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Covid-19: Excess deaths vary widely across England and Wales, show data

BMJ 2020; 371 doi: (Published 18 November 2020) Cite this as: BMJ 2020;371:m4500

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  1. Gareth Iacobucci
  1. The BMJ

Excess deaths in England and Wales remain above the five year average, while deaths from covid-19 rose 40% last week, latest data1 show.

Figures from the Office for National Statistics show that in the week ending 6 November, deaths registered for any reason were 14% (1481) above the five year average across England and Wales. But within this there was wide regional variation, with sharp rises in the north of England and Wales but no excess deaths in London.

The number of deaths involving covid-19 increased for the ninth consecutive week, the data show. There were 1937 deaths involving covid-19 registered in England and Wales in the week ending 6 November, an increase of 558 (40%) from 1379 the previous week.

Deaths involving covid-19 increased in all English regions and Wales in the week ending 6 November, with the north west of England having the largest number (568 deaths) and the highest proportion of deaths involving covid-19 (30%). In Wales, 166 deaths (20% of all deaths) involved covid-19.

In the same week, all English regions and Wales had higher or the same overall deaths as the five year average. But while London saw no excess deaths and the south east had only 16 deaths (1%) more than the five year average, the north west saw 496 (35%) more deaths than would be expected, and Wales had 207, 33% higher than the five year average.

Nuffield Trust deputy director of research Sarah Scobie noted the “stark” regional differences, adding, “These figures most likely reflect people who contracted the virus in October, so given we are yet to see a fall in the number of cases we will need to brace ourselves for further increases over the weeks ahead.”

The latest data show that the number of deaths in hospitals was above the five year average for the third consecutive week (520 more deaths). The number of deaths in private homes and care homes were also above the five year average (997 and 38 more deaths respectively). But deaths in other locations were below the five year average (76 fewer deaths).

Kevin McConway, emeritus professor of applied statistics at the Open University, said he was concerned about the number of deaths at home, which amounted to 140 excess deaths a day. “Deaths at home have been at that kind of level, over 100 above average each day, since mid-May, just after the first peak of the pandemic. I still haven’t seen any clear explanation of why this might be happening, and that worries me,” he said.

David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication, University of Cambridge, said, “These extra home deaths, very few of which are from covid-19, have continued since March. It would be good to know the quality of end-of-life care being received and how many of these deaths might have been delayed through, for example, more rapid treatment of heart attacks and strokes.”

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