May 11, 2021

expert reaction to ONS stats on deaths involving COVID-19 in the care sector in England and Wales

The Office for National Statistics (ONS) have released provisional figures on deaths registered involving COVID-19 during wave one (week ending 20 March 2020 to week ending 11 September 2020) and wave two (week ending 18 September 2020 to week ending 2 April 2021) of the pandemic in care homes, in England and Wales.

Prof Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, said:

“The new ONS data on deaths of care home residents looks back right to the start of the pandemic, and compares patterns of registered deaths during the first wave that began last spring, and the second wave from last autumn onwards until the star of April this year.  So it won’t tell us about current trends.  Of course we already knew that the pandemic had a major impact on the numbers of deaths of care home residents, particularly during the peaks in April and May last year and in January and February this year.  What this new bulletin adds to that is a comparison of the two waves, and also more analysis on what caused the deaths and on some of the reasons for differences between the two waves.  The comparison between the waves isn’t straightforward, because there are many differences between the way Covid-19 was diagnosed and in the ways deaths were recorded in the two waves.  More deaths of care home residents were recorded as involving Covid-19 in the second wave than the first, but the number of deaths compared to the five-year average before the pandemic (for 2015-2019) was much higher in the first wave. ONS believe (and I agree) that an important reason there were more registered deaths involving Covid-19 in the second wave was simply that a lot of deaths that really involved Covid-19 in the first wave were not recorded as such, because there were many undiagnosed cases, because there was much less testing and health care workers had much less experience of the diseases back then.  Those issues will make it difficult to understand the patterns in the data when we eventually come to an inquiry about the pandemic.  ONS give several reasons why there were more deaths compared to the five-year average in the first wave rather than the second.  These include delayed access to some aspects  care, including availability of PPE, during the first wave; no rapid testing then (and, I’d add, not enough PCR testing); no vaccines during the first wave, while there were vaccines for the most vulnerable groups during the peak of the second wave; what ONS call “mortality displacement”, meaning that some people who, without the pandemic, would have died in the autumn and winter, had previously died of Covid earlier least year; and possibly fewer people living in care home during the second peak.

“The ONS bulletin also makes clear that, despite the toll from Covid-19 in care homes, it wasn’t the most common cause of death for female residents in either wave.  That place was taken by Alzheimer’s disease and dementia, which accounted for almost a third of deaths of female care home residents during each of the waves.  Covid-19 was the second most common cause, with about a fifth of deaths in females.  In male care home residents, Covid-19 accounted for about a quarter of deaths in each wave, with dementia and Alzheimer’s disease very close behind, also with almost a quarter of deaths.

“This analysis is interesting and important, but tells us much more about the past than what might happen in the near future.  Vaccines did become available for care home residents during the peak of the second wave, but vaccine roll-out can’t be instant and vaccines take two or three weeks to become effective, and many care home residents would not have had their second dose during the period covered.  Given what we know about vaccine effectiveness against serious disease and death, the effect of any future wave on deaths of care home residents is likely to be a great deal smaller.  Sadly, though, that won’t effect the continuing toll from dementia.”

https://www.ons.gov.uk/releases/deathsinvolvingcovid19inthecaresectorenglandandwales

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

www.sciencemediacentre.org/tag/covid-19

Declared interests

Prof Kevin McConway: “I am a Trustee of the SMC and a member of its Advisory Committee.  I am also a member of the Public Data Advisory Group, which provides expert advice to the Cabinet Office on aspects of public understanding of data during the pandemic.  My quote above is in my capacity as an independent professional statistician.”