Around 9,000 non-COVID-19 deaths in England during three months of the pandemic would not have occurred had the pandemic not happened.

This is one of the findings of a new report looking at excess non-COVID-19 deaths in the period between 29 February to 5 June 2020, using historic trends.

Although the majority of deaths over this time were not directly attributed to COVID-19, some may have indirectly been caused by the pandemic.

"Estimating the number of excess deaths is an important measure for tracking the pandemic.“ Professor Giovanni Forchini Report author

In the period studied, England reported 189,403 deaths of which 44,736 were registered COVID-19 deaths.

Based on the model presented in the report, the researchers say approximately 136,000 deaths could have been expected in that period had the pandemic not occurred. The researchers estimate that there were approximately 8,983 excess non-COVID-19 deaths.

For every 100 COVID-19 deaths, the report estimates there were approximately 19 excess non-COVID-19 deaths, with excess non-COVID-19 deaths accounting for approximately 4.4% of all reported deaths in that time in England, with small variations between regions.

In that same period, Wales reported 11,278 deaths of which 2,294 (20.3 percent) were registered COVID-19 deaths. The models suggested that in the absence of a pandemic Wales could have expected 8,983 approximately deaths, so the researchers did not find evidence of non-COVID-19 excess deaths in Wales.

Excess non-COVID-19 deaths were highest in London and the South East. The report describes evidence of excess non-COVID-19 deaths being concentrated among age groups 85 plus, 75-84 and 45-64 years old. There is no evidence of excess non-COVID-19 deaths for younger age groups.

The report is by researchers from the WHO Collaborating Centre for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis, Jameel Institute (J-IDEA) at Imperial College London.

Understanding excess deaths

There are several factors that could lead to a greater than usual number of deaths in addition to those caused by COVID-19. Severely ill patients may have been unable to access life-saving emergency treatment because of constraints in healthcare provision, or patients may have avoided seeking care because they were concerned over hospital acquired infection, or so as not to overburden healthcare providers. In addition, some COVID-19-related deaths may not have been reported as such on the death certificate.

Report author Alessandra Lochen from Imperial said: "Excess non-COVID deaths are equally important to monitor in order to understand the potential ripple effects of COVID-19. Granularity in mortality data is crucial to distinguishing actual excess non-COVID deaths from undiagnosed COVID-19 deaths."

The researchers explain that uncertainty is inherent when forecasting deaths due to natural variation in the number of deaths from week to week. In addition, variation in the reporting of deaths contribute to uncertainty, as for example holidays cause reporting delays. The models are calibrated on historic data going back to 2010.

Professor Giovanni Forchini, another report author from Imperial, added: "Estimating the number of excess deaths is an important measure for tracking the pandemic. However, it is also critical to understand and quantify the uncertainty of these estimates.”

A weekly updated dashboard including estimates of excess non-COVID-19 deaths for England and Wales will be published online. 

Dr Katharina Hauck, report author and Deputy Director of J-IDEA at Imperial, said: “The online J-IDEA excess death tracker will provide an invaluable timeline of the short-, mid- and longer-term mortality impacts of the pandemic in the UK.”

Since the emergence of the new coronavirus (COVID-19) in December 2019, the Imperial College COVID-19 Response Team has adopted a policy of immediately sharing research findings on the developing pandemic.

The full report, number 28 from the Response Team, is available on the Imperial COVID-19 Response Team report website.