Coronavirus: Thousands of deaths ‘exported’ into communities after NHS shutdown, warn experts

Thousands of deaths have been “exported” to community settings from hospitals as a result of the NHS shutting down routine services during the coronavirus outbreak, one of Britain’s leading statisticians has said.

Professor Sir David Spiegelhalter said there had been a “staggering” 30,000 more deaths than normal in places such as care homes and private homes during the eight weeks since the coronavirus outbreak in the UK started, with only about 10,000 of those deaths attributed to Covid-19 on death certificates.

Sir David, professor of public understanding of risk at the University of Cambridge, said the latest data from the Office for National Statistics showed a decrease in non-Covid deaths in hospitals at the same time as the large rise in the community.

He said this indicated about 6,000 deaths that were “exported back to the community because of the closure of the hospitals”.

He added: “We have got a huge number of essentially unexplained extra deaths in homes and care homes. This is extraordinary. When we look back on this whole episode, this rise in non-Covid extra deaths outside hospital is something I hope will be given really severe attention, because every one of these is a story, I think, of many people who may well have lived longer had they actually got to hospital.”

Sir David said that the mortality risk for men among these “excess deaths” was much less than for men who died from Covid-19, where the risk was double – suggesting, he said, that the excess deaths were not simply undiagnosed coronavirus deaths, where the risk would be the same.

He said the constant rate of between 25 and 30 per cent excess deaths not labelled as Covid-19 in the ONS data “would suggest many of them are indirect deaths, collateral damage of the health service disruption”.

Professor Carl Heneghan from the University of Oxford agreed and said it was vital “as a matter of urgency” that underlying causes of death be included in information to help researchers understand what was driving the increase in non-Covid deaths.

He said: “For a few weeks it has never been as quiet in frontline healthcare, that I’ve seen in 20 years. This suggests that the message of ‘stay at home’ has potentially been interpreted by people who have been unwell [as] staying at home and this has led to this excess death.”

He added that there were big questions to be asked about “the resourcing in care homes” to cope with the huge increase in deaths and the extra work this has added to staff in those homes.

Concerns about the care of patients with heart disease, stroke, cancer and other conditions have prompted repeated calls to the public not to avoid seeking healthcare when they need it.

NHS hospitals have been told to begin planning to re-start routine services after the cancellation of thousands of surgeries and appointments since March.

More than a million patients thought to be at severe risk from the coronavirus have been advised to shield themselves at home and to avoid unnecessary contact with people outside their homes.

The deputy chief medical officer, Jenny Harries, told a Royal Society of Medicine webinar on Tuesday that concerns over the physical and mental health of these patients were now being actively considered.

She said that NHS England was leading work looking at how to care for shielded patients in the longer term: “It’s one thing asking people to do this for a few weeks, maybe up to a couple of months, but if we’re looking forward into something which might continue, it needs different care and attention, because putting off blood test for a month might be fine, but it isn’t fine to put it off for three months.

“So there is a very specific piece of work looking at how services can be delivered safely on a continuous basis through different means … and what mental health as well as physical support services we need going forward.”