FOLLOW US FacebookTwitter

How has COVID-19 contributed to excess deaths in Northern Ireland?

What are ‘excess deaths’?

Excess deaths are defined as deaths during a given period that are greater than the usual number of deaths in similar historic time periods. Changes in the number of excess deaths above or below the predicted average may indicate an event, for example a strain of Flu that resulted in more deaths than usual.  For 2020, the most significant event associated with excess deaths is likely to be the COVID-19 outbreak.

Has COVID-19 contributed to excess deaths in Northern Ireland?

On 28 July 2020, the Northern Ireland Statistics and Research Agency (NISRA) published a bulletin that includes a chart of the cumulative number of excess deaths and COVID-19 related deaths in Northern Ireland between 1 March and 30 June 2020. Over this four month period, there were:

  •  885 excess deaths (compared with previous five year average)
  •  837 deaths with COVID-19 mentioned on the death certificate.

These figures and other analysis in the NISRA bulletin are based on the date when people died rather than when their death was formally registered. It includes data from the deaths registered up to 15 July 2020, to account for any time lag between occurrence and registration of death.

Do excess deaths differ by age?

In Northern Ireland, both excess deaths and COVID-19 related deaths increase by age.

  • Excess deaths for the age group 55-64 years (95 deaths) was more than double that of COVID-19 related deaths (40 deaths).
  • NISRA suggests that “direct effects of the pandemic could account for less than half of the impact on excess mortality in this age group”.

Do excess deaths differ by place of death (at home, nursing home, in hospital)?

Over the four month period, the NISRA report shows:

  • A lesser excess death figure in hospitals (88 less deaths) and a higher figure of excess deaths at home (556 deaths).
  • This is in contrast to the figures for COVID-19 related deaths in hospitals (434 deaths) and at home (44 deaths).
  • NISRA suggests that this might be partly explained by hospitals retaining capacity for COVID-19 patients as well as restrictions on hospital visitors, leading some patients to decide to receive palliative care at home.
  • At care homes, the figures for excess deaths (336 deaths) and COVID-19 related deaths (346 deaths) are similar.
  • NISRA states that during this period, total deaths in care homes were almost one third (32.1%) higher than the average over the past five years.

How does Northern Ireland compare with the rest of the UK?

Weekly data on deaths are available for England, Wales, Scotland, and Northern Ireland.

Over an 11-week period that covers the worst weeks of the pandemic.   England recorded the highest figure of excess deaths. By standardising per million population, the following table shows relative figures of excess deaths during this 11-week period, by country.

Table: Excess Deaths from Week 13-23 by UK Country per Million Population

Country

Excess Deaths

Excess Deaths/Million Population

England

55,775

991

Wales

2,211

701

Scotland

4,808

880

Northern Ireland

973

514

Sources: Office for National Statistics (England and Wales); National Records of Scotland (Scotland); and the Northern Ireland Statistics and Research Agency (Northern Ireland).

The table suggests that England had the highest figure of for excess deaths per million of the population (991) of the country, while Northern Ireland had the lowest figure (514) per million of its population.

What will be the total excess deaths associated with COVID-19?

As was the case during the first wave of the pandemic, several circumstances will affect the figures for both absolute deaths and relative excess deaths associated with COVID-19:

  • how quickly an outbreak spreads before identification (track and trace systems);
  • the quality and adherence to intervention policies (e.g. lockdown, social distancing, PPE, testing);
  • the demography of the population, especially for those more at risk (e.g. levels of obesity, those with existing comorbidity conditions);
  • the quality of health care for those with COVID-19; and
  • the quality of health care for those without COVID-19.

NISRA will release their next regular report on causes of death based on death registration coding on 17 September 2020, which may shed more light on changes of proportions of causes of deaths between 2020 and previous years. The level of immunity for those who have survived infection along with any possible future vaccination programme may need to be factored into analysis. In summary, a final excess death figure for this specific COVID-19 event cannot be predicted.

 

have written a full article with more information on excess deaths in NI, including how the UK compares with the rest of Europe.                                                                Read it here.