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expert reaction to new PHE findings on excess mortality in England

Public Health England (PHE) have published new reports with data detailing excess mortality in the UK between 20th March and 31st July 2020, split by region.

 

Dr Lucy Pocock, a Primary Care Research Fellow specialising in older people at the University of Bristol, said:

“The place of death graphs clearly show the striking impact on care homes (58% of excess deaths in the South West were in care homes and 45% of those across England).

“A mention of Covid-19 on the death certificate is not the same as saying that the death was due to Covid-19. Whilst there is no great plot for under- or over-reporting Covid-19 deaths on death certificates, it’s important to recognise that it is an imprecise science and often based on clinicians’ ‘best guess’. There is no requirement to have a positive Covid test in order to put covid-19 on the death certificate.

“How do these figures take into account the revised method of reporting death stats? PHE are now only going to report deaths from covid-19 if they occurred within 28 days of having a positive test, so this is likely to represent an underestimate – some people are not tested and many die of Covid several months after testing positive.

“How do we protect care homes? One of the central aims of the government in the first wave was to “Protect the NHS”, did we get this wrong? The NHS managed admirably in the first wave, and the Nightingale hospitals were not needed. If the second wave comes in the autumn/winter we need to think about how we cope with the usual winter pressures, in addition to Covid-19, and how we support social care and care homes at the same time.

“Mortality data only captures information about those who have lost their lives during the pandemic, yet we know that alongside this there is considerable morbidity. Those who were very sick, but did not die, with Covid-19 will have long-lasting physical and psychological issues to face, and the phenomenon of “long-Covid”, which can affect even those people who appeared to only have a mild infection, is just beginning to be understood by clinicians.

“They state that “Excess deaths in this report were estimated only for weekdays, with deaths registered on a Saturday added to the preceding Friday each week.” I am left wondering what about excess deaths on a Sunday…

“According to PHE, in the south west, 88.5% of the excess deaths had a mention of Covid-19 on the death certificate. In my own practice, we saw a definite increase in deaths (in May we had 14 deaths, we would usually expect about 5) but none of them mentioned Covid on the death certificate as far as I’m aware.”

 

 

*Excess mortality in English regions:

https://www.gov.uk/government/publications/excess-mortality-in-english-regions

 

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

 

Declared interests

None received.

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