Last week we explored how the death tally shared at the daily Downing Street briefings were materially underestimating the true scale of COVID-19, due to a combination of “missing” and “missed” deaths. Since then the official statistics have been revised. However, underreporting remains an issue.
Sadly, our previous conclusion remains true: the true loss of life directly and indirectly from COVID-19 is likely to be double the official tally. As at 5th May 2020 that could mean the loss of 60,000 lives across the UK.In this blog we explore the latest data, and how the issues of “missing” and "missed” deaths have evolved over the last week.
The “missing” deaths…
The daily numbers being reported in the media are those on the official government site. Initially these figures covered deaths in specific locations and often only included those who were tested positive for COVID-19 prior to death. This misses a significant number of COVID-19 deaths.
In particular, England’s contribution to the daily tally previously only included hospital deaths. However, from 29 April the approach used in England was revised to include those who died “in the community” (generally, but not limited to, deaths in care homes). This approach is closer to that adopted in Scotland.
In both countries the ‘official’ count continues to only includes those deaths where the individual tested positive for COVID-19. As such they exclude those with symptoms of COVID-19 but for whom no test was carried out.
There will therefore still be issues with ‘missing’ deaths, as reflected in differences between the official figures and those published by the ONS (along with similar publications from the respective national statistical agencies of Scotland and Northern Ireland).
How has the change in approach impacted the ‘missing’ deaths?
The latest statistics from the ONS include COVID-19 deaths registered up to the 2nd May, where there is a mention of COVID-19 somewhere on the death certificate, regardless of location.
Focussing in on the 24th April we can again compare what we now know had happened in terms of deaths (i.e. including those deaths registered between the 24th and 2nd May), with the official statistics published the following day. This provides an indication of the level of “missing” deaths. (We have chosen the 24th of April as it is the end of the last week detailed in the ONS publication.)
The change in approach to the data published for England has reduced the under-reporting gap, however a significant issue remains.
We estimate that the official figures may understate direct COVID-19 deaths by around 40%, equivalent to some 11,500 missing deaths, which would bring the total UK death toll to over 40,000.
The “missed” deaths…
Our second blog of last week looked at the issue of ‘missed’ deaths; the un-seasonally high levels of deaths which make no mention of COVID-19. The past few weeks have seen around 2,000-3,000 more such deaths each week than is usual for this time of year. These deaths may sadly be indirectly related to COVID-19.
This trend has continued, with the latest data suggesting some 3,500 ‘extra’ deaths (excluding COVID-19) in the week to 24th April, bringing the total since mid March to over 12,000.
Weekly figures for Scotland use a different definition of weeks, running from Monday to Sunday rather than Saturday to Friday. The chart above is based on using the Scottish data for the week ending on the Sunday immediately after the date shown on the horizontal axis.
We estimate that the total ‘missed’ deaths, allowing for experience over the last few days, may now be as high as 20,000.
Combining these 20,000 “missed” indirect deaths with the 11,500 “missing” deaths not counted in official COVID-19 statistics, suggests that the combined direct and indirect loss of life from COVID-19 may now already be 60,000 lives across the UK
Have deaths peaked?...
Understanding the wider death toll is one of the key factors to consider when contemplating moving towards ending lockdown. While the headline daily deaths figures have been tending downwards for a week or two, there were concerns that the ‘true’ figures may still have been increasing.
The fact that the total weekly deaths figures (including all deaths) appear to be starting to decline is therefore very welcome news. Hopefully this has continued since the 24th April.
What do we know about the COVID-19 deaths?
The death registrations data includes information on where a death took place. While the reduction in COVID-19 attributed deaths is clearly welcome, it is noticeable that the proportion of such deaths occurring in care homes has been increasing steadily.
Given the ongoing concerns around availability of PPE in care homes, alongside the challenges care homes can face in isolating those symptomatic of COVID-19, it seems likely that we will continue to hear sad news of tragedy emerging in UK care homes.
"All of the team at Club Vita wish to extend our condolences to anyone who has personally been touched by bereavement in recent weeks. We know that these deaths leave behind people who are missing loved ones. Our thoughts are with you…"