Intended for healthcare professionals

Rapid response to:


Excess deaths: government commissions review

BMJ 2018; 361 doi: (Published 26 June 2018) Cite this as: BMJ 2018;361:k2795

Rapid Response:

Government exaggerates flu mortality again: why cannot the public be trusted with the truth?

I was perturbed and slighty astonished last week to see last winter's excess mortality being largely attributed to the bad flu season, though it is well-established that this was not the case - the main culprit being on this occasion apparently the Office for National Statistics [ONS].

The BBC reported [1]:

"There were around 50,100 excess winter deaths in England and Wales in 2017-18 - the highest since the winter of 1975-76, figures from the Office for National Statistics show.

"The increase is thought to be down to the flu, the ineffectiveness of the flu vaccine in older people and spells of very cold weather last winter."

The Daily Mail reported [2]:

"More than 50,000 excess deaths were recorded across England and Wales last winter, official figures show.

"Excess deaths refer to the amount of patients that died unexpectedly, calculated by comparing the mortality rate from winter months to the rest of the year.

"The shocking figures have been partially blamed on the deadly strains of flu that swept the nations over the colder months of December to March. "

So the government are now apparent not only blaming fluctuations in winter mortality on flu but all excess winter mortality on flu, to the the tune of more than 50,000 deaths. The reality is that Public Health England had already published the flu mortality figures for the season in May [4]:

"Through the USISS mandatory scheme, a total of 3,454 ICU/HDU admissions of
confirmed influenza were reported across the UK from week 40 2017 to week 15 2018,
including 372 deaths, based on combined data from England, Scotland and Northern
Ireland. In England, the total number of influenza confirmed admissions to ICU/HDU
was 3,175 (rate of 0.22 per 100, 000 population) and 320 deaths during the same

"The cumulative number of cases and deaths were higher compared to the 2016 to 2017
season (992 cases (rate of 0.06) and 112 deaths) and to the 2015 to 2016 season
(2,173 cases (rate of 0.14 per 100, 000) and 166 deaths) in England. This season
represents the highest number and rate observed since the beginning of the scheme

On this basis, the number of deaths in England and Wales in an admittedly exceptionally bad year would have been only in the region of 335-340 deaths, and the ONS seem to have exaggerated the risk to the public by in the region of 150 times.

The House of Commons Science and Technology Committee have been complaining about low flu vaccine uptake again [5] but we do not even have any information about the vaccination status of the people who died. There are serious ethical issues both for medicine and government here which have yet to be addressed.

[1] 'Excess winter deaths highest since 1970s, says ONS' BBC Health 30 November 2018,

[2] Vanessa Chalmers, 'Winter death toll highest since 1975: Failure of flu jab to combat severe outbreak resulted in more than 50,000 extra people dying in England and Wales last year', Daily Mail 30 November 2018,

[3] John Stone, 'Discrepancies in published data', BMJ 2010; 340 doi: (Published 02 February 2010)

[4] 'Surveillance of influenza and other respiratory viruses in the UK: Winter 2017 to 2018' , Public Health England May 2018, p 21,

[5] Commons Select Committee: "Committee shocked by low uptake of flu vaccine",

Competing interests: No competing interests

05 December 2018
John Stone
UK Editor
London N22