COVID-19: EXCESS DEATHS (to week 33)

There are three vital statistics in the fight against COVID-19:

1. New daily infections
2. Survivors suffering from LongCOVID
3. Excess deaths

New infections kick off the 'process' which leads to death or survival.  The number of daily new infections is therefore critical in managing COVID-19, and is covered extensively elsewhere in this blog.

The initial symptoms of COVID-19 often last up to 3 weeks.  But a significant proportion subsequently suffer from LongCOVID for 2 or 3 months or more.  The symptoms are of two main types:

• Lethargy
• Pain and other problems where the virus has attcked the heart, liver, kidney, brain, lungs and other organs

Statistics for LongCOVID are scant as yet, but is thought that this could become a bigger problem than death, especially for young people.  It is such a problem that a specific support group has been set up, which provides a host of resources to help 'longhaulers'.

But death is still a massive issue for COVID-19.  So this blogpost takes a closer look.  As there are issues with establishing cause of death, it is simpler and more reliable to look at "excess deaths".


EXCESS DEATHS

The Office for National Statistics (ONS) collects and publishes data from death certificates.

The reasons given on the death certificates are of two relevant types, as the ONS explains:

• "An 'underlying cause of death' refers to the main cause of death"
• "A cause being 'mentioned on the death certificate' means that it might be the main reason or a contributory reason to the cause of death."

The problem with both statements is someone has had to decide, and the methods used in different countries are not necessarily comparable.

A more reliable and comparable method is to track "Excess Deaths", which is simply comparing total deaths for 2020 against the average of the previous 5 years 2015-2019.

Graphing the ONS weekly data, on a cumulative basis for year to date, we get:

There are four distinct phases:

• 2020 started well, with deaths falling behind the average for the last five years until mid-March.  
• Then the excess rose dramatically through till mid June.  
• After this deaths have fallen slightly
• Until mid August, when they started to rise again

The total excess for 2020 at 14 August was 53,084.  But the total from mid-March to mid-June, covering the peak of the pandemic, is 59,345.


60,000 in round  terms.  This would have been far higher if there hadn't been a lockdown and subsequent restrictions.
 
Excess deaths take into account three aspects:

• Death from COVID-19 itself
• Any additional deaths indirectly caused, for example by not identifying other criticial illnesses as early as normal
• Any reduction in deaths indirectly caused, such as fewer road deaths as a result of less travel

Excess deaths is therefore a reliable measure of the net impact of COVID-19 and the nation's response.


WHAT ABOUT OTHER SPECIFIC YEARS?

Within the last five years, the worst total of deaths was for 2018.  Charting 2020 against 2018 and the five-year average, again on a cumulative basis for year to date, gives this picture:

This clearly shows total deaths for 2020 overtaking 2018, which wasn't that much different from the average.


BUT AREN'T DEATHS MAINLY OF OLDER PEOPLE?

This is true, but let's look at younger adults.

The basic ONS statistics only use seven age categories in 2015-2019, whereas there are bands of just 5 years for 2020.  For comparative purposes let's look at the 15-44 year old bracket.

Here are the excess deaths of 2020 compared to the average of 2015-2019 for the 15-44 age group, again on a cumulative basis for year to date:

This graph again shows four periods:

• 2020 started well, with deaths falling behind the average on January, but increased in February and March to levels seen in some previous years.  
• Then the excess rose dramatically through April, to a cumulative total of 254, being 5% higher than normal
• The lockdown had a more marked affect than other age groups from May to July
• Stopping the rapid rise
• Curtailing other dangerous activities
• Then in August, started to rise again when restrictions reduced

So COVID-19 looks like it killed some 250 more young adults than normal in the first wave, and the lockdown restrictions not only stopped the rise but reduced other dangerous activities.  Though excess deaths are now increasing as resttictions are reduced, such as pubs opening.


IN THE CONTEXT OF INFLUENZA

The BBC reports that 4,000 deaths from 'flu in the season spanning 2018-19 to more than 22,000 in 2017-18.

The ONS data used for the analyses above reports deaths from all respiratory diseases, which is a higher number totalling between around 40,000 and 50,000 a year.

Using thjis ONS data, in the four months from mid-March to mid-July, cumulative deaths from COVID-19 overtook the worst previous year 2018, despite the lockdown's restrictions.

Had there not been a lockdown, it looked like hospitals would have been overrun, and deaths from COVID-19 would have exceeded the usual level of all respiratory diseases by a big margin.  Again on a cumulative basis for year to date:

IN CONCLUSION

By looking at cumulative numbers, as we've done above, we can see the total impact of COVID-19 on deaths in England and Wales.  Specifically:

• The total number of deaths in 2020 so far is significantly higher than any of the last five years.

• By comparison to flu and other respiratory diseases, deaths related to COVID-19 caught up seven months in just four.  Deaths would have become far higher if there had been no lockdown.

• The excess deaths in England and Wales to week 33 (14 August) is 53,084.  But the total from mid-March to mid-June, covering the peak of the pandemic, is 59,345.  Nearly 60,000.  A significant number of people dying before their time.

• The impact on younger adults in the 15-44 age range has, as would be expected, been lower in absolute numbers. But cumulative excess deaths rose to some 5% of the average number of deaths, and we are again seeing a rise.

• These figures would have been far higher if there hadn't been the restrictions of the lockdown.  The coming winter threatens to make the figures rise far higher if suitable precautions are not followed.