COVID-19 The latest picture as at 24th February 2021

The fall was again driven by a further marked reduction in deaths mentioning COVID-19, which were around 22% lower than in the previous week. Despite this welcome fall, COVID-19 deaths remain at high levels, accounting for over 35% of registered deaths over the week.

The latest data also shows continued falls in daily case numbers and hospital admissions, as well as deaths. These trends will have helped support the talk this week of planning the phasing out of some lockdown restrictions over the weeks and months ahead, although the risk remains of further rises in case rates as restrictions are lifted.

COVID-19 in the UK: Current position

COVID-19 case numbers continue to grab the headlines. While many cases show only relatively mild symptoms, and some are entirely asymptomatic, there will unfortunately be a proportion who will require hospital treatment and potentially intensive care. Sadly, while medical treatments continue to improve, a number of those admitted to hospital will tragically die. The progression from first infection, to developing serious symptoms requiring hospitalisation, to death occurring typically takes a number of weeks.

It is therefore very useful to look at the numbers of COVID-19 cases as an indicator of imminent hospitalisation requirements, and to look at hospitalisation figures themselves as an indicator of future rises in COVID-19 linked deaths.

The chart below compares these three figures for the UK as a whole (averaged over the 7 days to the date shown to smooth out variations, such as weekends and bank holidays). We have focussed on the figures for the past few months, given the very low levels of COVID-19 seen over the summer months.

We can see how COVID-19 cases in the UK (purple line, left hand axis) increased steadily from early September, then more rapidly from the start of December, reaching a peak around the turn of the year. Since early January, case numbers have fallen fairly rapidly, which is welcome news. There may be some signs of a slow down in the rate of fall though, which is something to keep an eye on, especially as some lockdown restrictions start to be gradually lifted.

There will not always be a direct correlation between cases and hospitalisations (solid green line, right hand axis), for example due to changing rates of infection across different age groups, who are likely to have differing levels of hospitalisation. However, hospitalisations (green line, right hand axis) have broadly followed case numbers (with some anticipated time lag) in the chart. While numbers also remain high, and there continue to be pressure points in particular parts of the country, at the national level numbers have also been falling rapidly over recent weeks. The news this week that the vaccines may significantly reduce hospital admissions is very encouraging. As the vaccination programme continues to be rolled out rapidly, we will hopefully continue to see hospitalisations fall.

COVID-19 deaths (dashed green line, right hand axis) are also following similar patterns, although the rate of increase since early December was less dramatic and closer to that seen over November. Note that, unlike in the rest of this blog, these death figures are based on date of death rather than date of registration, and count deaths within 28 days of a positive COVID-19 test. Deaths on this measure continue to fall steadily, which is very welcome news.

Weekly deaths remain well above average seasonal levels

The latest statistics from the ONS include detailed breakdowns of deaths registered in England & Wales up to 12^th February 2021. Combining this information with similar data from the corresponding statistical bodies in Scotland and Northern Ireland, we can examine emerging patterns in the data.

Total weekly deaths registered in the latest week were 10% lower than in the previous week, which was a bigger drop than we would expect for the time of year, and so the level of excess deaths also fell, although they remain over 25% higher than expected.

Deaths directly attributable to COVID-19 have fallen sharply

We focus on deaths where there is any mention of COVID-19 on the death certificate in the chart below.

The number of registered deaths which mention COVID-19 on the death certificate increased rapidly over the start of 2021. It is therefore encouraging to see that COVID-19 deaths have again fallen sharply, with a drop of almost 22% over the last week. Deaths mentioning COVID-19 still accounted for over 35% of all deaths registered over the week, illustrating that there is still some way to go.

Deaths excluding those linked to COVID-19 continue to be below average levels (compared to 2015-2019), as can be seen from the chart below.

The bars shaded in red indicate weeks where total deaths were above average seasonal levels. This effect was particularly evident at the same time as the COVID-19 pandemic first hit the UK over April and May and was explored as ‘missed’ COVID-19 linked deaths in our earlier blog.

While the weeks around the turn of the year were impacted by variations in the timing of festive bank holidays, the latest week again saw non COVID-19 deaths that were significantly below expected levels. The extent to which the numbers were lower than average appears to be dropping steadily over the past few weeks, although care should be taken in interpreting these patterns over relatively short periods.

As noted above, while cases, hospitalisations and deaths continue to fall, they all remain uncomfortably high. We are sadly likely to see further tragic COVID-19 deaths in the weeks and months ahead, and concerns remain that the impact of disruption to healthcare services during the pandemic may have consequences in the short to medium term. Offsetting that, the hope is that the continued rollout of vaccinations will help stem case levels, hospitalisations, and ultimately, deaths.

We will be keeping a close eye on the emerging statistics in the weeks and months ahead.