The leading causes of death are within the standard range (the five-year average): heart and lung disease, cancers, dementia and Alzheimer’s disease. Deaths from Covid-19 could account for half of the excess mortality, but the other half is puzzling, as there is no clear reason that escapes. It’s likely to be a combination of factors: Covid makes us sicker and more vulnerable to other illnesses (research shows it can contribute to late heart attacks, strokes and dementia). an aging population; an extremely hot summer; and an overburdened health service that means people are dying for lack of timely medical care. This winter, the cost of living crisis and fuel poverty concerns will add to these contributing factors, given the link between deprivation and ill health. So we may see these excessive death tolls continue. The excess mortality puzzle has been weaponized by some to argue that this is a delayed consequence of the lockdown. In essence, this means that mandatory restrictions on legal mixing and stay-at-home orders, as well as the conversion of the NHS into a Covid health service during the first and second waves of infection, prevented people from being diagnosed or treated for other conditions like cancer, heart disease or even depression – and that these long-term conditions are now killing people. Of course, some medical care has suffered during the pandemic, and delayed diagnosis leads to poor health outcomes. But to say that no restrictions would have solved this problem is naive. The restrictions ultimately limited the number of people being treated for Covid-19 at any one time so that health services could cope with those numbers. Healthcare is finite: the best way to preserve resources for non-Covid conditions was to keep Covid infections as low as possible. Given the English government’s delay in responding to Covid-19 and implementing measures to suppress it in the first and second waves, the NHS struggled to provide high-quality care to everyone who arrived in hospital. Countries that managed to avoid large numbers of Covid-19 patients in the pre-vaccine era through clever testing-based suppression and isolation, such as New Zealand and South Korea, have been able to keep their health services running for a wider range of conditions. England went the route of delayed, and therefore longer, lockdowns with no clear exit strategy and a failed test/trace/isolation system. The excess mortality data points to three main issues. The first is that the NHS is overburdened, the quality of care suffers, staff are burnt out and leaving their posts and this leads to delays in medical care for acute conditions (heart attacks and strokes) but also chronic ones, where every week matters and month, such as cancer treatment and surgeries. Too many ambulances cannot be unloaded. Unfortunately, some politicians have turned to accusing NHS staff of being lazy and only making virtual appointments or being off work due to illness. What is clear is that we need real investment in the NHS, its people, facilities and operations, so that it is an attractive workplace that can deliver the volume and quality of care that is needed. Second, data from the Office for National Statistics showed that mortality increased on days with extreme heat. We know that extreme weather events are becoming more common and that warmer temperatures can lead to strokes, heart attacks and blood clots in older and vulnerable groups. This problem is not going away as climate experts warn that what we see as unusually high temperatures will become the norm over the next 50 years. But more importantly: Covid-19 is still circulating and killing people, especially those in the elderly and those who have not been vaccinated. Although it has fallen from the number one cause of death, it is still one of the top 10 causes of death in the population, and even with a much reduced mortality rate due to vaccination and previous infection, it contributes to this 10-13% jump in excess mortality summer. In fact, as these figures from the ONS show, many other leading causes of death are slightly below the five-year average. The good news is that the fatality rate for Covid-19 – the chance of dying when infected – is now below seasonal flu for the vast majority of people. This is due to scientific developments and efforts by governments to delay the spread of Covid-19 until vaccinations are available. The bad news is that it continues to be a cause of disability and death, along with heart disease, cancer, dementia and other challenges. Instead of absurd arguments about whether the lockdown is responsible for excess mortality – completely without evidence – it is worth taking a closer look at the data, which suggests that it is, in fact, a combination of the new burden of Covid-19 and a overloaded health service, with days of extreme heat. As always, a clearer picture will emerge with more research and analysis over time. For now, we should focus on how to develop better treatments and vaccines to further reduce the death rate of Covid-19, invest in the NHS to ensure quality and timely care and consider how to better deal with extreme weather . Global events like the Covid-19 pandemic and climate change are making us all sicker. If we could just recognize their impact across political lines, we could work together on solutions.
Do you have an opinion on the issues raised in this article? If you would like to submit a letter of up to 300 words to be considered for publication, please email it to [email protected]
