Covid deaths

Only Half of Excess Deaths in England and Wales Since July Linked to Covid

The Office for National Statistics (ONS) has reported that 22,000 excess deaths have occurred in England and Wales since the beginning of July, with 56% of the total figure (roughly 12,000) being linked to Covid. However, in some parts of England, Covid has been held responsible for causing only one in five excess deaths, with the Head of Mortality Analysis at the ONS saying that “health service disruption” may have played a key role in bringing this about. The Telegraph has the story.

As few as one in five excess deaths in parts of England can be attributed to Covid, official figures show.

Since the start of July, 22,542 more deaths than usual for this time of year have been recorded across England and Wales.  

Of these deaths just 12,551, about 56%, have been linked to coronavirus, according to the ONS.

However, this figure drops to 19% in West Berkshire, where just 17 of the 90 excess deaths listed Covid as an underlying cause.

Other areas, mainly in the South West and South East of England, have seen just one in three deaths above average linked to Covid, including Somerset, Torbay, Dorset and Herefordshire.

In previous waves, almost all excess deaths could broadly be explained by Covid.

Some 59,324 excess deaths were recorded between March 13th and June 20th last year. In 81% of these, Covid was an underlying cause.

And between September 4th and March 5th this year, there were more Covid deaths than excess deaths. This trend was due to lockdowns offsetting other illnesses common over the winter, including flu.

The reverse in this trend in this most recent wave comes as England and Wales saw its 87th consecutive week of excess deaths in the home.

Since the start of the pandemic, over 78,000 more people than usual have died in a private residence, contributing to more than half of the 125,494 excess deaths recorded across all settings.

Sarah Caul, head of mortality analysis at the ONS, says reasons for this may include “health service disruption” or “people staying at home rather than being admitted to other settings for end-of-life care”.

Worth reading in full.

Norway Study Finds ZERO Vaccine Effectiveness Against Death for Covid Hospital Patients

A new pre-print study from Norway looking at differences in outcomes between vaccinated and unvaccinated hospital patients has found that being vaccinated makes zero difference to the risk of dying once hospitalised for COVID-19.

“There was no difference in the adjusted odds of in-hospital death between vaccinated and unvaccinated patients in any age group,” the researchers write. They also observed no difference between vaccinated and unvaccinated in the length of hospital stay for patients not admitted to ICU. These findings are adjusted for age and other risk factors so are not simply due to the vaccinated being older or at higher risk (though, as always, the validity of the adjustments may be questioned). The findings also only include patients admitted primarily due to Covid, so aren’t confounded by patients admitted for other reasons who also tested positive at some point.

The researchers did however find that vaccinated patients aged 18-79 had “43% lower odds of ICU admission” and an estimated 26% shorter hospital stay than unvaccinated patients.

It is curious that vaccinated patients were 43% less likely to need ICU but no less likely to die. Did the antibodies from the vaccines just mean that those who were going to fight it off did so a bit more quickly and easily, but the vaccine antibodies weren’t actually able to save anyone who wasn’t going to survive anyway? That appears to be the researchers’ conclusion:

Our results suggest that once hospitalised the risk of death among vaccinated and unvaccinated patients in Norway is similar. However, for survivors the disease trajectory is milder in vaccinated patients, with reduced need for hospital care and organ support.

Hospitalisations and Deaths Can “Increase” Simply Due to Higher Transmission

The Telegraph reported on Monday that more than half of patients counted in the COVID hospitalisation numbers did not test positive until they were admitted. (Everyone must take a COVID test before entering a hospital in England.) Only 44% tested positive prior to being admitted.

The data seen by The Telegraph correspond to 22nd July. On that date, 827 “COVID-19 patients” were admitted to hospital, according to the Government’s coronavirus dashboard. However, the true number of people hospitalised because of COVID-19 may be far lower.

Crucially, the hospitalisations numbers do not exclude people who were admitted for non-COVID reasons (say, a broken leg) but simply happened to test positive upon admission.

Given that tests are now widely available, it seems likely that someone who had symptoms resembling those of COVID-19 would take one before going to hospital. Consequently, many of those who only test positive upon arrival may be suffering from other ailments. The true number of “COVID-19 patients” admitted to hospital last Thursday could be as low as 363 (i.e., 44% of 827).

The Telegraph story highlights an important point, which lockdown sceptics have made over and over again during the pandemic. Testing positive on a PCR or lateral flow test is not the same thing as having the disease COVID-19. (It would be more accurate to describe a positive test result as ‘an instance of SARS-Cov-2’.)

One important implication is that the number of hospitalisations and deaths – indicators that supposedly capture the impact of the pandemic on public health – can increase simply due to higher transmission.

According to the ONS’s Coronavirus Infection Survey, the percentage of people in England infected with the virus went from 0.22% in the week ending 19th June to 1.36% in the week ending 17th July – an increase of 1.1 percentage points.

In July of 2019, there were 1.3 million inpatients admissions, or 42,000 per day. If the percentage of inpatients testing positive rose by 1.1 percentage points due to a general increase in transmission, that would yield an additional 462 “COVID-19 patients” by the end of the month.

Now this calculation isn’t an exact representation of what’s going on at the moment. We know that infections are concentrated among people in their 20s and 30s, who are unlikely to be hospitalised for any reason. But it illustrates the point that even the hospitalisation numbers have to be taken with a grain of salt. 

As I’ve noted many times, the only truly reliable indicator of the pandemic’s impact is excess mortality. And going by that measure, the pandemic has been over since March.  

Why Not Donate Our Remaining Vaccines to Other Countries?

In its latest U-turn, the Government has announced that full vaccination will be a “condition of entry” to nightclubs and other crowded venues from the end of September.

The Vaccines Minister, Nadhim Zahawi, had previously ruled out vaccine passports, noting, “That’s not how we do things”. Back in January, Claire Fox even asked him on Twitter, “Can we hold you to this?” and he replied, “Yes you can Claire”.

Given the number of delays there have been to the “full” re-opening, this latest U-turn hardly comes as a surprise. Indeed, the Government’s journey out of lockdown has had more about-turns than a middle-distance swimming event.

Making full vaccination a condition of entry for nightclubs seems designed not only to curtail super-spreading, but also to incentivise more young people to get vaccinated. But why is getting young people vaccinated a Government priority in the first place?

We’ve known since the beginning of the pandemic that COVID deaths among young people are vanishingly rare. As I noted recently, only 25 people aged under 18 in England died of COVID-19 up to February of this year, which equates to a survival rate of 99.995%. And the survival rate for 18–25 year olds isn’t much lower.

Rather than for their own safety, the main justification for vaccinating young people is to reduce the spread of COVID-19, i.e., for older people’s safety. But the vast majority of older people – for whom vaccination does offer clear benefits – are already vaccinated.

According to figures from the ONS, more than 95% of English adults aged over 50 have received both doses of the vaccine. And SARS-COV-2 will almost certainly become endemic, which means that most of us will catch it several times during our lives.  

The best we can do is vaccinate the elderly and vulnerable (check!) and accept that the disease will continue to spread in the population until it reaches an equilibrium.

Of course, young people should have the right to get vaccinated. But assuming that some have decided the benefits simply aren’t worth the risks, the Government ought to refrain from imposing even more costs on them that it already has. (I say this as someone who has had his first dose, and intends to have his second.)

Rather than trying to strong-arm every last 18 year-old into getting a vaccine they don’t need, couldn’t Britain’s remaining vaccine stockpile be put to better use?

There are still millions of elderly and vulnerable people in other countries who lack any immunity against COVID-19. Why not start donating our left-over vaccines to these countries (most of which are much poorer than the UK)?

The risk of death from COVID-19 among 70 year olds is about 300 times higher than among 20 year olds. Hence the benefit from vaccinating an additional 20 year old in Britain must be minuscule relative to the benefit of vaccinating a 70 year old in Africa, Asia or Latin America.

Having offered the vaccine to every high-risk person in Britain, isn’t it time we did something for countries with fewer resources than our own?

COVID-19 Mortality Rate Among Children Is Even Lower Than Previously Thought

We’ve known since the early weeks of the pandemic that age is the single best predictor of COVID-19 mortality, and that the risk of death for young people is vanishingly small.

A letter in the New England Journal of Medicine reported that zero Swedish children aged 1–16 died of COVID-19 up to the end of June 2020. And only 15 were admitted to the ICU, of whom four had a serious underlying health condition.

Of course, England is a much larger country than Sweden, and it’s been a whole other year since those Swedish data were collected. So how many English children have died of COVID-19?

In an unpublished study, Clare Smith and colleagues sought to identify the number of COVID-19 deaths among people aged under 18 between March 2020 and February 2021. They examined data from the National Child Mortality Database, which was linked to testing data from Public Health England and comorbidity data from national hospital admissions.

The structure of their dataset allowed the authors to distinguish deaths that were plausibly from COVID-19 and deaths that were merely with COVID-19.

3,105 under 18s died from all causes in England during the relevant time period. Sixty one of these involved people who had tested positive for the virus. However, the authors determined that only 25 were actually caused by COVID-19. And of the 25, 76% had a serious underlying health condition.

Given that an estimated 469,982 under-18s were infected with the virus up to February of 2021, the survival rate in this age-group (the inverse of the IFR) was 99.995%. What’s more, 99.2% of total deaths were caused by something other than COVID-19.

Smith and colleagues’ findings underline just how small a risk COVID-19 poses to young people, and hence – I would argue – why a focused protection strategy was preferable to blanket lockdowns.  

As early as 10th April 2020, Martin Kulldorff – co-author of the Great Barrington Declaration – published an article on LinkedIn titled ‘COVID-19 Counter Measures Should be Age Specific’.

Based on the data that were then available, he estimated one would need to stop 3.5 million children being exposed in order to prevent the same number of deaths as one could prevent by shielding 1,000 people in their 70s. He argued, therefore, that Covid counter-measures must vary by age.

A similar argument was made by George Davey Smith and David Spiegelhalter in a piece for The BMJ last May. These authors called for “stratified shielding”, while noting that this would “require a shift away from the notion that we are all seriously threatened by the disease”.

According to the medical researcher Russell Viner, who spoke to Nature, “There’s a general feeling among paediatricians that probably too many children were shielded during the first wave.” And the epidemiologist Elizabeth Whittaker said that efforts to shield children “have probably caused more stress and anxiety for families than benefit”.

In addition to “stress and anxiety”, there’s also the learning losses associated with months of online teaching. All this compared to the marginal impact closing schools had on the spread of COVID-19.

When we look back at the response to Covid, serious questions will have to be asked about the costs of lockdown, not only to society in general, but to young people in particular.

U.K. Records Just Seven Covid Deaths – Down 75% in a Week

Coronavirus deaths in the U.K. have fallen by three-quarters after just seven deaths were revealed today. MailOnline has more.

While last Saturday 15 people in the UK died of coronavirus, today the Government announced seven deaths, demonstrating a steady decline in fatalities.

It comes after Office for National Statistics data suggested the total number of infections is lower than at any point since early September and infections have been falling constantly for five weeks.

Experts said the data “should be celebrated” and were the first proof that, despite the reopening of outdoor hospitality and allowing the rule of six earlier this month, there was still “no evidence of an increased transmission risk”.

Worth reading in full.

Small Proportion of Vaccinated People Have Died Of Covid – and Most Caught the Virus before the Vaccine Could Have Taken Effect

NHS data shows that only a very small proportion of people who have received a Covid vaccine have been admitted to hospital with the virus and died. Around 70% of these people caught Covid before the vaccine would be expected to work, according to a new study, and many were also elderly and frail. The Guardian has the story.

A small number of people vaccinated against Covid have been admitted to hospital with the disease and died, researchers have found, but most were frail and elderly and caught the virus before the jab could have taken effect.

Scientists say their findings are reassuring. They bear out the conclusions of trials of the vaccines in use in the U.K., which show the jabs are highly effective but do not protect everyone.

The ISARIC/Co-CIN study was designed to give the Government’s scientific advisory body, SAGE, an early signal of whether or not the vaccines were working. 

“We’re saying that the vaccine does work. In fact, this is good real-world evidence of it working, but there are some few failures. And when these failures do occur, sadly, people die, but that’s because they’re elderly and frail,” said Professor Calum Semple, a Co-Lead of ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium).

More than 52,000 people were admitted to hospital with Covid in England, Scotland and Wales between December 8th and March 10th. Of those, 3,842 had been vaccinated. The researchers had information on the date of the first dose of vaccine for 3,598 of them and information on the date of a second dose for 140.

The vaccines would not be expected to work fully until three weeks after they were given, said Dr Annemarie Docherty, an Honorary Consultant in Critical Care at the University of Edinburgh. Most of those admitted post-vaccination were infected just before or in the couple of weeks after receiving their jab. The median time from vaccination to symptoms in the study was 15 days.

“Around 71% of the vaccinated patients that we have in hospital in Isaric developed their symptoms before the vaccine would be expected to work,” she said. “So we’re really only talking about 29% of these patients where we would have hoped the vaccine to prevent hospital admission.”

A total of 526 patients out of 52,000 (1%) had been vaccinated more than three weeks before they developed Covid symptoms and were hospitalised. Of those, 113 died. Most of them (97) were in the two highest risk categories, so frail, elderly or otherwise highly vulnerable.

Worth reading in full.

22 Million Brits Are Living In Areas That Have Seen Zero Covid Deaths in a Month

Fear of Covid may not be subsiding in the U.K., but the virus is. New Government data shows that a third of Britain has seen zero Covid deaths so far in the month of April. Some areas have gone even longer without reporting a single Covid death – 57 days in Plymouth and two whole months in Oxford and Maidstone. MailOnline has the story.

Around 22 million people are living in areas across the U.K. where there have been no Covid deaths so far in April, official figures revealed today. 

Data from the Government’s Covid dashboard suggests the threat of the virus has almost been eradicated in a third of the country, despite everyone still being subjected to harsh lockdown restrictions. 

It marks a seismic shift from the U.K.’s dire situation in January at the height of the second wave, when fewer than 50,000 Britons were in places with zero coronavirus victims during that month.

Analysis by BBC News shows some areas have gone even longer than a month without reporting a Covid death – Plymouth last recorded one 57 days ago and Oxford and Maidstone, in Kent, have gone two months.

The statistics, which go up to April 29th, show fewer than 600 deaths within 28 days of a positive test have been reported this month, compared with more than 30,000 throughout the same period in January.

More than half (56%) of local authorities in Scotland haven’t yet recorded a virus fatality this April, with only Glasgow posting more than nine so far.

In England 44% of authorities are yet to record one. The areas are scattered all over the country, showing how the situation is improving everywhere and is not limited to certain regions…

England faces at least seven more weeks of restrictions. June 21st has been earmarked as the earliest possible date that most curbs can be lifted. The rest of the U.K. has yet to announce when it will drop measures.

Given the waning of Covid across much of the U.K., along with the success of the vaccine rollout and the damage which continues to be inflicted on so many aspects of our lives because of lockdown, how can the Government continue to justify the implementation of lockdown measures until June 21st (at the earliest)?

The MailOnline report is worth reading in full.

How Many Covid Deaths Are Really Due to COVID-19?

The Telegraph‘s front page led today with the story that nearly a quarter of deaths (23%) registered “with Covid” in the latest official data for England and Wales were not “due to Covid” but were due to another underlying cause, according to the information entered on the death certificate. This percentage is up on earlier figures. The same figure for the original wave up to August 31st in England and Wales was just 8% (4,159 out of 52,327).

However, there is good reason to think both figures are too low. A Freedom of Information enquiry (pictured below) found that for Northern Ireland, the proportion of deaths that mentioned Covid but identified an antecedent condition (or conditions) as the cause of death for the period March 1st to November 20th was 38% (494 out of 1,301).

Why would Covid be the underlying cause of 62% of Covid deaths in Northern Ireland but 92% in England and Wales for broadly the same period? It wouldn’t, of course. The difference is how the deaths are recorded.

One reason may be because doctors in England and Wales were given a stronger steer to record Covid as the underlying cause of death. The British Medical Association told doctors early in the pandemic:

In those cases where the doctor is confident on medical grounds that a particular cause of death is likely then that should be entered on the MCCD [death certificate]. COVID-19 is an acceptable direct or underlying cause of death for the purposes of completing the MCCD, even without the results of a positive test, and it is important that likely COVID-19 deaths are reported as such via the registrar.

No similar guidance appears to exist for Northern Ireland.

Even 38% may be too low, however. A review by a county in Sweden in August found that 85% of the 122 Covid deaths investigated were due to a different underlying cause.

The Östergötland region has examined all deaths that have died at home or in special housing with confirmed COVID-19. Records from 122 people have been reviewed, which is 51% of the 240 people who had died in the county when the review was done.

The cause of death in the cause of death certificate has been COVID-19, but the review shows that other diseases may have contributed or been the decisive cause of death – for example, heart disease, lung disease or dementia.

111 of the deceased outside the hospital had extensive comorbidity and 11 moderate comorbidity. Half were 88 years or older.

COVID-19 was estimated to be the direct cause of death in 15% of deaths. For a majority of the deceased – as many as 70% – COVID-19 was a contributing factor rather than a direct cause. In 15%, the cause of death was judged to be other diseases, then most often heart disease.

The definition of a “Covid death” has been a consistent issue throughout the crisis, with the Government even knocking thousands of deaths off the running total in August after changing the definition following criticism. It has been frequently observed that different standards have been applied to Covid deaths than to other similar diseases – a frail elderly person who died with an acute respiratory condition such as influenza would not, prior to the pandemic, usually have had influenza recorded as the underlying cause of death, whereas Covid will often be recorded as such in similar circumstances. This novel practice has inflated the pandemic death toll and fed the narrative of fear.

Overall death totals (from all causes) are generally a much better guide to the impact of the pandemic – though even there deaths due to interventions become mixed up with the Covid deaths. Trying to get to the bottom of the true Covid death toll will not be an easy task at all.