Shining a light on the 2nd wave

The rapid rollout of the Pfizer vaccine across the UK has the potential to dramatically reduce the number of excess deaths given the expected impact on hospitalisations. However, in the meantime many are concerned about demands on the NHS during the coming winter, and how this will compare to previous winters.

However, the almost constant comparisons between the 1st wave and the 2nd wave are frequently flawed by comparing "apples with oranges". The focus at the time of the 1st wave was on deaths in hospital - now we have a more complete picture of excess deaths throughout the population. During the 1st wave, tests were in short supply and many most likely had COVID without knowing about it. Now, care home residents and staff are tested routinely and mass testing is increasingly possible.

So continuing our focus on excess deaths, where do we actually stand in the UK - and how do the two waves compare so far. Throughout this analysis, I will be using the Excess Deaths Calculation B approach that allows for changes in population age structure and trend in mortality improvements.

During week 50, there were 979 male excess deaths and 409 female excess deaths, a total of 1,388. This is down from a peak three weeks ago of 2,274 excess deaths. Let us not be fooled by the terminology. Every life lost is a tragedy for friends and family. The concept of whether the death was actuarially expected or not does not help.

But context is helpful for those attempting to understand the impact of COVID-19 and the need for restrictions. At the peak of the 1st wave, there were 6,658 male excess deaths and 5,977 female excess deaths, a total of over 12,600 deaths. Almost 9 times the number of excess deaths we saw this last week. Indeed, there were 8 weeks between March and May when the number of excess deaths was higher than 2,000.

However, even these stark figures hide differences in how much worse the 1st wave was for different regions compared to the 2nd wave so far. Table 1 illustrates how the 2nd wave has been more devastating in the North, the Midlands and the devolved countries in the UK.

Table 1 - Regional comparison of excess deaths between 1st and 2nd Waves (so far)

A succession of improvements in detection and treatment inside and outside the hospitals has driven down mortality rates. Detailed analysis is essential to clear insights on the impact of new virus variants, of vaccination and of regional restrictions.

Rushed or flawed comparisons muddy the water and distort expectations. More analysis on Week 51 will follow next weekend. Those of you who want to see more evidence of the breakdowns by age, please just ask.

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