Deaths from heart failure in the 15 weeks from week ending March 24th 2023 to the end of June 2023 were 27% higher than the level expected for the same period in 2020. Why?
The Office for Health Improvement and Disparities has produced the data for England. They show that from week 12 to week 26 of 2020 there were expected to be 16,752 heart failure deaths. Whereas in 2023 from week 12 to week 26 17,825 deaths were expected. For some reason we expect 6% more people to die of heart failure now than we did three years ago, even more of a surprise when you consider that the ‘pandemic’ was supposed to have cut a swathe through the ‘dry tinder’! In the event 21,222 people died from heart failure in England during this period in 2023.
Figure 1 shows weekly deaths from heart failure since week 12 of 2020. You can see, with or without Covid linked deaths, there has been a significant and sustained increase.
An article published in the Telegraph by consultant cardiac surgeon Julian Gaer focuses on the failings of the NHS to provide timely and effective treatment for cardiac patients. It’s an interesting read but, to my mind somewhat partial, though he’s very clear about where the blame lies:
I do blame a system that has allowed us to reach the point of having dangerous shortages of permanent skilled staff and dilapidated facilities habitually operating at 100% of theoretical capacity (something the NHS hierarchy persists in believing demonstrates value-for-money). I blame the fact that the U.K. has fewer hospital beds per capita than all but five of 38 OECD countries (Mexico, Costa Rica, Colombia, Chile, Sweden). France has three times more hospital beds per capita than the U.K. and Germany four times. Germany has 29 intensive care beds per 100,000 population, whereas the U.K. has seven. Little wonder therefore that Germany recorded just over 2,000 Covid deaths per million of the population, for our 3,000-plus.
So, according to Mr. Gaer it’s all about money and resources. But, let’s just see where Mr. Gaer gets his numbers from in relation to Covid deaths in Germany and the U.K.
Figure 2 is taken from Our World in Data and shows cumulative Covid deaths from the beginning of January 2020 to July 12th 2023, the day before Mr. Gaer’s article was published.
You can see that, as Mr. Gaer asserts, Covid deaths in Germany over the past three-and-a-half years are recorded as about 2,000 per million compared to the U.K.’s 3,376 per million. However, this variance is wholly due to the course of the pandemic from March 2020 to March 2021, by which point all the variance we see now had already occurred. Is he claiming that Germany’s relatively low number of deaths during the first year of the pandemic was wholly down to its treatment protocols, higher number of ICU beds and the organisation of its healthcare systems? If that’s the case, why did Germany’s Covid deaths match ours for the subsequent two-and-a-half years? Except for Sweden and Belarus, all European countries followed the same public health policies but with hugely variable outcomes, Finland saw one sixth of the Covid deaths that Germany did. Was this because Finland’s health service was superior to Germany’s? Of course not.
Rather than just looking at Covid deaths let’s look at all-cause excess deaths and compare the U.K. to Germany. Most experts agree that all-cause deaths is a far better measure of how a healthcare system works, rather than just the narrow focus on Covid deaths.
Again, a chart from Our World in Data illustrates perfectly that since the beginning of 2020 cumulative excess deaths in the U.K. stand at about 3,134 per million, whereas in Germany they’re 725 per million lower at 2,409 per million. However, all this difference and more was accounted for in the first Covid wave. By June 14th 2020 cumulative all-cause excess deaths in the U.K. were 1,001 per million higher than in Germany (868 – 133 = 1,001).
Since the U.K.’s March 7th 2021 pandemic peak, all-cause excess deaths in the U.K. have been lower than in Germany. While we’ve recorded 1,433 per million excess deaths the Germans have seen 35% more at 1,932 per million. To what does Mr. Gaer attribute the failure of Germany’s healthcare system over this period?
It doesn’t look like it’s British exceptionalism that accounts for the relative performance of the U.K. or German healthcare systems. In the same way that when you look a little more closely the apparent variance between Germany and the U.K. becomes obscured, so it is with excess heart deaths. Mr. Gaer would appear to attribute the rise in heart failure deaths to NHS failings in treatment and delivery. If this were the case, why don’t we see the same thing with cancer deaths?
Figure 4 reproduces charts from the Office for Health Improvements and Disparities showing excess deaths from heart failure and cancer from week ending March 26th 2021 to the end of June 2023. Cancer deaths are tracking the expected rate while heart failure deaths are dramatically elevated.
Figure 5 compares heart failure deaths with that other big killer, dementia and Alzheimer’s. Surely, if the NHS is letting down heart failure patients it must also be failing these patients?
It would seem not. Over the past two years or so dementia and Alzheimer’s deaths have been well below the expected rate.
Figure 6 illustrates another issue that’s been too much ignored. Since the beginning of the pandemic, with the exception of the two short spikes in April of 2020 and January of 2021, excess deaths in hospitals haven’t been exceptional. However, excess deaths ‘at home’ shot up and have consistently stayed high.
Whatever is causing the alarmingly elevated rate of heart failure deaths, it is not currently causing elevated deaths from cancer or dementia and thus it is hard to see how the primary driver can be the failings of the health service, however acute. For the same reason it is hard to see how the explanation can lie in an ageing population. Something else has seriously impacted on heart health in particular over the past three years.