50 | New Scientist | 15 August 2020
The covid mortality spike
So let’s look at coronavirus. We can look at the
data for deaths in England and Wales, as in the
diagram (right). The blue is the deaths
happening with covid not mentioned on the
death certificate, and the red is deaths with
covid mentioned. The base line is the five-year
average of deaths for the same period. We can
see a massive spike starting at the end of
March, but we can see that now, even
allowing for continuing covid deaths, there
are fewer deaths than normal. Is it just
continuing the pattern of lower deaths that
we observed early in the year, when we had a
milder flu season than normal? Or is this the
first sign of what's called mortality
displacement, in which deaths of frail elderly
people that would have occurred later in the
year have been brought forward?
And there are other fascinating patterns
going on when you look closer. For example,
we know that young men between 20 and
24 had lower mortality than usual over the
lockdown period, at one point 30 per cent
down, even including a few covid deaths. We
don't know the details, but we can probably
guess it might have to do with fewer car
accidents and maybe less going out getting
drunk.Displaced deaths
But let's go deeper: let's look at the place in
which people are dying (diagram, middle
right). Let's look at care homes. There's been
a big spike in deaths in care homes, but with a
lot of non-covid deaths. It's thought many of
these could be covid deaths, especially of
elderly people with dementia, just not
labelled as such on the death certificate. It's
very difficult to make a definite diagnosis in
these cases, and doctors have been unwilling
to put it on the certificate.
When we look at hospitals, we can see this
big rise starting in the middle of March. This
is when they emptied the hospitals and sent
people back home without testing whether
they had covid, or sent people back to care
homes. It’s been strongly suggested that that
was one of the causes of the rise in deaths in
care homes, along with the staff moving
between different institutions.
But there is also a dip in non-covid deaths
in hospitals. There’s been a huge reduction in
attendance in hospitals of people with heart
symptoms, with strokes and so on. Where
have these people been dying? Well, they've
been dying at home. It's extraordinary. There
has been an enormous number of extraSOURCE: PUBLIC HEALTH ENGLAND/
WINTON CENTRE/DAVID SPIEGELHALTERSOURCE: WINTON CENTRE/
DAVID SPIEGELHALTERSOURCE: PUBLIC HEALTH ENGLAND/
WINTON CENTRE/DAVID SPIEGELHALTERAge0 5 15 25 35 45 55 65 75 85 95 0 5 15 25 35 45 55 65 75 85 952000
1900
1800
1700
1600
1500
1400
1300
1200
1100
1000
900
800
700
600
500
400
300
200
100
01200010000800060004000200002000
1000
500
200
100
50
20
10
5
2
1
0.5
0.2
0.1
0.05AgeThe covid-19 age profile
The population mortality rate expresses the risk of catching covid-19 and dying from it. Men have roughly
double the risk of women of the same age, while the risk increases exponentially with age, with a 10,000-fold
variation in risk across all ages (Deaths registered in England and Wales 7 March - 26 June 2020)Deat
hsper^100,^0
00peopleWeek endedMarch April May June July March April May June July March April May June July■ Covid mentioned on death certificate
■ Covid not mentionedExce
ssover
5 -year^aver
ageNum
ber^ of^ deathsDate---- Normal risk: Male
---- Normal risk: Female● Covid death rate: Male
● Covid death rate: FemaleCovid-19 mortality over time
After a huge spike beginning in late March, deaths in England and Wales have recovered to below the
five-year average, even counting deaths from covid-19. Data is death registration data from the UK Office
of National Statistics, and does not necessarily show week of death owing to reporting delaysWhere have the deaths occurred?
Looking at place of death, whether care home, hospital or private home, shows a distinct
displacement effect, with many more non-covid deaths occurring at home
■ Covid-19 ■ Covid-19 not mentioned ---- Adjusted five year average8000600040002000004
Oct
18
Oct
01
Nov
15
Nov
29
Nov
13
Dec
27
Dec
10
Jan
24
Jan
07
Feb
21
Feb
06
Mar
20
Mar
03
Apr
17
Apr
01
May
15
May
29
May
12
Jun
26
JunCare home Hospital Home