In the last release of mortality statistics from the ONS (data to 2014-04-03) showed a sudden increase in deaths. Unsurprisingly, many of the excess deaths are attributed to COVID-19, about 3,000. What was very surprising is that,compared to the five year average, 2,500 additional non-Covid deaths occurred in a single week.


Image Source: Sir David Spiegelhalter, Winton Professor of the Public Understanding of Risk, Cambridge University

The big question is, what are the cause of these additional 2,500 deaths. Could it be a failure of the registering doctor to correctly identify COVID-19 as a cause of death on the death certificate - or - are these extra deaths collateral damage happening as a unintended consequence of the lockdown?

In connection with the West African Ebola epidemic of 2014-2016, several studies tried to quantify the indirect effects of the Ebola epidemic on mortality, factoring in interruptions in malarial control programs like distribution of bed nets, and found that more people died of indirect effects than died from the virus itself.

For the time being at least, the data is not available for us to understand the breakdown of these recent excess deaths, and its likely is that the explanation includes a combination of failure to diagnose and collateral damage.

Here are some possible explanations of what is happening from people with relevant expertise.

  • Francesco Checchi, an epidemiologist at the London School of Hygiene & Tropical Medicine: “Initially, the health system is just unprepared to make adequate triage decisions, to actually decide whom to admit and whom not to admit, and therefore what you get is a lot of people dying basically because they can’t get the proper care that they need.”

  • Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “But for the back of the envelope, all you need to do is think out a scenario where mortality rates from the leading causes of death, like heart disease, cancer, and so forth, increase by 10 percent and you’re suddenly dealing with very big numbers.”

  • A study in The Lancet connected at least 250,000 cancer deaths to the 2009 recession, and the stress of the Covid-19 pandemic and the economic crisis it has ignited will likely precipitate increased smoking, alcohol consumption, and drug use, as well. “The opioid epidemic was in the headlines until this came along, and it really hasn’t gone away,” said Woolf. “Now my colleagues in addiction medicine are reporting an increase in opioid overdoses during this pandemic.”

  • NHS Doctor, Dr Max Pemberton writing in the Daily Mail:

    • "In our understandable but frenzied drive to 'Save the NHS' from the scourge of coronavirus, are we inflicting long-term damage on millions of individuals with health problems — some of them life-threatening — that have nothing to do with Covid-19?"

    • In the week ending Friday, April 3, there was an excess of more than 2,500 deaths over what would be expected at this time of year. It is possible that some of them may have occurred among

      • heart attack and stroke victims who haven’t sought or received the treatment they needed fast enough

      • people whose heart bypass or stent operations were cancelled

      • individuals with sepsis, meningitis or serious urinary tract infections, and who did not get the drugs they needed in time because they were worried about going to A&E or adding pressure to the health service

    • Cancer patients have had operations, chemotherapy and radiotherapy cancelled.

    • Stroke and heart attack victims may not get the emergency treatment they need.

    • I shudder at what the fall-out will mean for all these patients — but as a psychiatrist, what I am seeing makes me profoundly worried for the mentally ill and for those who may become so.

    • The chilling truth is that the number of deaths will potentially be far higher if we include mental health patients who can’t get the help they need.

    • Yes, we must fight the scourge of coronavirus with all the resources we can muster — but in doing so, we cannot ignore the thousands of other patients who are being sacrificed.

    • I don’t believe the Prime Minister’s office is being as open and transparent about the research on which it has based its decisions on tackling coronavirus as it should...The Government’s defensive approach seems suspicious. Credit the public with more intelligence and tell us the truth

This kind of "collateral damage" is probably not limited to the UK

  • An Italian study appeared to show that, in some regions of the country,the total death count was up as much as sixfold from previous years. Those deaths officially attributed to the coronavirus accounted for barely a quarter of the increase.

  • In Spain, El País obtained a study that showed mortality rates in some regions had almost doubled, with only a fraction of the increase officially attributed to COVID-19

In the long run, the lockdown is likely to be killing more people than it is saving

Heard somewhere on the Internet:

One guy I know works in a lab analysing samples for determinations of cancer or other disease problems. Their workload has gone down 85% because of the virtual shutdown of primary care. What happens to those who would otherwise have diagnoses of clinical conditions needing prompt treatment to maximise the chances of a good recovery? Are we now going to get a silent epidemic of deaths of people with a wide variety of other conditions whose diagnoses came too late?