Coronavirus has become a significant underlying cause of death figures in the past couple of years, and has affected the majority of countries across the world, none more so than the UK. But is it right to treat coronavirus as comparable in its effects to more familiar diseases such as influenza?
The Office of National Statistics has released figures showing that the virus has been the main cause of death in more than four times as many cases as flu and pneumonia in England and Wales since the beginning of the pandemic in March 2020. Annually, deaths due to COVID-19 have been higher than those due to flu and pneumonia in any year since 1929.
Even though the mortality rate from the virus has lessened since the beginning of the pandemic, it is still not entirely clear whether the disease is behaving similarly to the flu and pneumonia. So how should they be compared?
In England and Wales, there were 148,606 deaths where COVID-19 was identified as the underlying cause of death between the weeks ending 13th March 2020 and 1st April 2022, compared with 35,007 deaths due to flu and pneumonia.
At the same time there were 170,600 deaths where COVID-19 was mentioned anywhere on the death certificate as cause or contributory factor. In comparison, there were 219,207 deaths involving flu and pneumonia.
Limits
There are limits to the value of comparing the number of deaths from COVID-19 with those with flu and pneumonia. For instance, death certificates likely underestimate flu deaths, because not all patients are tested for it, and circulating flu causes increases in deaths due to other conditions such as cardiovascular diseases. But it does provide the chance to compare trends and approximate mortality associated with each.
Less than two-thirds (62%) of deaths in relation to COVID-19 in the week ending 1st April 2022 were due to it, with similar proportions throughout March. This is a decrease of 90% on spring 2020 and the early months of 2021. It is possible that this could be as a result of the booster vaccination program and the high levels of antibodies across the population in the UK.
While the proportion of COVID-19 deaths due to the disease reduced in early 2022, it is still higher than those due to flu and pneumonia. In the week ending 1st April 2022, a fifth of deaths involving flu and pneumonia (20%) were due to these conditions, similar to most weeks since March 2021.
Concentration
Deaths because of COVID-19 have occurred more evenly across age groups than deaths due to flu and pneumonia. But, in both cases, a large number of deaths have been among the oldest.
The average age of death for COVID-19 has been lower than that of flu and pneumonia throughout the coronavirus pandemic. In summer 2021, the average age of death fell as low as 73 – however this has since been on the rise due to much of the population being fully vaccinated.
Between March 2020 and March 2022, almost 73.7% of deaths due to flu and pneumonia in England and Wales occurred among those aged 80 years and over, compared with 58.3% of deaths due to COVID-19.
In terms of the younger age groups, those age up to 14 years old accounted for 0.03% of deaths due to COVID-19, compared with 0.16% of deaths due to flu and pneumonia.
The number of deaths due to COVID-19 has generally remained higher across all age groups than the number of deaths due to flu and pneumonia. But the biggest difference have been evident among adults of middle age or retirement age.
Underlying
When COVID-19 deaths were at their highest in January 2021, the number of deaths due to the virus was nearly 32 times higher than the number due to flu and pneumonia among people aged 40 to 59 years and aged 60 to 79 years. Among those aged over 80 years, deaths due to COVID-19 were 16 times higher than those due to flu and pneumonia.
COVID-19 was the underlying cause of 73,766 deaths in 2020 and 67,258 deaths in 2021. Flu and pneumonia have not reached these types of figures since 1929 when they were recorded to be the underlying cause of 73,212 deaths in 1929. The most severe outbreak occurred in 1918, the year of the “Spanish flu” pandemic, when there were more than 170,000 deaths.
In more recent times, the number of deaths due to flu and pneumonia fell below 20,000 in 2020 for the first time since 1948, before reaching a record low of 16,237 in 2021. This decrease could be as a result of the restrictions that were put in place due to the COVID-19 pandemic.
