Today the ONS released their anticipated (but dreaded) update on deaths registered in England & Wales up until 10 April. The stark comparisons reveal excess deaths of 7,500 in a single week as compared to mid-March. Hospital deaths up by 72% (3,600), deaths at home up by 51% (1,400), deaths in care homes up by 99% (2,450). Comparisons against deaths where COVID-19 is mentioned on death certificates highlight the need for much more detailed analysis to understand the LUMBs.
Location - deaths that took place somewhere else than would normally be the case with normal exchange between home, hospitals and care homes. Undiagnosed COVID-19 - deaths at home and in care homes that were most likely caused or worsened by COVID-19 but were either not tested or not confirmed so far from death registrations. Missed interventions - deaths that might have been prevented normally but were not captured early enough or where treatment was interrupted. Behavioural changes = some positive, some negative. Improved air quality and less traffic as against changed exercise patterns and the many dimensions of social confinement. But understanding mortality is just the tip of the iceberg. The fog of COVID-19 has exposed our limited understanding as to the heterogeneity of our vulnerabilities, but also shines a bright light on the many information roadblocks that delay and prevent action. We are learning much. Just as well because this is only the "end of the beginning".