Coronavirus: One in ten fatalities were otherwise healthy

Detailed analysis shows one person in 10 who died in the UK had no underlying health conditions, particularly those aged under 50.

Rainbow coloured hands made by local children, in support of British health workers. Picture: Getty Images.

One person in ten who dies from the coronavirus in England and Wales has no underlying health condition, according to the latest figures.

Detailed analysis of death certificates for March by the Office for National Statistics found that when COVID-19 was mentioned it usually represented the underlying cause of death.

In 91 per cent of cases where COVID-19 appeared on the document, the person who died had a pre-existing condition. Coronary, or ischaemic, heart disease – caused by a build up of fatty substances in the blood vessels supplying the heart muscles – was the most common main issue, followed by dementia and respiratory illnesses.

In 14 per cent of COVID-19 deaths the primary health problem was a type of coronary heart disease. Analysts said that this finding might, in part, explain a decrease in deaths from heart diseases in March this year, with coronavirus killing those who might otherwise have died from heart problems.

Dementia and Alzheimer’s disease, together as one category, were the main underlying condition in 14 per cent of coronavirus deaths. Some 13 per cent of those who died had chronic lower respiratory diseases such as asthma or severe obstructive pulmonary disease.

While 9 per cent had no pre-existing condition recorded on the death certificate, 11 per cent of people had already been suffering from influenza and pneumonia. On average, people dying from coronavirus also had three other health conditions.

The ONS said that a pre-existing condition was defined as “any health condition mentioned on the death certificate that either came before the coronavirus or was an independent contributory factor in the death”.

If COVID-19 alone was mentioned on the death certificate, or the virus and subsequent conditions it had caused were detailed, those deaths are counted as having “no pre-existing conditions”.

The analysis also showed the interaction between age, underlying conditions and the risk posed by coronavirus.

Hospital workers wheel a concealment trolley, typically used for transporting bodies, to the mortuary at Lewisham Hospital on April 16, 2020 in London.

In people under 50, a greater proportion of deaths from coronavirus were recorded in otherwise healthy people than in those with any single category of illness. In men under 69, 12 per cent of COVID-19 deaths were of people with no pre-existing condition, falling to 9 per cent in men over 70. For women the figures were 11 per cent and 8 per cent.

This is likely to be partly because people tend to accumulate health conditions as they age, with smoking, alcohol, or obesity taking a toll.

Overall, one in five deaths from COVID-19 was in people aged between 80 and 84, while the death rate was highest in over nineties.

The ONS looked at 3,912 deaths during March in England and Wales where COVID-19 was mentioned on the death certificate. In 86 per cent of cases, COVID-19 had been assigned as the underlying, or main, cause of death.

With rising numbers of deaths being recorded as involving the virus, analysts had been keen to determine to what extent people were dying of COVID-19, rather than simply with it. Iain Bell, deputy national statistician at the ONS, said it was “one of the main questions asked by the public, on social media, [and] in the mainstream media. Our analysis shows that nearly 4,000 people died with COVID-19 in March – most (3,372), directly because of it.”

The analysis confirmed suggestions from earlier research that men are hit harder, with the death rate calculated for men twice as high as that for women. COVID-19 accounted for 9 per cent of men’s deaths, and 6 per cent of women’s during the month. COVID-19 was the third most frequent underlying cause for deaths last month. Alzheimer’s and dementia, and coronary heart disease were the most frequent.

The ONS has begun releasing weekly figures on virus deaths. Its data is more complete than that released daily by the Department of Health because it counts any death that has COVID-19 mentioned on the death certificate – government figures only include those where the patient has tested positive for the virus. In England, this means only hospital deaths are counted.

-------------------------------

THE Good Law Project said it had seen leaked hospital guidance telling doctors there was no need to write COVID-19 on death certificates and that it may be mentioned in another part of the form relating to indirect causes “should the doctor wish”. The not-for-profit group said: “If doctors are being gently discouraged from reporting deaths as COVID-19, we have no way of knowing if government figures on deaths from coronavirus – the daily in-hospital figures as well as the weekly ONS figures – are accurate.”

The Times