Intended for healthcare professionals


Covid-19: Deaths in England and Wales are lowest since pandemic began

BMJ 2020; 370 doi: (Published 19 August 2020) Cite this as: BMJ 2020;370:m3266

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  1. Shaun Griffin
  1. London, UK

Deaths from covid-19 in England and Wales dipped to their lowest in 20 weeks in the first week of August, latest figures from the Office of National Statistics (ONS) show. Of the deaths registered, 152 (1.7%) mentioned covid-19—down from 193 the previous week.1

Wales and the north west of England were the only regions where deaths were increasing. All other areas of England saw a reduction in fatalities.

The latest findings from the monthly covid-19 infection survey conducted in England show that between 26 April and 2 August only 28% of 165 people who tested positive for SARS-CoV-2 or virus antibodies reported symptoms around the time of their test.2

James Naismith, of the Rosalind Franklin Institute at the University of Oxford, said, “While this is good news, since for the vast majority covid-19 is not a serious illness, it makes it much harder to spot its spread.”

There was also some provisional evidence of a higher level of previous infection among people from ethnic minorities. Around 4.8% of people identifying as white tested positive for antibodies compared with 11.1% of people from all other ethnic groups.

The previous infection survey report showed higher covid-19 infection rates in those working in patient or resident facing health and social care roles. The latest report suggests, however, that in more recent periods the heightened risk of infection for patient facing healthcare workers has reduced compared with those not in these roles.

Depression symptoms double

The ONS also studied depression in the same group of 3500 adults in Britain before and during the pandemic.3 Using a standardised screening questionnaire they found that 19.2% people reported symptoms of depression between March and June 2020, up from 9.7% between July 2019 and March 2020.

Although not formally diagnosed, in the year to June 2020, 12.9% of adults reported moderate to severe depression, almost double those who had symptoms already (6.2%). Self-reported symptoms of depression showed an improvement in one in 25 (3.5%) adults.

Younger adults, women, and those with disabilities or health problems were more likely to report symptoms of depression, as were those from poorer households, people who were unemployed, and those facing unexpected expenses.

Predicting unprecedented levels of depression as unemployment rates continue to increase, Til Wykes of the Institute of Psychiatry Psychology and Neuroscience, King’s College London, called for “investment in mental health support and treatment services now to ensure that this can be dealt with rather than allowed to escalate and worsen.”

Dying at home

Latest data show a continued decreasing trend in the number of excess deaths compared with the five year average—now seen for eight consecutive weeks. But the increase in deaths in private homes over this period suggests that people are choosing to die away from hospitals, with implications for palliative care services, say experts.

According to the ONS1 excess deaths in hospitals, care homes, and other communal establishments remain below average, while those in private homes consistently remain above average.

Deaths in private homes have nearly cancelled out those in hospitals over the past eight weeks, according to analysis by Carl Heneghan, director of the Centre for Evidence Based Medicine at the University of Oxford, and Jason Oke, senior statistician at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

Speaking to The BMJ, they said, “The large excess in private home deaths is likely because of a shift in the place where people choose to die—away from hospitals.”

Heneghan and Oke added, “A previous lack of resources in the community for palliative care meant that people often did not die where they wanted to. The Health Select Committee End of Life Care report4 set out plans to enable people to die at home, where that is their preference, rather than in hospital.

“Recognising the additional burden on community palliative resources is vital to ensure the move to dying at home is adequately resourced.”

According to the ONS report, of the 702 excess deaths occurring in private homes, most (574) occurred in people aged 70 years and over.