A week is a long time in a pandemic

According to British Prime Minister Harold Wilson, "a week is a long time in politics". As with politics, so also with the ongoing COVID-19 pandemic. We know from China and Italy of the strong link between COVID-19 mortality and age, and we know from Italy that males have two and three times the mortality rate of females. Now the weekly death counts in England & Wales (Figure 1) and Scotland (Figure 2) show how suddenly mortality jumped in Week 14 due to the SARS-Cov-2 virus.

Figure 1. Deaths in Weeks 1–15 in England & Wales in 2020 as percentage of average in 2015-2019. Source: own calculations using data from ONS (2020b).

Figure 2. Deaths in Weeks 1–16 in Scotland in 2020 as percentage of average in 2015-2019. Source: own calculations using data from General Registrar of Scotland (2020).

During March 2020 COVID-19 became the third leading cause of death in England & Wales (ONS, 2020a); as an all-new cause of death, the World Health Organization (2020) had to issue emergency codes for statistical classification.  As always with cause-of-death data, however, there are uncertainties over classification: was infection with the SARS-Cov-2 virus incidental to the chain of causes leading to death, or the actual driving cause?  And could the extra fatal heart attacks noted by ONS (2020a) be undiagnosed COVID-19 cases?

In contrast, all-cause mortality statistics are particularly useful because there is no problem of classification: someone is either dead or not.  All-cause data also capture indirect victims of COVID-19, i.e. people who died because of the disruption to normal services caused by the nationwide lock-down.  Figures 1 & 2 demonstrate a sobering 60% surge in mortality in Week 14, a surge that has so far been maintained at 180% of normal mortality in Weeks 15 and 16.

References:

General Registrar of Scotland: Deaths registered weekly in Scotland; Provisional counts for week commencing 13th April 2020; accessed 23rd April 2020.

ONS (2020a), Deaths involving COVID-19, England and Wales: deaths occurring in March 2020; accessed 20th April 2020.

ONS (2020b), Deaths registered weekly in England & Wales.  Provisional counts for week to 10th April 2020; accessed 21st April 2020.

World Health Organization (2020), International guidelines for certification and classification (coding) of COVID-19 as cause of death, WHO 16th April 2020.

Written by: Stephen Richards
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