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Covid-19: Lack of action on government statistics is unacceptable, says expert

BMJ 2020; 370 doi: (Published 29 July 2020) Cite this as: BMJ 2020;370:m3025

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  1. Shaun Griffin
  1. London

A leading expert has strongly criticised the UK government’s inertia on accurately reporting the deaths of people with active covid-19 infection.

Carl Heneghan, director of the Centre for Evidence Based Medicine at the University of Oxford, expressed his frustration that considerable discrepancies between data from the Office for National Statistics (ONS) and from Public Health England (PHE) on the website had not been dealt with despite government commitments to do so.

ONS data show that covid-19 was mentioned on 284 death certificates in the week ending 17 July in England,1 while the website reports 442 deaths (56% more) over the same period.2 In Wales the equivalent data show 11 covid-19 deaths in ONS figures and five on

Heneghan said, “The inaccuracies in these datasets are unacceptable. Some of the deaths in [the week ending 17 July] have occurred in individuals who may not have an active infection. It has been over 10 days since the government said it was looking into the issue of reporting of deaths, and we have not yet heard an answer.

“The reasons for this delay are not clear, but it should be straightforward to report the number of deaths of those who died with an active infection in the last 28 days.”

Urgent review

On 17 July England’s health secretary, Matt Hancock, called for an urgent review into how coronavirus deaths were recorded in England, after PHE confirmed that people who had tested positive for covid-19 months before they died may have been included in their daily figures.

David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said, “This PHE count is fraught with difficulties . . . it apparently includes any of the 250 000-plus people who have tested positive in England and then subsequently died of any cause, whether related to covid or not.

“[It] has been officially suspended by the Department of Health and Social Care [DHSC], and it is surprising to see it still being published by PHE and finding its way onto international comparison websites.”

When asked to account for the promised review a DHSC spokesperson reiterated the department’s previous position, saying, “The health secretary has asked PHE to conduct an urgent review into the reporting of deaths statistics, aimed at providing greater clarity on the number of fatalities related to covid-19 as we move past the peak of the virus.” The spokesperson also confirmed that the PHE data continue to be published on the website.

Expressing his frustration, Heneghan said, “We should be focusing on the data that matters: admissions to hospital, critical care bed occupancy, and the deaths from active infection, to guide our current responses.”

Excess deaths

The ONS figures also show that, in the week ending 17 July, the number of deaths registered in England and Wales was 270 lower than the five year average. However, concerns continue to be raised about the number of excess deaths registered in private homes, which were 766 higher than the five year average.

Spiegelhalter noted that, while this was “at least a reduction from the peak of the epidemic, when there were 2000 additional deaths a week occurring at home . . . presumably some of these deaths might have been delayed if they had gone to hospital.”

Over the past five weeks 1252 fewer deaths than expected have occurred across all ages: 44 971 deaths, compared with a five year average of 46 223 over this period, equal to a reduction of 2.7%. Heneghan said, “This significant trend . . . is likely due to deaths occurring a few months earlier in the frail and the elderly from covid-19.”

On covid-19 deaths specifically, the ONS data from England and Wales show a decline from a peak of 8758 in the week ending 17 April, to 295 in the week ending 17 July.

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