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

In this week’s blog we explore the latest data on weekly deaths, which for the third consecutive week are above seasonal norms. COVID-19 deaths have continued to fall, contributing just 1.1% of deaths in the latest reported week. While absolute numbers of non COVID deaths have fallen compared to the previous week, the fall has been less than the fall in average deaths for the week, meaning that they remain above seasonal levels for the latest week. This may in part be due to timing of the August Bank Holiday in the UK (except Scotland). However, the upwards trend in recent weeks gives cause for concern that this may be the start of a prolonged period of higher deaths; something medical professionals have feared, given reductions in the numbers both seeking and receiving medical treatment as a result of the pandemic. The past week has seen further local lockdowns being put in place in both Scotland and, for the first time, in Wales, as well as several additions to the PHE ‘watchlist’ of areas of concern in England. Our recent blog post explored the reasons behind the changes seen in England, as well as highlighting areas which may be at risk of being added to the watch list in the near future. It will be important to keep a close eye on case numbers in the weeks ahead.

Weekly deaths slightly above seasonal levels

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 28th 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 remain above the average for the time of year. The numbers of both COVID-19 and non COVID-19 deaths are slightly down on the previous week, but the reduction is less than that seen in the average for the 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. While the latest week 35 did not include the August bank holiday this year, the corresponding week has included a bank holiday in 4 of the previous 5 years. This contributes to the average (dashed) line on the chart appearing to dip down in the most recent week. Some part of the increase in ‘excess’ deaths this week may be down to the impact of not having a bank holiday in the latest week this year – in which case we would expect to see a (partial) reversal next week when any impact of the 2020 August bank holiday will be seen.

Non COVID-19 deaths continue to cause concern

As medical facilities understandably prepared for a feared surge in COVID-19 cases, and many people avoided seeking medical help, through a combination of not wanting to be an ‘inconvenience’ or else fear of catching COVID-19 in a hospital setting, many ‘routine’ hospital services were scaled back over the summer, resulting in reduced capacity at clinics and cancelled operations. 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 medical professionals have been concerned about the risk of these circumstances leading to a rise in non COVID-19 deaths, 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 three weeks (noting that the latest week may be impacted by timings of the August Bank Holiday).

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. 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. 

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 above average deaths seen over the past few weeks have, however, nudged the cumulative value up slightly again.

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. The rise in new COVID-19 cases seen across various parts of the country, coupled with hospital admissions relating to COVID-19 starting to creep up in early September, is fuelling concerns that we could be entering a fresh phase of rising excess deaths in the weeks ahead. The upwards trend in non COVID-19 death figures relative to average levels over the past few weeks also highlights the broader health impacts arising from the pandemic. As we seek to restart the economy, it appears we are walking 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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