UK suffers second-highest death rate from coronavirus | Free to read
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The UK has suffered the second-highest rate of deaths from the
coronavirus pandemic after Spain, according to excess mortality figures.
The UK has registered 59,537 more deaths than usual since the week ending March 20, indicating that the virus has directly or indirectly killed 891 people per million.
Until Thursday, the UK had a higher rate of death than in any country for which high-quality data exist. However, Spain made a revision to its mortality estimates, adding 12,000 to its toll of excess deaths from coronavirus in a one-off adjustment to 43,000. This increased its death rate to 921 per million.
The absolute number of excess deaths in the UK is the highest in Europe, and second only to the US in global terms, according to data collected by the Financial Times.
The country fares no better on another measure: the percentage increase in deaths compared with normal levels, where the UK is the worst hit in Europe and behind only Peru internationally.
The data were compiled from national statistical agencies for 19 countries for which sufficient information exists to make robust comparisons. The figures include all of the European countries hit hard by coronavirus. The periods for comparison are from when death rates in individual countries climbed above five-year averages.
The FT has made these comparisons for the first time because the level of deaths in other hard-hit European countries, such as Italy and Spain, has returned close to the seasonal norm.
Other countries like China, Brazil and Russia have suffered large death tolls during the pandemic. However, their mortality rates are far below the UK as the number of deaths is smaller compared with their much larger populations.
The timing of lockdowns relative to the spread of the virus had a significant effect on the total level of excess deaths, the data show.
Countries such as Germany and Norway, which imposed restrictions when the spread of the virus was limited, suffered much lower levels of additional deaths than those in the UK where the government waited longer before ordering a lockdown.
A UK government spokesperson said it was “wrong and premature to be drawing conclusions at this stage” and that excess deaths should be adjusted for age.
“We will, of course, learn lessons from our response to this virus, but these must be drawn from an accurate international analysis in the future,” Number 10 added.
David Spiegelhalter, Winton professor of the public understanding of risk at Cambridge university, said: “If we can believe the data from other countries, then the UK has done badly in terms of excess deaths. The issues now concern what will happen for the rest of the year, and trying to understand the processes contributing to our large excess.”
The FT analysis shows that the UK's excess deaths figure remains the highest whether younger people are excluded or the analysis is limited to pensioners.
Please see below for a correction note regarding this chart*.
Jonathan Ashworth, Labour's shadow health secretary, said the government had “not got on top of this crisis as well as other countries. We were too slow into lockdown, off the pace on testing and PPE, and too slow to protect our care homes”, referring to the shortage of personal protective equipment for frontline health and care workers.
Unlike other hard-hit countries, there was a large rise in the excess death rate across all parts of the UK, with London reporting by far the biggest jump.
By contrast, in Italy, the epidemic was concentrated in the northern region of Lombardy, and there were two hotspots in France: one around Paris and the other around the eastern city of Mulhouse, near the German and Swiss borders.
Excess deaths is internationally recognised as the best way to compare countries’ performance in handling infectious diseases. Chris Whitty, the UK’s chief medical officer, called excess deaths “the key metric”.
When Boris Johnson sought to defend his government from criticism over the mounting death toll in the UK at the end of April, he said using international comparisons, such as of those who had died after testing positive, was “bedevilled with difficulties”.
The UK prime minister added: “The only real comparison is going to be possible at the end of the epidemic when you look at total excess deaths.”
Excess mortality is calculated by counting everyone who has died in a country and subtracting the average number of people who passed away over the same period in the past five years.
It therefore tallies the number of people who died either directly from Covid-19 or indirectly, for example if they were unable or unwilling to seek treatment in hospital, and does not reflect different testing regimes for the virus in different countries.
Examining the cause of the high death rates in certain countries, the strongest link appears at this stage to be between the date of a country’s lockdown and the probable number of infections that already existed when restrictions were applied.
Although the exact number of infections can only be estimated at the moment of lockdown, the statistical relationship between that and excess deaths is strong.
Natalie Dean, assistant professor of biostatistics at the University of Florida, said some countries such as Italy had “bad luck” as they were caught by the virus early on. This gave other countries, such as the UK, time to learn lessons, she added.
“I was very surprised by the delayed response in the UK. Given what we were observing in Italy at the time and that the UK was on the exact same trajectory, had the same very steep rise, I was surprised to see discussion about waiting. There was an immediate need to stop what was happening,” she said.
“For London, in particular, it was clear that there was a steep rise, so it’s reasonable to think earlier intervention would have saved lives.”
Along with the US and Peru, the UK is still registering a large number of excess deaths, although the toll has dropped sharply since the 12,000 weekly peak in mid-April.
Peru has seen a large rise in deaths this year partly because it has had to battle other diseases, in addition to coronavirus, with its overstretched health system.
Peru has 1.6 hospital beds per 1,000 people, or 40 per cent below the global average according to the World Bank, and authorities there have also faced a dengue fever epidemic at the same time. In the UK, the number for hospital beds is 2.8 per 1,000.
This article has been amended to take into account a one-off revision to Spanish data on Thursday. This meant the UK now has the second-highest death rate from coronavirus after Spain rather than the highest rate as originally reported. This article has been modified to replace a chart linking excess deaths to lockdown dates with one showing deaths per million.
*A chart in this article has been corrected to show infections per million on its horizontal axis instead of excess deaths per million.
Letter in response to this article:
The difficulty in making ‘robust’ comparisons / From Dick Sands, London TW11, UK