England death toll updates halted over ‘statistical flaws’
The government has halted the publication of the daily number of coronavirus deaths over concerns that “statistical flaws” might be rendering the data inaccurate. The pause in publication was decided by the Department of Health and Social Care after the health secretary, Matt Hancock, ordered a review into the figures.
A study by academics published late this week suggested that the toll is subject to “over-exaggeration” because of the way Public Health England (PHE) measures deaths.
A statement on the government’s website read: “The secretary of state has today, 17 July, asked PHE to urgently review their estimation of daily death statistics. Currently the daily deaths measure counts all people who have tested positive for coronavirus and since died, with no cut-off between time of testing and date of death. There have been claims that the lack of cut-off may distort the current daily deaths number. We are therefore pausing the publication of the daily figure while this is resolved.”
Meanwhile, NHS England, which is separately reporting confirmed deaths in hospitals under its jurisdiction, said on Saturday that a further 13 people who tested positive for the coronavirus had died. This brings the total of confirmed deaths in hospitals to 29,173, the body said. The patients are understood to have been aged between 49 and 96 years old and all had known underlying conditions.
The suspension of UK-wide statistics is related to observed differences in data reported in England and the other countries of the UK.
Professor Yoon K Loke, of the University of East Anglia, and Carl Heneghan, professor of evidence-based medicine at the University of Oxford’s Nuffield Department of Primary Care, said on Thursday night that a “statistical flaw” in the way Public Health England compiles data on deaths had created a disparity in figures published by the different UK nations.
“It seems that PHE regularly looks for people on the NHS database who have ever tested positive, and simply checks to see if they are still alive or not,” they wrote. “PHE does not appear to consider how long ago the Covid test result was, nor whether the person has been successfully treated in hospital and discharged to the community. Anyone who has tested Covid-positive but subsequently died at a later date of any cause will be included on the PHE Covid death figures.”
The two experts said the issue specifically relates to England because Scotland and Northern Ireland use a 28-day cut-off.
“A patient who has tested positive, but [was then] successfully treated and discharged from hospital, will still be counted as a Covid death even if they had a heart attack or were run over by a bus three months later,” added Prof Loke and Prof Heneghan.
On the government death statistics website for England, the issue is acknowledged, saying: “Deaths are counted where a lab-confirmed positive coronavirus test result is reported in any setting. This means that not all deaths reported here are caused by coronavirus.”
Prof Loke and Prof Heneghan said this is the reason why PHE figures “vary substantially from day to day” and said that about 80,000 recovered patients in the community were still being monitored by PHE for the daily death statistics, even though many are elderly and may die of other causes. They suggested defining community coronavirus-related deaths as “those that occurred within 21 days of a Covid-positive test result” to fix the flaw.
PHE said it could not be ruled out that the coronavirus was a contributory factor in some deaths. Dr Susan Hopkins, its incident director, said in a statement: “Although it may seem straightforward, there is no [World Health Organisation]-agreed method of counting deaths from Covid-19. In England, we count all those that have died who had a positive Covid-19 test at any point, to ensure our data is as complete as possible.
“We must remember that this is a new and emerging infection and there is increasing evidence of long-term health problems for some of those affected. Whilst this knowledge is growing, now is the right time to review how deaths are calculated.”