COVID-19: The latest picture as at 8th December 2020

In this week’s blog, we explore the latest data on weekly deaths in the UK. Total weekly deaths remain above average for the time of year, but show a slight drop compared with the previous week. As we approach the end of the year, the cumulative ‘excess’ deaths in the UK are approaching 72,000.

The higher than average deaths over the latest recorded week are due to a continued increase in COVID-19 deaths, which contributed around 24% of the deaths registered in the most recent week. Meanwhile non COVID-19 deaths remain below average, by a steadily increasing amount over recent weeks.

The sharp decrease in COVID-19 cases in the UK over the past few weeks appears to be showing signs of levelling off more recently. Meanwhile hospital admissions of COVID-19 patients have also been falling, albeit more gradually.  Stubbornly high case numbers combined with a slower decrease in hospitalisations raises concerns that COVID-19 linked deaths will continue in the weeks ahead.

Deaths directly attributable to COVID-19 continue to increase

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 27th November. 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.

COVID-19 deaths continue to increase, both in absolute number and as a percentage of overall deaths. While in last weeks blog we suggested that the growth rate may be slowing, the most recent registered week has seen a return to a higher growth rate. Similarly the growth in COVID-19 as a percentage of overall deaths has seen a slight increase this week from 21% to 24%.

The chart below looks at the split of COVID-19 deaths (in England & Wales) over recent weeks by age band: 

COVID-19 deaths continue to be primarily amongst the older age groups, with around 75% of deaths occuring in those aged 75 and over. This highlights just how vulnerable these age groups are to COVID-19, and the reason that they are amongst the first in line for vaccinations which started this week.

Weekly deaths remain above average seasonal levels

Despite an increase in deaths mentioning COVID-19 on the death certificate, total deaths have decreased slightly, while remaining above the 5-year average for the twelfth consecutive week. Deaths excluding those linked to COVID-19, which have been below average for the past few weeks, have again fallen in the most recent week, 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 five 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 downward trend seen over the past few weeks is nonetheless welcome, particularly at a time of rising 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 the increasing COVID-19 deaths and below seasonal average non COVID-19 deaths can be seen in the below chart.

Despite cumulative non COVID-19 deaths now over 1,000 below the corresponding 5-year average, total excess deaths are almost 72,000 above the expected number at this point in the year.  As we enter the last few weeks of the year, the picture by the end of the year may still worsen. However we hope that this week’s vaccinations may be the start of a better year ahead.

 Comparing cases, hospitalisations and deaths

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. This is emphasised by the discussion above around increasing deaths for those in older age groups despite sustained decreasing cases numbers – this effect would more likely be picked up by also looking at the trend in severe cases resulting in hospitalisation.

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, but show signs of levelling off over the past few weeks.

As expected, there was some lag between the increase in cases and corresponding rises in hospitalisations (solid green line, right hand axis), with a further lag in the rise in deaths. There will not be direct correlation between these figures, for example impacts may depend on the changing rates of infection across different age groups, who are likely to have differing levels of hospitalisation.

It is however encouraging that COVID-19 linked hospitalisations are also now falling, albeit more gradually than cases.

Time will tell whether there will be further bad news on COVID-19 deaths throughout the last few weeks of the year.  We will be sure to keep our eyes on the latest data to quickly identify any emerging signals.

“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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