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

Thomas, Drew M

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 registered deaths in England and Wales during the 2010s. The model produces baseline rates of death registrations expected in the absence of the COVID-19 pandemic, and comparing those baselines to recent counts of registered deaths exposes the emergence of excess deaths late in March 2020. Among adults aged 45+, about 38,700 excess deaths were registered in the 5 weeks comprising 21 March through 24 April (612 $\pm$ 416 from 21$-$27 March, 5675 $\pm$ 439 from 28 March through 3 April, then 9183 $\pm$ 468, 12,712 $\pm$ 589, and 10,511 $\pm$ 567 in April's next 3 weeks). Both the Office for National Statistics's respective count of 26,891 death certificates which mention COVID-19, and the Department of Health and Social Care's hospital-focused count of 21,222 deaths, are appreciably less, implying that their counting methods have underestimated rather than overestimated the pandemic's true death toll. If underreporting rates have held steady, about 45,900 direct and indirect COVID-19 deaths might have been registered by April's end but not yet publicly reported in full.