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What is the true death toll from Covid-19 - and how does the UK compare to other countries?

How do we know how many have died from Covid-19?

Official figures, recorded by the government, tell us how many people who have tested positive for the coronavirus have died.

Analysing the death toll from Covid-19 is highly complex
Analysing the death toll from Covid-19 is highly complex

But not everyone who has died as a result of Covid-19 will have been tested.

This means the precise death rate is not known. While hospitals are testing patients, those who died in other locations may never have been tested.

Complicating matters further is the fact that some people may have tested positive for Covid-19, but it may not have been considered the cause of death.

The Office for National Statistics found that 14 per cent of the death certificates mentioning Covid-19 in March, for example, did not state the virus as the underlying cause of death.

And it found that deaths from one of the UK’s biggest killers, ischaemic heart disease, were 26 per cent below the average for March.

Did Covid-19 claim the lives of those of those already close to death? Or were some deaths from heart disease wrongly attributed to Covid-19?

The answers to such questions are, sadly, unknowable.

We are able, however, to examine the number of ‘excess’ deaths compared to previous years.

Changes in the excess death rate from all causes have coincided with changes in the number of deaths recorded from Covid-19, suggesting - unsurprisingly - a clear connection between the two.

This has led to the suggestions that the excess death rate is a good proxy for the Covid-19 death rate.

In 2020, the UK has recorded 42,900 excess deaths to April 24, compared to previous years - up 61 per cent. This compares to the government’s figure of Covid-19 deaths of 30,076 by May 5.

In the Eastern region, which includes Cambridgeshire, there were 3,800 excess deaths - up 54 per cent - to April 24.

This comparison with the UK total indicates that the region has fared better than some, although the picture has varied, with Hertfordshire and Essex figures worse than Cambridgeshire’s - perhaps reflecting the proximity to London, which has been badly affected.

A graphic showing where people who have died from Covid-19 are from. Graphic: Cambridge Independent
A graphic showing where people who have died from Covid-19 are from. Graphic: Cambridge Independent

The FT has used the figures of excess death to April 25 and scaled it forward to suggest the UK death toll relating to the virus by May 5 was in fact 53,800.

Excess death figures may indeed be a truer reflection of the death toll from Covid-19.

But that is not quite the same as saying that all these excess deaths were directly caused by the virus, however. Doctors have expressed concern that many people may not be coming to A&E, or seeking medical help when they need it, due to concerns about contracting Covid-19.

This means some people may have died from other causes because they were avoiding healthcare. The indirect causes of death linked to Covid-19 are even harder to quantify.

How does our record compare to other countries?

With help from Our World in Data, we can compare how many confirmed cases of Covid-19 there have been across a number of European countries.

And we can adjust this for population, exploring how many cases per million there are in each country.

We can also see whether we are ‘bending the curve’ of infections, and bringing the rate down - and how that compares to our European neighbours. On this basis, the UK does not compare particularly well.

All these figures suggest the UK’s death toll is high. But direct comparisons of how the country is faring remain problematic.

Writing in the Guardian, statistician Prof David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, warned: “Every country has different ways of recording Covid-19 deaths: the large number of deaths in care homes have not featured in Spain’s statistics – which, like the UK’s require a positive test result.”

The government seized on this to ward off questions about why the UK’s death toll seems much higher than most European countries.

Prime Minister Boris Johnson
Prime Minister Boris Johnson

But Prof Spieglehalter responded on Twitter: “Polite request to PM and others: please stop using my Guardian article to claim we cannot make any international comparisons yet. I refer only to detailed league tables - of course we should now use other countries to try and learn why our numbers are high.”

His calculations suggest that Covid-19 has roughly double your chances of dying this year.

Your individual risk, of course, depends on a range of factors, particularly your age and underlying health.

The majority of deaths have been in those aged over 65 and, taking those registered by April 24, some 43 per cent of Covid-19 deaths have been in those over 85, according to the ONS.

It is worth noting that ONS figures are based on all deaths where Covid-19 was mentioned on death certificates. They differ from those published by the Department of Health and Social Care, which are based on deaths occurring to date among those who have tested positive for the virus. These figures are available more quickly, but change over time, whereas the ONS figures are more comprehensive but take longer to compile.

More men are dying of Covid-19 than women, ONS figures show.

How the number of deaths from Covid-19 compares among men and women. Image: ONS (34427266)
How the number of deaths from Covid-19 compares among men and women. Image: ONS (34427266)

Meanwhile, ONS data shows most ethnic minority groups are at greater risk of death from Covid-19 than the white population.

One useful way to assess your risk is to use the Covid-19 risk calculator from Chronomics, a pioneering epigenetic testing company established by Cambridge graduate Dr Tom Stubbs.

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