There is no doubt that the pandemic has led to many deaths; however, in the past week, new claims have emerged that the true number of people who have died from Covid in England and Wales is much lower than previously thought. These claims have been widely shared on social media and even amplified by a senior MP. Can it really be true that new data shows that Covid has killed far fewer people than we previously thought?
To arrive at an answer, we first need to delve into the various ways that Covid deaths are counted in England and Wales. There are two main sources of this data: the first, published by the UK Health Security Agency (UKHSA) and featured prominently on the government’s coronavirus dashboard, is a simple count of all deaths that occur within 28 days of a positive Covid test.
The second, published by the Office for National Statistics (ONS) is based on death certificates that list Covid as a cause of death. Being based on a medical assessment of the circumstances of each individual death, the ONS figures represent the gold standard.
The UKHSA figures will include some deaths that are clearly unrelated to Covid – for example, somebody who has a mild case of Covid and is involved in a car accident three weeks later – and exclude some Covid deaths where someone is in hospital for more than 28 days. The UKHSA data gives us a picture of what is happening now – albeit an imperfect one – while the ONS data takes several weeks to process.
We also need to understand how death certificates work in England and Wales. When somebody passes away, a medical professional completes a death certificate. This includes a field for the “disease or condition directly leading to death” – often called the “underlying cause”. It also includes the option to list one or two diseases or conditions that were not the underlying cause, but which contributed to the death (“contributory causes”).
The data that the ONS publishes shows that, in 2020 and 2021 combined, 157,889 deaths were registered where Covid was mentioned on the death certificate. Of these, 139,839 listed Covid as the underlying cause. In almost 90% of cases where Covid was a factor in somebody’s death, it was considered by medical professionals to be the primary reason they died. So where does the figure of 17,371 Covid deaths come from?
Freedom of information request
This figure originates from a freedom of information request to the Office for National Statistics that asked for the number of deaths where Covid was the only cause of death recorded. This is complicated by the fact that often Covid itself can cause complications, such as severe respiratory difficulties or organ failure, which will then be listed alongside Covid on the death certificate.
To exclude these deaths, the ONS responded by giving the number of deaths where no “pre-existing conditions” were listed on the death certificate. Which comes to 17,371 for the period up to the end of September 2021. But what is a “pre-existing condition”?