There are two ‘official’ death tolls on the Government’s COVID-19 dashboard. 138,852 is the number of deaths within 28 days of a positive test. 162,620 is the number of deaths with COVID-19 on the death certificate.
The main reason the latter is larger than the former is lack of testing during the first wave. In the spring of last year, about 15,000 people in whose death COVID-19 was a contributing factor died without being tested.
So is 162,620 the pandemic’s true death toll? No. And that’s because it includes a large number of deaths that probably would have happened anyway.
How do we know this? Because if we calculate the excess deaths – the number of deaths in excess of what we’d expect based on previous years – we get a much lower number.
The official death toll for England and Wales, based on death certificates, is 147,031. Yet if we add up all the deaths since the start of March 2020, and subtract the average over the last five years, we get a figure of 117,476 (about 20% lower).
What’s more, due to population ageing, the average over the last five years understates the expected number of deaths. Hence the true number of excess deaths is about 15% lower. Taking this into account, the pandemic’s total death toll in England and Wales is about 100,000.
However, when it comes to events like pandemics, estimating the total death toll isn’t the best way to gauge the impact on mortality. Consider an example.
Japan and Mexico have about the same population, but there are more deaths each year in Japan. How can this be, when everyone knows Japan is a very long-lived country? The reason is simple: there are more elderly people in Japan, so there are more people at high-risk of dying each year.
A better way of comparing the level of mortality in Japan and Mexico is to use the age-standardised mortality rate or life expectancy. Both of these measures take into account the risk of dying at different ages, as well as the age-structure of the population. (In 2019, Japan’s life expectancy was 84, whereas Mexico’s was only 76.)
Last year, the U.K.’s age-standardised mortality rate rose by 12.8%. Although this is the largest one-year change since 1940 (the first year of the Blitz), the level to which mortality rose was lower than in 2008. And even the change should be put into context: 2019 was a year of unusually low mortality.
I previously estimated that the life expectancy in England and Wales last year was 80.4 – down from 81.8 in 2019. (Other researchers have reported similar figures.) So despite tens of thousands of excess deaths, life expectancy was still around 80.