Excess mortality in England post COVID pandemic

The Lancet has published a so-called ‘Comment’, authored by Jonathan Pearson-Stuttard, Sarah Caul, Stuart McDonald, Emily Whamon and John N. Newtone, in which their opening sentence acknowledges that:

“Many countries, including the UK, have continued to experience an apparent excess of deaths long after the peaks associated with the COVID-19 pandemic in 2020 and 2021”

They then go through the various depressing metrics which we have shared on HART repeatedly, eg.

“there were 7.2% or 44,255 more deaths registered in the UK in 2022”.

The following paragraph is the most troubling:

“The causes of these excess deaths are likely to be multiple and could include the direct effects of Covid-19 infection, acute pressures on NHS acute services resulting in poorer outcomes from episodes of acute illness, and disruption to chronic disease detection and management.” 

Can any HART reader provide the missing fourth possible contributing factor? Could the declaration of interests of the first author, Jonathan Pearson-Stuttard (JP-S “reports personal fees from Novo Nordisk and Pfizer Ltd outside of this submitted work”), be in any way relevant to this elephant-sized omission? 

The authors go on to look by age bands, for the period June 2022 to June 2023, and report

“excess deaths for all causes were relatively greatest for 50–64 year olds (15% higher than expected)”

and they point to an increase in various specific causes of death including

“all cardiovascular diseases (12%), heart failure (20%), ischaemic heart diseases (15%)”.

This looks even worse when age is also included:

“For middle-aged adults (50–64) in this 13-month period, the relative excess for almost all causes of death examined was higher than that seen for all ages. Deaths involving cardiovascular diseases were 33% higher than expected, while for specific cardiovascular diseases, deaths involving ischaemic heart diseases were 44% higher, cerebrovascular diseases 40% higher and heart failure 39% higher”.

There were also:

“22% more deaths in private homes than expected”.

They conclude:

“The greatest numbers of excess deaths in the acute phase of the pandemic were in older adults. The pattern now is one of persisting excess deaths which are most prominent in relative terms in middle-aged and younger adults, with deaths from CVD causes and deaths in private homes being most affected. Timely and granular analyses are needed to describe such trends and so to inform prevention and disease management efforts.” 

Here is where we must take note of the second author, Sarah Caul, who works at the ONS. Where has she been for the last almost two years since HART and the Pandemic Response & Recovery APPG wrote open letters on this topic to the MHRA and the JCVI respectively? Or indeed, since staff from the ONS agreed in the High Court ¹ that the excess deaths in males aged 15-19 were statistically significant? The ONS is the one group who have access to the data required to finally answer this question one way or the other. Professor Norman Fenton has even provided a template for the data and analysis required. 

It is rather reminiscent of the ’timely’ investigation by Healthcare Improvement Scotland into two peaks of neonatal deaths (in September 2021 and March 2022) which specifically stated that they would not be looking at vaccination status of the mothers, as this might increase vaccine hesitancy. This ‘timely’ investigation has yet to report back.

The Lancet article ends with:

“Leveraging such granular insights has the potential to mitigate what seems to be a continued and unequal impact on mortality, and likely corresponding impacts on morbidity, across the population.” 

Surely it is the ONS that has its hand on the lever. When will it start to use it?

This article was originally published by HART Group and is republished here with permission