Intended for healthcare professionals


Covid-19: Death rate in England and Wales reaches record high because of covid-19

BMJ 2020; 369 doi: (Published 14 April 2020) Cite this as: BMJ 2020;369:m1484

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  1. Jacqui Wise
  1. London

The death toll in England and Wales is at its highest level since weekly statistics began 15 years ago, with 16 387 deaths registered in the week ending 3 April—37% more than expected.

This is 5246 deaths more (14%) than the previous week and 6082 more (59%) than the five year average for this week in the year, the Office for National Statistics (ONS) has reported.1 The ONS said that 3475 of these registered deaths mentioned “novel coronavirus (covid-19),” which was 21.2% of all deaths. In London, nearly half (46.6%) of deaths in the week ending 3 April involved covid-19. The West Midlands also had a high proportion of covid-19 deaths, accounting for 22.1% of deaths registered in the region.

It is not yet clear, however, what proportion of the excess deaths are due directly to covid-19 and what proportion to patients without covid-19 not getting the treatment they need.

Martin Hibberd, professor of emerging infectious disease at the London School of Hygiene and Tropical Medicine, commented: “We know that, for some situations, we may be overplaying the role of covid-19—for example where covid-19 was mentioned in a death but where it may have actually played only a minor role. Whereas in other situations, a death may not mention coronavirus, even though it may have contributed, possibly as a result of the indirect consequences of the lockdown and stretched healthcare services.”

Hibberd added: “This is the problem of getting the covid-19 strategy balanced correctly to minimise these total figures and save as many lives as possible. We look forward to further analysis of these numbers and next week’s release of data to get a clear idea of the consequences of the covid-19 outbreak.”

The latest ONS data show that 90% of deaths (3716) in which covid-19 was mentioned occurred in hospital, with the remainder occurring in hospices, care homes, and private homes. The ONS said that 217 registered deaths were linked to a care home setting. The government is under mounting pressure to include care home deaths in its daily death toll figures.

The latest figures from the ONS are higher than those previously reported by the Department of Health and Social Care. The ONS reported 6235 deaths involving covid-19 occurring by 3 April and registered by 11 April, which is 2142 higher than the 4093 reported by the Department of Health And Social Care for England and Wales.

The differences between the two sources are partly because ONS figures are based on date of death, whereas the department reports on date of notification. The ONS figures also include deaths outside of hospital and those in which covid-19 was reported on the death certificate but there was no positive test.

NHS England reports covid-19 deaths by date of death using data from the same source as the Department of Health and Social Care, but the figures are continuously updated. It reported 5186 deaths by 3 April, 793 less than ONS figures for England by date of death.

Nick Stripe, head of health analysis and life events at the ONS, said: “The latest comparable data for deaths involving covid-19 with a date of death up to 3 April show there were 6235 deaths in England and Wales. When looking at data for England, this is 15% higher than the NHS numbers as it includes all mentions of covid-19 on the death certificate, including suspected covid-19, as well as deaths in the community.”

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