Deaths registered weekly in England and Wales, provisional: week ending 24 April 2020

• Comparison of weekly death occurrences in England and Wales: up to week ending 24 April 2020
• Death registrations and occurrences by local authority and health board: week ending 24 April 2020
• Deaths involving COVID-19 in care homes notified to the Care Quality Commission, England

• The provisional number of deaths registered in England and Wales in the week ending 24 April 2020 (Week 17) was 21,997, a decrease of 354 deaths registered compared with the previous week (Week 16); this is the first decrease in the number of deaths since the week ending 20 March 2020 (Week 12) but is 11,539 more than the five-year average for Week 17.
• Of the deaths registered in Week 17, 8,237 mentioned “novel coronavirus (COVID-19)”, which is 37.4% of all deaths; this is a decrease of 521 deaths compared with Week 16 (39.2% of all deaths).
• The number of deaths in care homes (from all causes) for Week 17 was 7,911, which is 595 higher than Week 16. The number of deaths in hospitals for Week 17 was 8,243, which is 1,191 lower than Week 16.
• In London, over half (50.5%) of deaths registered in Week 17 involved COVID-19; the North West and North East also had a high proportion of COVID-19 deaths, accounting for 38.8% and 38.0%, respectively, of deaths registered in these regions.
• In Wales, there were 413 deaths registered in Week 17 involving COVID-19, accounting for 36.7% of all deaths registered in Wales.
• Of deaths involving COVID-19 registered up to Week 17, 71.8% (19,643 deaths) occurred in hospital with the remainder mainly occurring in care homes (5,890 deaths), private homes (1,306 deaths) and hospices (301 deaths).
   

Figure 1: The number of deaths involving COVID-19 and the number of deaths involving “Influenza and Pneumonia” decreased compared with the previous week

Number of deaths registered by week, England and Wales, 28 December 2019 to 24 April 2020

Notes:

1. Figures include deaths of non-residents.
2. Based on date a death was registered rather than occurred.
3. All figures for 2020 are provisional.
4. The ICD-10 definitions are as follows: COVID-19 (U07.1 and U07.2), Influenza and Pneumonia (J09-J18).
5. A death can be registered with both COVID-19 and Influenza and Pneumonia mentioned on the death certificate. Because pneumonia may be a consequence of COVID-19, deaths where both were mentioned have been counted only in the COVID-19 category.

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The provisional number of deaths registered in England and Wales in Week 17 (week ending 24 April 2020) decreased from 22,351 in Week 16 (week ending 17 April 2020) to 21,997. This is 11,539 more deaths than the five-year average of 10,458. More information is in Measuring the data.

The number of death registrations involving the coronavirus (COVID-19) decreased from 8,758 in Week 16 to 8,237 in Week 17. This means that 37.4% of all deaths registered in Week 17 mentioned COVID-19, compared with 39.2% of all deaths in Week 16.

The number of deaths mentioning “Influenza and Pneumonia” on the death certificate (without COVID-19) decreased from 1,931 in Week 16 to 1,696 in Week 17. There were 2,944 deaths in Week 17 that mentioned both “Influenza and Pneumonia” and COVID-19 on the death certificate.

In Week 17, 45.2% of all deaths mentioned “Influenza and Pneumonia”, COVID-19, or both. In comparison, for the five-year average, 18.5% of deaths mentioned “Influenza and Pneumonia”. “Influenza and Pneumonia” has been included for comparison, as a well-understood cause of death involving respiratory infection that is likely to have somewhat similar risk factors to COVID-19.
 

Figure 2: Deaths from COVID-19 were registered in all age groups apart from those aged under 15 years

Deaths by age group, England and Wales, week ending 24 April 2020

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In Week 17 (week ending 24 April 2020), there were no deaths registered involving the coronavirus (COVID-19) in the youngest age groups (that is, those aged 1 year or under and ages 1 to 14 years). The highest number (3,507) of COVID-19 deaths were among those aged 85 years and over, but the highest proportion of deaths involving COVID-19 out of all causes was among those aged 75 to 84 years (40.2%).  

Figure 3: The highest number of deaths involving COVID-19 was recorded in London, while the lowest number recorded was in Wales

Deaths by regions in England and Wales, week ending 24 April 2020

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In Week 17 (week ending 24 April 2020), there were 413 deaths involving the coronavirus (COVID-19) registered in Wales. The region of England with the largest number and proportion of deaths involving COVID-19 was London with 1,406 deaths, making up 50.5% of all London deaths and 17.1% of all COVID-19 deaths.

Looking at the year-to-date (using the most up-to-date data we have available), the number of deaths in 2020 is currently higher than the five-year average. The current number of deaths is 229,294, which is 33,593 more than the five-year average. Of the deaths registered by 24 April 2020, 27,356 mentioned the coronavirus (COVID-19) on the death certificate; this is 11.9% of all deaths.

Between Weeks 1 and 12, 138,905 deaths were registered, which is 4,878 fewer than the five-year average for these weeks. However, between Weeks 13 and 17, 90,389 deaths were registered, which is 38,471 more than the five-year average for these weeks.

In each age group, except those aged 1 to 14 years, there have been more deaths involving COVID-19 in males than in females. There have been two female deaths in the 1 to 14 years age group but no male deaths. The largest difference was in the 75 to 84 years age group where there were 5,604 deaths involving COVID-19 in males and 3,511 in females.

The year-to-date analysis shows that, of deaths involving the coronavirus (COVID-19) up to Week 17 (week ending 24 April 2020), 71.8% (19,643 deaths) occurred in hospital, with the remainder occurring in care homes (5,890 deaths), private homes (1,306 deaths), hospices (301 deaths), other communal establishments (105 deaths) and elsewhere (111 deaths).

Looking at the change in total deaths registered by place of occurrence between Week 16 (week ending 17 April 2020) and Week 17, the number of deaths in care homes has increased from 7,316 deaths to 7,911 (an increase of 8.1%). There has also been a 5.8% increase in deaths occurring in private homes (4,570 to 4,834), while deaths occurring in hospitals decreased by 12.6% (9,434 to 8,243).

Deaths in care homes made up 26.6% of all deaths in Week 15 (week ending 10 April 2020), 32.7% in Week 16 and 36.0% in Week 17. In Week 17, the proportion of deaths occurring in care homes that involved COVID-19 was 35.3% (2,794 deaths).

Figure 7 is based on date of death for deaths registered up to 2 May 2020, rather than date of registration. This means as more deaths are registered, deaths per day are likely to increase, especially later dates. On each day, over half of deaths involving COVID-19 occurred in hospitals, with deaths occurring in private homes and care homes increasing. In the most recent days, the proportion of deaths occurring in care homes have accounted for over a third of deaths. Although we expect numbers of deaths to increase as more are registered, it currently appears that deaths per day are decreasing.

The Office for National Statistics (ONS) is 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. More information can be found in our comparisons article.
 

Coronavirus (COVID-19) deaths

Coronavirus (COVID-19) deaths are those deaths registered in England and Wales in the stated week where COVID-19 was mentioned on the death certificate as “deaths involving COVID-19”. A doctor can certify the involvement of COVID-19 based on symptoms and clinical findings – a positive test result is not required.

Week 16 includes the Easter Monday bank holiday. Based on past years, we would expect the proportion of deaths occurring in the week including Easter Monday to drop for the period. The Coronavirus Act 2020 permitted Registry Offices to continue to take death registrations over the holiday period this year. This may reduce the usual drop in registration of deaths occurring in the week.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the Mortality statistics in England and Wales QMI.

To meet user needs, we publish very timely but provisional counts of death registrations in England and Wales in our Deaths registered weekly in England and Wales, provisional dataset. These are presented by sex, age group and regions (within England) as well as for Wales as a whole. To allow time for registration and processing, these figures are published 11 days after the week ends. Because of the rapidly changing situation, in this bulletin we have also given provisional updated totals based on the latest available death registrations, up to 2 May 2020.

Because of the coronavirus (COVID-19) pandemic, our regular weekly deaths release now provides a separate breakdown of the numbers of deaths involving COVID-19: that is, where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions. If a death certificate mentions COVID-19, it will not always be the main cause of death, but it may be a contributory factor. This new bulletin summarises the latest weekly information and will be updated each week during the pandemic.

These figures are different from the daily surveillance figures on COVID-19 deaths published by the Department of Health and Social Care (DHSC) on the GOV.UK website, for the UK as a whole and constituent countries. Figures in this report are derived from the formal process of death registration and may include cases where the doctor completing the death certificate diagnosed possible cases of COVID-19, for example, where this was based on relevant symptoms but no test for the virus was conducted. Our figures also include any deaths that occur outside hospital.

In contrast to the GOV.UK figures, we include only deaths registered in England and Wales, which is the legal remit of the Office for National Statistics (ONS). Table 1 provides an overview of the differences in definitions between sources.

From 29 April 2020, the DHSC started to publish a new series that uses improved data for England produced by Public Health England (PHE) as their daily announced figures on deaths from COVID-19 for the UK. These figures provide a count of all deaths where a positive test for COVID-19 has been confirmed, wherever that death has taken place; this is a change from previously reporting only confirmed COVID-19 deaths in hospitals. Figures for Scotland, Wales and Northern Ireland have already begun to include deaths outside hospitals, so this change ensured that the UK-wide series has a shared and common definitional coverage. A statement was published by the ONS that provides more detail of the changes.

We will publish accompanying articles periodically, giving enhanced information such as age-standardised and age-specific mortality rates for recent time periods and breakdowns of deaths involving COVID-19 by associated pre-existing health conditions.

Within the accompanying dataset we have also provided weekly provisional figures on COVID-19 deaths registered in the UK along with age breakdowns by UK and sex and age breakdowns by Great Britain estimates.

Our User guide to mortality statistics provides further information on data quality, legislation and procedures relating to mortality and includes a glossary of terms.

Figures are based on the date the death was registered, not when it occurred. There is usually a delay of at least five days between occurrence and registration of a death. More information on this issue can be found in our impact of registration delays release.