Initial estimates of Excess Deaths from COVID-19

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1. Background

The novel coronavirus (COVID-19) pandemic will affect the number of deaths in the UK. This extends beyond people dying from contracting COVID-19, as there will also be impacts on the population’s health and mortality due to changes in healthcare activity to tackle COVID-19, and government’s other responses to the pandemic. We have investigated the potential impacts of four categories of ‘excess death’, which is any death due to the COVID-19 pandemic which would not have occurred otherwise within one year. Where possible, both the numbers of deaths expected and the years of life lost (YLL) have been estimated. Years of life lost is an important measure for understanding the extent to which COVID-19 has brought forward deaths which would have occurred in the short-term without COVID-19. These four categories of excess death are: 1. Deaths directly from COVID-19 2. Indirect COVID-19 deaths due to additional pressures on the health and social care system, unable to maintain previous standards and unable to adequately treat and care for patients with COVID-19 and other conditions 3. Deaths from changes to healthcare activity, such as cancellation or postponement of elective surgeries and other non-urgent treatments 4. Deaths from factors affecting the wider population, both direct, resulting from the pandemic and from government’s Behavioural and Social Interventions to address the pandemic (BSIs); and economic (resulting from a pandemic/BSI-induced recession).

results We compare the current Mitigated Reasonable Worst Case scenario with poor compliance (RWC-M) from 28 March 2020 with the previous Unmitigated Reasonable Worst Case scenario (RWC-U) from 5 March 2020. The RWC-M assumes the current social distancing measures, or Behavioural and Social Interventions (BSIs), are in place for the 6 month period from the end of March until September 2020.

Note that the RWC scenarios contain large uncertainties in the characteristics of the virus and how society will respond to social distancing measures. If the RWCs overestimate or underestimate the reality of COVID-19’s impact, the excess deaths estimated here will reflect that difference from the true effect. Each of the four categories of deaths is calculated independently. There is likely to be some overlap in deaths in separate categories, and it has not been possible to account for this. The co-morbidities for increased susceptibility to COVID-19 (Category 1) also make an individual more likely to have an elective admission postponed (Category 2) and an emergency hospital admission (Category 3).