High deaths in middle age

Excess mortality in England post Covid-19 pandemic: implications for secondary prevention

Many countries, including the UK, have continued to experience an apparent excess of deaths long after the peaks associated with the COVID-19 pandemic in 2020 and 2021.

Numbers of excess deaths estimated in this period are considerable.

The UK Office for National Statistics (ONS) has calculated that there were 7.2% or 44,255 more deaths registered in the UK in 2022

OECD, UK

Excess deaths in 2022, 52,514 (9.26%)

This persisted into 2023 with 8.6% or 28,024 more deaths registered in the first six months of the year than expected.

OECD, UK, weeks 1 – 44, 2023

Excess deaths, 49,389 (9.44%)

The causes of these excess deaths are likely to be multiple and could include the direct effects of Covid-19 infection,

acute pressures on NHS acute services resulting in poorer outcomes from episodes of acute illness,

and disruption to chronic disease detection and management.

Further analysis by cause and by age- and sex-group may help quantify the relative contributions of these causes.

Office for Health Improvement and Disparities

3rd June 2022 to 30th June 2023

Excess deaths for all causes were relatively greatest for 50–64 year olds (15% higher than expected)

11% higher for 25–49 and under 25 year olds,

and about 9% higher for over 65s

Several causes

3rd June 2022–30th June 2023

All cardiovascular diseases, 12%

Heart failure, 20%

Ischaemic heart disease, 15

Liver diseases, 19%

Acute respiratory infections, 14%

Diabetes, 13%

For middle-aged adults (50–64)

Cardiovascular diseases, 33% higher than expected

Ischaemic heart disease, 44%

Cerebrovascular disease, 40%

Heart failure 39% higher

Deaths involving acute respiratory infections, 43% higher

Diabetes, deaths were 35% higher

The pattern now is one of persisting excess deaths which are most prominent in relative terms in middle-aged and younger adults

Timely and granular analyses are needed to describe such trends and so to inform prevention and disease management efforts.

JP-S is Partner at Lane Clark & Peacock LLP, Chair of the Royal Society for Public Health and reports personal fees from Novo Nordisk and Pfizer Ltd outside of this submitted work.