What are 'excess deaths' and why are people talking about them?

During the first half of July 2020, you may have seen reports that there were no “excess deaths” in the UK.
Coronavirus

This can sound like a heartless description, but in any given time of year there will be a “usual” or expected number of deaths – “excess deaths” means numbers above this level.

In simple terms, if 200 deaths were expected for a given week and there were 300 recorded, for this week there would have been 100 excess deaths.

During the Covid-19 pandemic, data analysts have been closely comparing the number of deaths each week with the expected number of deaths for the same week, estimated using an average of the number of deaths for the same week across the previous five years.

The sad fact is that since the Covid-19 pandemic began, there have been more than 65,000 excess deaths across the UK. This means that tragically, 65,000 more people have died than we would have expected at this stage in the year.

The more reassuring news is that there are now few excess deaths as we move away from the peak of the crisis in the UK. However, the numbers could still rise or fall going forward. It is important to remember that every life lost is a tragedy for the family affected.

The figures below show how the number of excess deaths dramatically increased in the last week of March, but now, across all four nations, deaths are stabilising from around the first week of June.

How the excess deaths in each of the nations within the UK have changed over the weeks

Source: ONS, NISRA, NRS

Excess deaths and people living with heart and circulatory diseases

In just one week at the peak of the pandemic, there were more than 700 excess deaths from heart and circulatory diseases, including around 300 from coronary heart disease and nearly 200 from stroke.

That’s according to analysis by Public Health England, which also found that throughout the whole of the pandemic, there were over 3,600 excess deaths from heart and circulatory diseases, some of whom will have also had Covid-19. This has significantly increased the impact of heart and circulatory conditions for people in the UK.

Why do excess deaths matter?

Excess deaths is one good way to measure the impact that Covid-19 has had.

It’s particularly useful because the causes of deaths during the pandemic may not always have been accurately recorded and reported – doctors are still learning about the virus and may mis-diagnose some illnesses as Covid-19, or miss some cases entirely. But the total number of deaths is not affected by this.

Equally importantly, measuring excess deaths allows us to more fully understand the impact that Covid-19 has had on the UK, including those people who have died from healthcare being harder to access (such as surgical procedures and life-saving treatments being rescheduled or cancelled) or those who put off going to A&E with symptoms of a heart attack.

Does this mean the UK crisis is over?

Unfortunately, we can’t say that yet. Excess deaths linked to the pandemic can be caused by many factors, from transmission rate, to how many older or unwell (and therefore at higher risk) people there are in the population, to the healthcare that those with and without Covid-19 receive.

In particular, the transmission rate is affected by social distancing and is likely to be higher during the winter months when people stay indoors more.

The unpredictability of this new disease, and the complex way in which it affects us, makes it very important that measures such as excess deaths are tracked over time, and that they help to inform changes in public policy and provision of health services.

To further complicate matters, some of the deaths due to Covid-19 in the first half of 2020 will have been people who we may have expected to die at some point later this year, because of their age or other health conditions.

This means that death rates at this time of year have actually gone below expected levels in some groups, as many of the most vulnerable people have already died. But this doesn’t mean the crisis is over.

International comparisons

Making comparisons between countries using number of Covid-19 deaths can be inaccurate and misleading, as the way that coronavirus deaths are recorded and reported varies between different countries. Using excess deaths allows us to measure the overall impact that Covid-19 has had on deaths in each country, without those issues.

But it is too soon to measure which country has the most or fewest deaths from the pandemic, either directly or indirectly.

As Covid-19 has spread across the world, each country has reached different stages of the outbreak at different times - some will have reached their peak in excess deaths, and some may still have an increase in excess deaths to come.

We will only really know the full impact that Covid-19 has had on each country once the pandemic has truly come to an end, which sadly, may be many months away.