Today I have written to the Council to urge it to compile and release more accurate figures about who is dying from the Coronavirus in Liverpool and where they live. In his letter he points out the considerable differences between the Daily Governmental figures and the deaths in the community as a whole revealed by weekly Office of National Statistic figures. I lead on health and social care at the LGA, the national body for local councils, and believe that if we are to come out of lock down quickly and safely, we must have accurate information so that sources of infection can be speedily assessed and dealt with. Not only do we not know where people live who die in hospital, we cannot relate those figures to deaths in the community and residential homes. This is further complicated by the fact that post-mortems are now showing that coronavirus is now killing more people than the bronchial routes. Significant numbers of deaths are now being shown to be CV related and killing people through strokes, heart, liver and kidney problems. Unless the Government knows nationally the full extent of coronavirus contagion we cannot assess when to come out of lock down, what should be allowed out of lock down and who will continue to need help by way of medical or emotional support. The Government needs to give the people of the UK the full figures so that local officials in our towns and cities can also provide to local councils the information we need to do our job properly. The full letter to Council officials can be seen here: Martin Farran, Director of Adult Services, Matthew Ashton, Director of Public Health Evidence coming in from the Office of National Statistics, and in other Countries including the USA, indicates that we are grossly underestimating deaths caused by Covid-19. In the UK we are still only making announcements of hospital deaths on a national basis. We are now getting better figures through from CQC about deaths in residential care homes and delayed information on deaths in the community. But even if you add all these together, they appear to be under assessing the Covid deaths because of a narrow definition of this. We now know that Covid is causing deaths because of the problems it has caused to liver, heart and kidneys. It also appears to be causing deaths to some by blood clotting which is leading to sudden and massive strokes in people with no personal or familial stroke history. In addition to these clear Covid associations there are suggestions that the Virus is having a greater effect as people suffer from mental illnesses leading to depression, deaths from Domestic Violence; a reluctance to go to hospital because they are considered dangerous and lastly because people don’t want to trouble the NHS in these crisis times. The ONS is monitoring excess deaths over seasonal average which is the standard way of judging the depth of a pandemic. These figures are not really hitting the headlines and creating the impact they should because they are issued by a statistician and not in a highly exciting way by a breathless politician. If we are to make sense of the figures and, crucially, use them for deciding when and how to come out of lock down, we need to know the full extent of the deaths and the type so that we can plan effectively. The NHS and Government need that information nationally but just as importantly councils and their partners need that information locally for our effective local planning. For that reason, I think we need to do two things in Liverpool if this is possible. 1. We need to build a heat map of where people in our city who are dying actually live. Many of the people who are dying in Liverpool hospitals are not Liverpool citizens. They did not catch the virus in hospital so where did they catch it. An analysis would show the places and people on which the Council and NHS needs to concentrate its scarce proactive resources. 2. We need to have the picture of average excess deaths in our City so that we can establish the true covid-19 mortality in the City for measures we can adopt to help us locally out of the lock down. Are these possible? If so can we do them on the knowledge base that we now have and the information routes open to us? I look forward to hearing from you.
296 excess deaths need explaining
Cllr Kemp says, “A standard way of checking the progress of deaths in pandemics or epidemics is to look not just at those cases which are ascribed to the pandemic but which relate to all deaths and so map the total effect of the pandemic.
The latest total death figures are for the period 2st March to 24th April for Merseyside.
In this period on Merseyside the number of deaths which occurred was almost twice the average expected number of deaths with 2,243 actual registered deaths against an anticipated seasonal average of 1,170 expected.
Of the total 777 are registered as Covid deaths, which means an unexplained number of 296 extra deaths. This is particularly surprising when the weather has been so glorious which normally reduces the death rate. There have also been drops in other causes of death such as road traffic collisions.
It is vital that we understand the nature of these deaths. Global and UK evidence is showing that a number of cases where CV was not suspected of being a cause of death were found to have been the probable cause of death after post-mortems have been held. Other causes are possible. For example there is some evidence that people are either scared of going to hospital because of the infections there or don’t want to trouble the NHS are busy.
Without an understanding of why these shocking excess deaths are occurring we cannot adequately at a local level plan to deal with these causes or effectively plan measures to safely release us from the lockdown.
I am renewing my call for these deaths to be reviewed and explained and for the provision of a heat or location map which shows where infections are likely to have occurred.
We cannot move to a trace and contain policy effectively on the information that we currently have.
It also shows why the Government have belatedly been forced to give the full figures daily with the number of deaths in care homes being approximately 4 times the expected volime on Merseyside.
Merseyside Figures extracted from today’s Office of National Statistics Report
Between 21 March and 24 April 2020, 2243 deaths were registered on Merseyside compared to 1170 expected (a 1.9 fold increase). Of the 2243 deaths, 777 (35%) were due to COVID and 1466 were non-COVID. When COVID deaths are excluded, deaths are still much higher than expected (i.e. 2243 deaths – 777 COVID deaths – 1170 expected deaths = 296).
Excess deaths in care homes Between 21 March and 24 April 2020, 636 deaths occurred in care homes on Merseyside compared to 222 expected (a 2.9 fold increase). Of the 636 care home deaths, 153 (24%) were due to COVID and 483 were non-COVID. When COVID deaths are excluded, deaths are much higher than expected (i.e. 636 deaths – 153 COVID deaths – 222 expected deaths = 261).
This means there were 261 excess deaths in care homes over the 4 week period which could have been due to people who died from COVID but weren’t tested or who died from complications due to other conditions which were not treated because of the virus.
Deaths over and above seasonal averages that are not registered as COVID-19 deaths may have been directly or indirectly caused by the virus. This includes people who died at home or in care homes and were not tested for the virus or those who died from non-coronavirus conditions because they were unable to get treatment. In 2018 there were 15,206 deaths on Merseyside (around 292 a week) and around a fifth of those occurred in care homes.
This means there were 296 excess deaths over the 4 week period which could have been due to people who died from COVID but weren’t tested (including people in carehomes) or those who died from complications due to other conditions because they were unable to get treatment.