Daily Insight: After the fanfare

Coronavirus update

The continuing crisis in personal protective equipment is showing no sign of abating. Shortages persist and bottlenecks in the systems intended to supply the crucial kit do not help matters.

Two weeks ago, the government announced a new online channel for health and care organisations to access the kit, run by commercial logistics firm Clipper. It was going to be open to primary, community and social care providers as well as secondary care. The system for out of hospital providers to access the service will be fronted by a website built by Ebay — but, a fortnight on from the fanfare, it is still being tested and has yet to be rolled out around the country.

Meanwhile, analysts working for the Institute and Faculty of Actuaries — who watch mortality closely — have estimated that, by now, there have been 26,654 to 31,419 “excess deaths” during the covid-19 outbreak in the UK.

“Excess deaths” represent the difference between the number of people who are dying, versus what would have been the case if age-adjusted mortality rates remained the same as recent years.

It is clear the death count is well above what has so far been officially counted. Rapid counting is inhibited for a number of reasons — mostly quite good ones — about practicality and accuracy.

Reporting issues have, however, for some time, masked the impact of the virus outside of hospitals.

HSJ analysis shows large numbers of “excess deaths” are taking place in care homes and at home — but, in these settings, the majority of fatalities are not being directly attributed to covid-19.

We don’t know exactly why. It is likely to be a mixture of some deaths caused by covid-19 but not recorded as such, and some deaths taking place as a side-effect of how people and services are responding to the outbreak.

We also don’t know what the final consideration of excess mortality across the outbreak will show. It will have to consider mortality in the coming weeks and months as the UK moves to the next phase of dealing with covid-19, and also give consideration to mortality ahead of the outbreak.