England and Wales mortality during the COVID-19 outbreak – a lay summary
In an outbreak, people focus on deaths resulting from the infection. But understanding the impact the infection is having on overall death rates can provide vital information about its effect in the population at large. This summary has been updated with figures published on the 19th May.
This study is tracking data published each week by the Office for National Statistics (ONS) on the total numbers of deaths in England and Wales. This includes deaths in the community, and in care homes, as well as hospitals. Data is published with a time lag of 11 days, and the latest data currently available is for the week ending 8th May, that is, week 19 of 2020. As the outbreak progresses and new data becomes available the study will update its answers to the following questions:
Is the number of deaths overall rising?
Not now. The total number of deaths from all causes in week 19 of 2020 was 12,657. The death rate has been falling since it surged in April and peaked at 22,351 in week 16. If you compare the current mortality rate with the typical rate when winter influenza strikes, week 19 of 2020 actually saw 11% fewer deaths than occurred in the earlier, pre-COVID peak of the 2nd week of January (14,058). A winter peak in deaths is seen most years, when respiratory illnesses such as influenza disproportionately claim the oldest members of the population. In a normal year we would expect to see the weekly death rates gradually fall from January towards summer. This year has been different.
Is the number of deaths this year higher than for previous years?
Yes. Although mortality rates are falling now, in week 19 of 2020 the number of deaths recorded from all causes was still 32% higher than the average for the 19th week of the previous five years (that average was 9576).
In this current outbreak, are deaths from respiratory conditions on the rise?
No. Week 19 of 2020 saw 923 deaths listed as being from underlying respiratory disease. This is less than for the previous week (1272), and much lower than 2020's week 2 winter peak of 2477 respiratory deaths.
Are deaths in older people rising?
Seventy-one per cent of all deaths in week 19 were of people aged over 75. The excess deaths are disproportionately among the older age groups.
In week 19, COVID-19 was mentioned on the death certificate for 3930 deaths, this has fallen considerably from 6035 the previous week. Remember that mention on the death certificate may not mean that the infection was the cause of death. And, there will be deaths from respiratory causes whose death certificates also mention COVID-19.
Mandy Payne, 21st May 2020
This is a lay summary, updated with latest figures, of a report prepared for the Oxford COVID-19 Evidence Service by the Oxford Centre for Evidence Based Medicine by Nick DeVito, Carl Heneghan, Jason Oke, Jeff Aronson and posted on 24th March 2020, updated 21st April 2020. The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. It has committed its skills and expertise in evidence synthesis and dissemination to the effort against the current COVID-19 pandemic. HealthWatch is supporting by providing lay summaries.
Disclaimer: the article has not been peer-reviewed; it should not replace individual clinical judgement and the sources cited in the original report should be checked. The views expressed in this commentary represent an interpretation by HealthWatch and do not necessarily represent those of Oxford CEBM, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute for professional medical advice.