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

In this week’s blog we explore the latest data on weekly deaths, which for the second week are slightly above seasonal norms. COVID-19 deaths have been relatively stable over the past few weeks. However, non COVID-19 deaths have been steadily creeping upwards since early July, both in absolute terms and relative to seasonal levels, and remain above seasonal levels for the latest week. There is a concern that this may be the start of the prolonged period of higher deaths that many medical professionals have feared, given reductions in the numbers both seeking and receiving medical treatment as a result of the pandemic. As England & Wales follow Scotland in reopening schools, and restrictions are further lifted, the risk of a further resurgence in COVID-19 is of concern. Cases are already increasing in various areas (which has triggered a retightening of restrictions across a swathe of the West of Scotland). Therefore it will be important to keep a close eye on case numbers in the weeks ahead. We will be sharing a blog post with detailed analysis of the latest case data over the next few days.

Weekly deaths slightly above seasonal levels

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 21st August. 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 were again above the average for the time of year.  The number of COVID-19 deaths is similar to the previous week, while there was a slight rise in non COVID-19 deaths.

Non COVID-19 deaths continue to cause concern

As the pandemic reached the UK, the focus of many medical facilities understandably switched to preparing for the feared surge in COVID-19 cases.  As a result, many ‘routine’ hospital services were scaled back, resulting in reduced capacity at clinics and cancelled operations. In addition, there is evidence that many people have been avoiding seeking medical help, through a combination of not wanting to be an ‘inconvenience’ or else fear of catching COVID-19 in a hospital setting. For conditions such as mild strokes, cancer symptoms etc, early diagnosis can make a marked difference to long-term prognosis, so any delays are likely to result in otherwise preventable deaths. 

Many in the medical profession have therefore been concerned about the risk of a rise in non COVID-19 deaths over the weeks and months ahead, and it appears that we may well be seeing this coming through.

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 have been higher than average for the past two weeks.  

There is inevitably some volatility in these weekly deaths, so some caution is required in interpreting them over short periods.  However the steady increase over the past seven weeks could potentially be signs of the feared increase in non COVID-19 linked deaths starting to appear, and it is something we will continue to keep a close eye on. 

The ONS have updated their analysis on deaths in England & Wales not involving COVID-19. Their initial analysis covered the period to 1 May 2020, while the updated analysis covered the period to 10 July 2020. They concluded that, while non COVID-19 deaths were 15.3% above 5 year averages for the period from 7 March 2020 to 1 May 2020, for the period to 10 July 2020 deaths were 6% below average. Older age groups, which saw the biggest increase in deaths to the start of May, subsequently saw the biggest reductions, leading the ONS to suggest that some deaths may have occurred ‘earlier’ than they would normally. (Although they do note that it is currently difficult to quantify how much of a factor this is in the reductions in deaths seen recently.) Meanwhile causes of death that saw large rises (e.g. dementia and Alzheimer’s disease) have now returned to seasonal levels. However, the period of study is prior to the increase in deaths seen in more recent weeks. 

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). 

Whilst it is reassuring that the level of excess deaths has levelled off recently, the charts 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.  Given the upwards trend in non COVID-19 death figures relative to average levels over the past few weeks, not to mention the risk of a resurgence in COVID-19 acknowledged earlier this week by the UK Health Secretary, there are real concerns that we could be entering a fresh phase of rising excess deaths.

“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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