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expert reaction to ONS data comparing deaths from COVID with deaths from flu and pneumonia

The Office for National Statistics (ONS) have released new data comparing deaths from COVID-19 with deaths from flu and pneumonia.


Prof Carl Heneghan and Dr Jason Oke, Centre for Evidence-Based Medicine and Nuffield Department of Primary Care Health Sciences, University of Oxford, said:

“The latest ONS release provides a comparison of deaths from “influenza and pneumonia” with deaths from COVID-19. Overall, the report confirms that in the first 9 months of 2020, the risk of dying from COVID-19 far exceeded the risk of dying from influenza and pneumonia. It is, however, a mistake to consider the difference in risk as being constant throughout this time and a mistake not to recognise the difference between deaths from underlying causes and deaths involving COVID or influenza and pneumonia. For example, between January and August 2020, there were more deaths in which COVID-19 was the underlying cause compared with deaths due to pneumonia and influenza (48,168 vs 13,619), but in the same period, there were more deaths involving pneumonia and influenza compared to COVID-19 (69,781 vs 52, 327).

“As a consequence, 56,162 pneumonia deaths were not registered as the underlying cause compared to 4,159 for covid. On the death certificate, these deaths could be the immediate cause of death, in the chain of events leading to death or possibly be in part 2 of the certificate that includes other significant conditions contributing to the death.

“It is well known that the risk of death from COVID-19 increases exponentially with age, but this report shows that the relative risk of death from COVID compared to influenza and pneumonia as the underlying cause is inversely related, with the age standardised rate of death being four times higher for 65-69 group and 1.7 times higher for people 85 or older. The age-standardised rate of death involving COVID-19 compared to influenza and pneumonia also decreases with age. Future reports should provide further granularity for people under the age of 65.

“Finally, it is reported that in comparison to the deaths due to influenza and pneumonia, deaths from COVID-19 has been higher than every year since 1959.  Unfortunately, this comparison does not appear to take into account population size, nor the age demographic.” 


Prof Rowland Kao, Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:

“The much larger number of deaths with COVID being noted as the underlying cause may be due to either increased numbers of infections or increased mortality amongst those infected or both – but the figures presented do not allow us to determine this. This is partially because influenza cases are almost certainly under-reported year on year, partially because the figures for COVID-19 will initially have uncertain diagnosis and is also subject to a highly variable testing rate (making it difficult to even compare covid-19 figures between time points, much less comparing to another disease).  Having said that, the substantially greater number of deaths attributed to COVID-19 does tell us that at the moment, COVID-19 is a greater risk to people than influenza – to some extent this is due to the fact that we have a flu vaccine that is given to individuals at high risk of severe illness/morbidity and mortality, whereas of course for COVID-19 we do not. Add to the fact that COVID-19 is new to us whereas we would expect some immunity between years of seasonal flu (highly variable, depending on the level of antigenic drift). Thus these data are entirely consistent with what we would expect.”


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


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