Coronavirus: High rate of non-Covid-19 deaths highlights concerns of indirect impact of virus

Deaths in England and Wales for the first week in April were nearly double above what would be expected, hitting a 20-year high. The Office for National Statistics (ONS) said there were 18,500 deaths in that week – about 8,000 more than normal, compared to a five-year average.

The ONS said 6,213 of the ‘excess’ deaths were linked to coronavirus, but that a further 1,783 were not, which the BBC said suggests the lockdown may be having an indirect impact on health.

Concerns have repeatedly been raised that the lockdown could cause other deaths through suicide, the postponement of operations for other serious conditions and the reticence of people to come forward with cardiac problems.

The News Letter recently revealed that almost half of acute hospital beds in NI are currently lying empty in preparation for a Covid-19 surge.

Queens University Belfast Emeritus Professor of Virology Bert Rima pointed out that almost one-quarter of the total number of unexpected deaths in England and Wales for the period had no known link to the virus, according to the ONS.

“It is this that has given rise to the concern expressed by many health officials that people with other life-threatening conditions do not avail themselves of the NHS at this moment,” he said.

He also warned that unless everyone has been tested in person for the virus, it is almost “impossible” to estimate the figures accurately. All the statistics are still being revised, he noted.

“I think, however, that with the numbers being as fluid as they are, it will indeed take a long time before we know what really happened,” he added.

The NI Statistics and Research Agency (NISRA) said that the first week in April in Northern Ireland 435 deaths were registered, an ‘excess’ death rate of 140 above the five-year average. Seventy-six (17.5%) of these (435) deaths mentioned Covid-19 on the death certificate, it added. This means that NI had an ‘excess’ or unexpected 64 deaths in the first week of April which were not known to be directly linked to Coronavirus.

The News Letter asked the ONS how many of the coronavirus-related deaths in England and Wales in the first week of April were caused by the virus, and for how many it was was a secondary feature?

The ONS said it was not yet able to say but did confirm that 86% of Covid-19 related cases in England and Wales for the month of March had the virus as “the underlying cause of death”. All England and NI deaths are counted as Covid-19 related, even if it is only mentioned as ‘suspected’ on the death certificate.

Last week the News Letter reported a leading doctors’ union as saying that some patients – with cancer sufferers at particular risk – could die due to resources being diverted to Covid-19, after the News Letter discovered that 49% of beds in acute hospitals across NI were lying empty.

Dr Tom Black, NI chair of the British Medical Association (BMA), told the News Letter that although planning for the worst case scenario of a Covid-19 surge had been essential, Government must now start to consider when it should reopen normal wards again.

He was speaking after it was revealed that tens of thousands of NHS hospital beds right across the UK are lying unoccupied amid the Coronavirus crisis — about four times the normal number of empty places — due to huge ongoing efforts to free up space for an expected Covid-19 surge.

The Health Service Journal (HSJ) reported that the national average for empty beds is now 40.9% – and that even the most serious Covid-19 hotspots – London, Birmingham and the Black Country — still have 28.9% and 38.2% of beds lying empty. The HSJ also reported that London’s Nightingale hospital is also largely empty.

The News Letter put the HSJ figures to the Department of Health (DOH) and asked what percentage of NI beds are empty, how many intensive care beds here are empty; and what percentage of NHS volunteers have been deployed? The DOH did not provide answers, instead redirecting the News Letter to the Health and Social Care Board (HSCB) on the first two questions. However, in the meantime, full details on all three questions were then released by Health Minster Robin Swann to the Assembly and wider media, when he briefed that the peak of the coronavirus crisis in Northern Ireland may be “less severe than first feared” and may already have been reached.

He said 1,900 acute and geriatric beds are currently lying empty across NI (49%) while hospitals are coping with a so-far comparatively smaller number of 603 patients with confirmed or suspected Covid-19. He also confirmed that 56 of NI’s 155 intensive care beds also remain empty. Technically, the News Letter has still not been provided with this information in response to its enquiries.

Asked if it was possible that non-Covid-19 patients would die because so many of them are going to be missing out vital treatments in hospital at this time, the BMA’s Dr Tom Black told the News Letter: “Sure. That was a decision that was made. Everything is about doing the best you can for the greatest number of people.”

NI had to ensure it did not run out of intensive care beds in light of the tragedies in Italy, Spain and France, he said, so he was “not surprised” that almost half of NI’s acute hospital beds are currently empty.

Dr Black said the level of empty NHS beds in NI is “reasonable” given that many doctors and nurses have been pulled from routine wards into Covid-19 related wards. He says up to one nurse per bed may have been required for a surge, as well as a dense coverage of doctors. “But I think your point is right,” he added. “They now have to look and see ‘do we transition people back into acute care beds?’ - cancer patients have been a real worry of ours throughout all of this.” He added: “I don’t think you should ignore this empty bed thing. I think it is reasonable we have to answer questions about this.”

However he noted that many non-Covid-19 patients are now being cared for in independent hospitals. A further 1345 non-Covid19 patients still remain in NI’s NHS hospitals.

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