The coronavirus pandemic appears to be killing more than twice the number of people recorded in daily figures from hospitals, according to the latest official death statistics for England and Wales.
The data suggest the extent of the crisis is deeper than previously thought, particularly in care homes — where a third of all deaths were recorded in the week to April 17.
In that week, 22,351 deaths were registered in England and Wales, according to the Office for National Statistics, the highest figure since comparable weekly data started in 1993 and worse than any figure in similar data of the past 50 years. The average for the comparable week from 2015-2019 was 10,497.
Since the beginning of March, there have been 27,015 more deaths registered up to April 17 than the five-year average for the time of year.
With an average delay of four days between someone dying and their death being registered, the figures relate to the period to April 13, during which the government said there had been 11,408 deaths of people testing positive for coronavirus in English and Welsh hospitals.
If data are included from Scotland and Northern Ireland, where the dates do not entirely match, 29,751 excess deaths were recorded by mid-April, far above the government’s latest daily running total of 21,678.
The official figures verified Financial Times modelling that suggested 41,000 people across the UK had died by last Tuesday either directly or indirectly as a result of coronavirus, with the death registrations higher than expected by the FT's model.
With almost 30,000 excess deaths by mid-April across the UK, approximately two weeks ago, the number of total deaths now is likely to be about 47,000, according to the FT model.
Much of the increase in deaths has been recorded in care homes. In the week to April 17, 7,316 deaths were recorded in care homes, compared with an average of 2,154 for that week in care homes over the past five years. The fact that excess deaths in care homes were 5,000 more than the long-term average in one week suggests the crisis in the care sector is even deeper than previously feared.
The ONS said the number of deaths in care homes had been rising as a proportion of total deaths, adding that the peak of the epidemic in care homes appeared to be later than that in hospitals. “We are starting to see more deaths occurring in private homes and care homes,” it said.
In the latest week of registrations, 33 per cent of all deaths occurred in care homes, compared with the average for the past five years of 22 per cent, the ONS said.
Matt Hancock, health secretary, said on Tuesday that from Wednesday the government would update daily death figures to include those in care homes and the community.
The new daily figures for deaths in all settings will, however, only count those who had been tested positive for coronavirus before they died, a condition that will not include many people who died in their own homes or in care homes.
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The ONS figures show that many deaths in care homes are not recorded as linked to Covid-19 on death certificates, suggesting that residents died of other causes or that doctors were reluctant to name coronavirus on death certificates for the very frail.
Nick Stripe, head of life events at the ONS, said it was too early to know exactly what was happening, although it was likely to be a combination of sick people not being transferred to hospitals and people dying of Covid-19 but not showing the normal symptoms.
Ian Hudspeth, chairman of the Local Government Association’s community wellbeing board, said: “It is truly shocking to see how many of the most elderly and vulnerable in our communities have died from this dreadful disease”.
“We are also yet to see the peak of the stress on the social care system, due to the delay between hospital admissions and discharge, which will require the need to start shifting capacity across from hospitals and into the community to meet a surge in demand,” he added.
Martin Green, chief executive of Care England, which represents private care home providers, said the statistics showed that “care homes are on the frontline and need to be at the centre of the government’s action”.
In Scotland, the government is requiring people returning to care homes from hospital to be tested twice to reduce the chance of false negatives. “If the scientific evidence tells us they need to do that in Scotland, we need to know why the guidance is different in England,” Mr Green said.
Carl Heneghan, professor of evidence-based medicine at Oxford university, criticised any decision to move infectious people into care homes. “Clinically, it just doesn’t make any sense whatsoever to put a person with an active infection into a home setting where other people are in significant numbers and are vulnerable.”
Care providers also said the sharp increase in deaths in care homes highlighted the need for real-time daily data and for that to be included in the overall daily figure quoted by the government. This would enable the government to understand the severity and trajectory of the pandemic and to provide ways to defeat it, they said.
Both in care homes and the community, the rise in death registrations outstrips the rise in death certificates that mention coronavirus. This suggests that doctors are misrecording deaths caused by the disease and that people are dying from other conditions indirectly linked to the outbreak.
NHS England said on Monday that 15,293 people had died in English hospitals after testing positive for coronavirus by April 17. Using unpublished estimates, the ONS said the number of people in England who had died with coronavirus on death certificates was running at 21,284 up to April 17, almost 40 per cent higher.
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