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Covid-19: UK deaths are higher than previously reported, new data suggest

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1330 (Published 01 April 2020) Cite this as: BMJ 2020;369:m1330

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  1. Gareth Iacobucci
  1. The BMJ

The number of UK deaths from covid-19 is higher than previously reported, show newly published figures that include people who have died outside of hospital.

Backdated figures from the Office for National Statistics (ONS) show that 210 deaths involving covid-19 occurred in England and Wales by 20 March, 40 more than the 170 deaths reported by the government at that time.1

The ONS figures have a time lag in reporting when compared with the government’s figures because they are based on death certificates, which take a few days to prepare. But the ONS figures include people who died outside of hospital, such as at home or in a care home, as well as people who had not tested positive for covid-19 but were suspected of having the virus.

More complete picture

Commenting on the figures, David Leon, professor of epidemiology at the London School of Hygiene & Tropical Medicine, said, “What ONS has done is important, as it starts to provide a more complete picture of the impact of covid-19 on mortality. The value of these data will increase with time.

“However, deaths which have covid-19 as a cause on the death certificate that occur among people who were not tested for covid-19 may misclassify them as such. On the other hand, untested deaths that were precipitated by covid-19 may still go unrecognised.”

Keith Neal, emeritus professor of the Epidemiology of Infectious Diseases at the University of Nottingham, said, “I support the reporting of new figures, but there is now a danger of the death figures becoming increasingly difficult to interpret. It would be useful if each separate reporting body produces a table or graph each time for their own figures, as the figures cannot [be] compared with each other.

“Surveillance is about monitoring trends, and this can only be done with consistent data sources.”

Slower to prepare

In a blog post outlining the differences between the ONS figures and the UK government’s data,2 Sarah Caul, head of mortality analysis at ONS, said that each set had its own “strengths and weaknesses.”

She wrote, “The figures published on GOV.UK are valuable because they are available very quickly and give an indication of what is happening day by day. Their definition is also clear, so the limitations of the data can be understood. But they won’t necessarily include all deaths involving covid-19, such as those not in a hospital.

“Numbers produced by ONS are much slower to prepare, because they have to be certified by a doctor, registered, and processed. But, once ready, they are the most accurate and complete information.”

Caul explained that using the complete death certificate allowed the ONS to analyse other information such as what other health conditions had contributed to a death, and she said that the agency would start publishing more detailed breakdowns of these numbers soon.

As of 5 pm on 30 March, the UK government reported that 1789 people had died from covid-19.

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