Excess registered deaths in England and Wales during the COVID-19 pandemic, March 2020 to May 2020

TL;DR

This study uses statistical modeling to estimate excess deaths during COVID-19 in England and Wales, revealing higher mortality than official counts suggest, and highlighting underreporting issues.

Contribution

It introduces a generalized additive model to accurately estimate baseline death rates, exposing excess deaths and underreporting during the pandemic.

Findings

Approximately 45,300 excess deaths by April 2020.

Total excess deaths up to May 22, 2020, estimated at around 56,600.

Official COVID-19 death counts underestimate true mortality.

Abstract

Official counts of COVID-19 deaths have been criticized for potentially including people who did not die of COVID-19 but merely died with COVID-19. I address that critique by fitting a generalized additive model to weekly counts of all deaths registered in England and Wales during the 2010s. The model produces baseline rates of death registrations expected without the COVID-19 pandemic, and comparing those baselines to recent counts of registered deaths exposes the emergence of excess deaths late in March 2020. By April's end, England and Wales registered 45,300 $\pm$ 3200 excess deaths of adults aged 45+. Through 22 May, the last day of available all-deaths data, 56,600 $\pm$ 4400 were registered (about 53% of which were of men). Both the ONS's corresponding count of 43,205 death certificates which mention COVID-19, and the Department of Health and Social Care's count of 33,671 deaths, are appreciably less, implying that their counting methods have underestimated, not overestimated, the pandemic's true death toll. If underreporting rates have held steady during May, about 59,000 direct and indirect COVID-19 deaths might have been registered through the end of May but not yet publicly reported in full.