they died. Here we focus initially on those deaths which mention COVID-19 on the death certificate and contrast England and Wales to Scotland.

We can see how the proportion of COVID-19 deaths occurring in care homes remains significantly higher in Scotland than in England & Wales. Similarly, the proportion of deaths occurring in a hospital setting is significantly lower in Scotland than in England and Wales.  While there are signs that the difference in this split is diminishing over time, in both locations over 90% of all the deaths which mention COVID-19 on the death certificate happen in either hospital or a care home.

A tale of two communities...

The impact of COVID-19 on hospital intensive care units and care homes has been a regular feature of daily news bulletins, and it is easy to see why. The number of cases both settings have had to deal with has been large, and sadly this has led to significant numbers of deaths. 

The charts below illustrate this, showing the weekly death registrations for hospitals and care homes, split between those which mention COVID-19 on the death certificate (“COVID”) and those which do not (“Non COVID”). We can see that, while encouragingly the numbers of deaths are falling in each setting, there are differences in the pace of decline, particularly for the COVID attributed deaths.

One way we can explore this further is to look at how the COVID-19 deaths progressed to their peak level and have subsequently fallen away for each of hospitals and care homes.

We see how:

  • In both Scotland and England & Wales, the peak in COVID-19 deaths in care homes came after the peak in hospitals (one week later in England & Wales and two weeks later in Scotland);
  • Care home deaths in Scotland climbed more quickly, and stayed higher for longer, than in England & Wales, but have also fallen more quickly to now be at similar proportions of the peak level (40%);
  • However, care home deaths remain a noticeably higher proportion of the peak levels than deaths in hospitals. 

If these trends continue in the weeks ahead, we are sadly likely to see a prolonged period of deaths continuing to come through which are attributed to COVID-19; albeit hopefully at ever-declining levels. It also remains to be seen how the impact of continuing loosening of the lockdowns across the home nations will impact on infection and death rates.

“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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