Government Replies to Question on Estimates of mortality of care home residents linked to the COVID-19 pandemic which found that “data on deaths in care homes directly attributed to COVID- 19 underestimate the impact of the pandemic on care home residents. In the reply, Professor Sir Ian Diamond, National Statistician and Chief Executive of the UK Statistics Authority, says he will analyse how the number of non-COVID-19 deaths occurring in different places of death (including care homes), for different age groups and for different causes of death differ from previous years’ data and will suggest how these findings correspond with possible reasons for the increase.


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Government Replies to Question on Estimates of mortality of care home residents linked to the COVID-19 pandemic which found that “data on deaths in care homes directly attributed to COVID- 19 underestimate the impact of the pandemic on care home residents. In the reply, Professor Sir Ian Diamond, National Statistician and Chief Executive of the UK Statistics Authority, says he will analyse how the number of non-COVID-19 deaths occurring in different places of death (including care homes), for different age groups and for different causes of death differ from previous years’ data and will suggest how these findings correspond with possible reasons for the increase.

Lord True, the Cabinet Office, has provided the following answer to your written parliamentary question (HL4465):

Question from Lord Alton of Liverpool:
To ask Her Majesty’s Government what assessment they have made of the report by Adelina Comas-Herrera and Jose-Luis Fernandez at the London School of Economics England: Estimates of mortality of care home residents linked to the COVID-19 pandemic, published on 12 May, which found that “data on deaths in care homes directly attributed to COVID- 19 underestimate the impact of the pandemic on care home residents” and that such data accounted for “an estimate 41.6 per cent of all excess deaths in care homes”; what assessment they have made of the accuracy of the data provided by the Office for National Statistics that 8,314 people had died from COVID-19 in care homes from 13 March to 8 May; what were the causes of the additional 10,000 recorded deaths in care homes during that period between 13 March and 1 May as set out in the report; and whether the total number of deaths over that period represents 18,000 more than the average estimate in previous years. (HL4465)

Tabled on: 14 May 2020

Answer:
Lord True:

The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.

Dear Lord Alton,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking what assessment has been made of the report by Adelina Comas-Herrera and Jose-Luis Fernandez at the London School of Economics England: Estimates of mortality of care home residents linked to the COVID-19 pandemic, published on 12 May, which found that data on deaths in care homes directly attributed to COVID-19 underestimate the impact of the pandemic on care home residents, and that such data accounted for an estimated 41.6 per cent of all excess deaths in care homes; what assessment they have made of the accuracy of the data provided by the Office for National Statistics that 8,314 people had died from COVID-19 in care homes from 13 March to 8 May; what were the causes of the additional 10,000 recorded deaths in care homes during that period between 13 March and 1 May as set out in the report; and whether the total number of deaths over that period represents 18,000 more than the average estimate in previous years (HL4465).

The Office for National Statistics (ONS) is responsible for publishing mortality statistics for deaths registered in England and Wales. The most recent year for which mortality statistics are available is 2018[1]. However, we do publish provisional statistics for weekly deaths registrations, which are currently published for deaths registered up to 8 May 2020[2]. National Records Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA) are responsible for publishing the number of deaths registered in Scotland and Northern Ireland respectively.

Cause of death is defined using the International Classification of Diseases and Related Health Problems, 10th edition (ICD-10). Deaths involving COVID-19 are identified by the ICD-10 codes U07.1 and U07.2.

We are working with the Care Quality Commission (CQC) and Public Health England (PHE) to better understand deaths that are occurring in care homes. From 28 April 2020, we have published counts of deaths reported by care home operators to the CQC involving COVID-19, in our provisional statistics for weekly death registrations release. We have also provided information about the different data sources in our comparison article[3] that was last updated on 19 May 2020.

The weekly mortality statistics published for England and Wales, Scotland and Northern Ireland are all designated as National Statistics, meaning they meet the Code of Practice for official statistics requirements of trust, quality and value. The most up-to-date figures for the number of registered deaths in care homes in England and Wales involving COVID-19 are contained in the ONS weekly deaths bulletin[4] and accompanying dataset[5] published on 19 May 2020. The year-to-date analysis in this report showed there were 9,980 deaths involving COVID-19 in care homes up to the week ending 8 May 2020 (these figures represent provisional numbers for deaths where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate). The analysis also showed there were 21,753 excess deaths that occurred in care homes up to the week ending 8 May 2020 as compared to the previous five-year average over the same period.

On 15 May 2020, we published further analysis of deaths involving COVID-19 in the care sector in England and Wales[6]. This report provides breakdowns of deaths involving COVID-19 in the care sector, by: characteristics of the deceased; place of death; geographical location; leading cause of death; and, pre-existing conditions. Included are figures on the number of deaths of recipients of domiciliary care, derived from data provided by the Care Quality Commission.

The analysis in this report found that since the beginning of the coronavirus (COVID-19) pandemic (between the period 2 March and 1 May 2020, registered up to the 9 May 2020):

  • there were 45,899 deaths of care home residents (wherever the death occurred); of these 12,526 involved COVID-19, which is 27.3% of all deaths of care home residents.
  • COVID-19 was the leading cause of death in male care home residents, accounting for 30.3% deaths, and the second leading cause of death in female care home residents, after Dementia and Alzheimer disease, accounting for 23.5% of deaths.
  • Dementia and Alzheimer disease was the most common main pre-existing condition found among deaths involving COVID-19 and was involved in 42.5% of all deaths of care home residents involving COVID-19.

No specific assessment has yet been made of the estimates presented in the preprint article by Adelina Comas-Herrera and Jose-Luis Fernandez released on 12 May 2020. The ONS is publishing a report on the increase in non-COVID-19 deaths observed in weekly deaths statistics, with a provisional publication date of 29 May. This is mentioned in the ONS’s statement of upcoming analysis on deaths and coronavirus (COVID-19)[7]. The report will analyse how the number of non-COVID-19 deaths occurring in different places of death (including care homes), for different age groups and for different causes of death differ from previous years’ data and will suggest how these findings correspond with possible reasons for the increase.

Yours sincerely

Professor Sir Ian Diamond

[1]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsregisteredinenglandandwalesseriesdrreferencetables

[2]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending8may2020

[3]https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/articles/comparisonofweeklydeathoccurrencesinenglandandwales/latest

[4]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending8may2020

[5]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

[6]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingcovid19inthecaresectorenglandandwales/deathsoccurringupto1may2020andregisteredupto9may2020provisional

[7]https://www.ons.gov.uk/news/statementsandletters/statementofupcominganalysisondeathsandcoronaviruscovid19

Date and time of answer: 28 May 2020 at 14:20.