Over the next few weeks we are likely to start hearing more and more about a growing death toll – not the one from Covid-19 but the one from other conditions. Disturbingly, it appears to be rising, and we are going to have to start asking what role the lockdown has played in this.
In its latest release on weekly deaths in England and Wales, released this morning, the Office for National Statistics reveals that there were 18,516 deaths in the week ending 10 April. That is 7,996 more than the five-year average for deaths in this particular week of the year. However, in only 6,213 cases was Covid-19 recorded as a cause. In other words, there were around 1,700 extra deaths from causes other than Covid-19. What were they caused by? Unfortunately, the ONS release does not say. Covid-19 and ‘respiratory disease’ are the only conditions for which a breakdown is offered. There were 1,810 of the latter, but there is a large overlap as Covid-19 is of course itself a respiratory disease, and many death certificates mentioned both.
Are we undercounting Covid-19 deaths? Possibly. But there is also a possibility that we are over counting them. The problem is that many people who die in care homes, or in their own homes, are not being tested for Covid-19. Are such deaths being wrongly attributed to Covid-19? Without testing, it is hard to be sure, given that other respiratory conditions such as influenza have pretty similar symptoms, and that the final cause of death in both cases is likely to be pneumonia.
There is another possibility, and one which ought to be causing a huge amount of alarm in the government and NHS: that people are dying from non-Covid conditions because they are failing to seek medical attention in time. They are taking too much to heart the government mantra that we should all stay at home to protect the NHS and save lives. Seeking medical attention is, of course, one of the officially validated reasons for leaving your home. But still the instruction not to bother the NHS is likely to be foremost in the mind of someone who isn’t sure whether their chest pain is a sign of heart disease or just indigestion.
There is plenty of anecdotal evidence that people are avoiding surgeries and hospitals during the lockdown. Yesterday, Waqar Rashid, a consultant neurologist at St George’s Hospital in South London, wrote here of how he is currently seeing half the number of patients he normally does. He set out his fears that the fall in the number of patients coming forward is a sign of trouble to come: that patients are still falling ill and that they will face greater harm owing to their failure to seek timely medical attention. He is not the only one. A GP friend of mine reports that his former practice has seen a similar collapse in consultations.
If there is a lockdown-induced death toll, its full effects will not become clear for some time. If you suffer a heart attack and fail to seek medical attention, you may well die this week. But if you notice a strange lump it is unlikely to kill you so quickly. But a delay in diagnosing and treating your cancer could well cause your premature death in months or years to come.
Government ministers are forever asserting that their slogan ‘Stay at home, protect the NHS, save lives’ has saved lives from coronavirus. They need to be asking themselves: how many other lives is it costing?
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