England and Wales coronavirus death toll 40 higher than previously stated

An additional 40 previously unreported coronavirus deaths occurred in England and Wales earlier this month, according to new official backdated figures that suggest almost one in four coronavirus deaths are occurring outside hospitals.

The Office of National Statistics figures, which are based on death certificates, show there were 210 deaths where Covid-19 was listed as a cause by 20 March, 40 more than the 170 announced by the NHS at that stage.

The figure is higher because it includes deaths outside hospitals, including those in homes and care homes, and includes patients who had not tested positive for the virus but were suspected of having the disease. It suggests that almost 24% of coronavirus deaths were previously going unreported in government figures.

What is Covid-19?

It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals.

What are the symptoms this coronavirus causes?

The virus can cause pneumonia-like symptoms. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties.

In the UK, the National Heath Service has defined the symptoms as:

• a high temperature - you feel hot to touch on your chest or back

• a new continuous cough - this means you've started coughing repeatedly

Should I go to the doctor if I have a cough?

Medical advice varies around the world - with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities.

In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

How many people have been affected?

China’s national health commission confirmed human-to-human transmission in January. As of 31 March, more than 780,000 people have been infected in more than 170 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.

There have been over 37,800 deaths globally. Just over 3,200 of those deaths have occurred in mainland China. Italy has been worst affected, with over 11,500 fatalities, and there have been over 7,700 deaths in Spain. The US now has more confirmed cases than any other country - more than 164,000. Many of those who have died had underlying health conditions, which the coronavirus complicated.

More than 166,000 people are recorded as having recovered from the coronavirus.

The ONS also found that Covid-19 deaths accounted for 1% of the UK’s total deaths in week ending 20 March.

The figures are the first set of backdated Covid-19 deaths that the ONS will announce every Tuesday morning.

A spokeswoman for ONS said the figures are based on registered deaths. She said: “It is based on mentions of Covid-19 on death certificates. It includes suspected cases of Covid-19 where someone has not been tested positive for Covid-19.”

Until now the only death rate figures available in the UK have been the daily count from hospitals of patients who have tested positive.

The ONS spokeswoman said: “If the coroner or doctor has written there was suspected coronavirus or coronavirus on a death certificate, that will be counted in this bulletin.”

Explaining the different methodologies used by the ONS and NHS in counting coronavirus deaths, the spokeswoman said: “Both sets of data have got their different merits, which we will outline in the bulletin. There are different reasons as to why both sets of data are being collected. The data from the NHS are the quickest, whereas with our data, we have to wait for the deaths to be registered.”

She added: “Future analysis will look at where Covid-19 is an underlying cause of death or a contributory factor.”

Sir Patrick Vallance, the UK’s chief scientist, conceded that both sets of data will need to be reconciled.

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Speaking at the daily Downing Street briefing on Monday, he said: “The ONS data will pick up also those people who didn’t die in hospital, but may have died from coronavirus in the community. So that will lead to some extra numbers. Don’t expect those to be large, and it is important going forward that we have this reconciliation between all of the numbers.”

Sarah Caul, head of mortality analysis at the ONS, said the new data was slower to put together than daily figures released by the NHS, but more accurate.

In an ONS blogpost on the new figures she said: “Numbers produced by ONS are much slower to prepare, because they have to be certified by a doctor, registered and processed. But once ready, they are the most accurate and complete information.

She added: “We include all deaths where Covid-19 was mentioned on the death certificate, even if only suspected: the government figures are only those deaths where the patient had a positive test result.

“We include deaths that happened anywhere in England and Wales, for example some might be in care homes: the government figures are only those that happened in hospital.”

Today’s release by the ONS also gives us our first detail about the age, gender and place of residence of some of the first people to have died with coronavirus in England and Wales, detailing 108 deaths registered before 20 March.

To date 64 were male, 59% of the total. This is in keeping with indications from China, France, Germany, Iran, Italy, South Korea and Spain that men are more likely to die from the disease.

The older age categories are hardest hit: 42% of deaths occurred among those aged 85 and over, while almost a third (31%) were between 75- and 84-years-old. Almost one in five were aged between 65 and 74.

The majority of deaths occurred in London and the South East at 41% and 18% respectively. A further 15% of deaths were among those living in the West Midlands while 12% were from the north-west.

Because the ONS figures are based on registrations, some of these deaths have already been covered by the Department of Health and Social Care’s daily figures which, to date, have listed all deaths involving coronavirus that have occurred in hospitals in the UK.

But because of the nature of how deaths are registered, (it takes at least five days for most deaths to be certified by a doctor, registered and the data processed) it is likely that more deaths have occurred which have not yet been counted by the ONS.

Separately there have been some significant delays in counting hospital deaths appearing in the NHS England figures. One death reported on Monday actually occurred on 13 March in Mid Essex hospital services NHS trust, a 17-day lag. Another, first reported on Saturday, actually occurred in Sandwell and West Birmingham hospitals NHS trust on 13 March.

At least 33 deaths reported by NHS England between Thursday and Sunday actually occurred more than a week earlier.

“There are various reasons why a hospital trust might delay reporting a death, including contact tracing, the internal validation processes and staff absences. For sheer capacity reasons, it’s occasionally necessary for some trusts to report over a longer time period,” an NHS spokesperson said.