By Therese Raphael
BACK IN APRIL, Britain’s Deputy Chief Medical Officer Jonathan Van-Tam told a news conference that the UK’s relative performance in combating the coronavirus would become clear only once there were comparative figures on excess mortality (deaths above a five-year average). Shortly afterward, the government stopped showing charts with comparative death rates altogether.
It wasn’t hard to see why: The emerging trends were deeply unflattering to Britain. But Boris Johnson’s administration also had a point. COVID-related deaths are recorded unevenly across countries, making comparisons difficult. Pressed on the issue, the prime minister said there would be time for drawing conclusions about relative performance later and he promised an independent investigation.
On Thursday the UK Office of National Statistics (ONS) released a trove of excess mortality data that allow more reliable comparisons to be made. The ONS got around the comparability problem by using total mortality figures, rather than simply COVID-related deaths, and drawing on data from Eurostat, which sets out clear criteria for reporting.
The data confirmed the picture the government was eager not to highlight in those charts: England had the highest excess mortality rate in Europe. Understanding why the government made the decisions it did as the pandemic arrived in Europe will occupy journalists, historians, and Parliament for many years. The data can’t provide those answers, but they do give an indication of how Britain can better arm itself in fighting a second wave, or preparing for the next virus.
It will be unforgivable for the government to again drag its feet on lockdowns, ignore what’s happening elsewhere in Europe, and not prepare adequately for a medical emergency. Late on Thursday, Health Secretary Matt Hancock surprised many with new lockdown restrictions on a large swath of northern England, including Greater Manchester. The new mantra seems to be “better safe than sorry,” although the timing and lack of clarity about the data used for the decision have created confusion that won’t help with getting people to comply.
What made the UK the most deadly place for COVID wasn’t big spikes in mortality in badly hit cities or regions. Some places in Italy and Spain suffered worse. In Bergamo, the peak of deaths was 857% the normal rate; in Madrid it was 432%. Brent in London had the highest UK peak at 357% of the usual level.
The real killer in Britain — literally — was that excess mortality continued longer than in any other European country. That may reflect the lockdown-lite policies Johnson pursued in the early stages. Britain’s slowness in shutting things down and its less stringent rules allowed the virus to spread faster and farther, making it harder to suppress.
The UK’s excess mortality rates were also more geographically dispersed than in most of western Europe. That could be due to a number of factors. Travelers returning from Europe and Asia to various parts of Britain faced no quarantine restrictions in the early stages of the outbreak and could have easily brought it home.
That the spike in deaths happened all over the place also reflects public health problems peculiar to the UK, especially high levels of obesity and weight-related disease. That conclusion is borne out by another piece of ONS data — excess deaths among people under the age of 65. Here again, Britain ranked worst.
While England is singled out for particular shame, Scotland, Northern Ireland, and Wal es also scored poorly, suggesting similar missteps and vulnerabilities. That provides some political ammunition for Johnson as he battles to hold onto Scotland, where the governing Scottish National Party has argued its superior handling of the pandemic shows the nation is better off on its own. Scotland’s excess deaths were higher than Italy’s.
Dealing better with future strains on the health-care system will be paramount. A study published Thursday from researchers at Sheffield and Loughborough universities, along with Economic Insight, estimates that some 21,000 UK deaths can be attributed not directly to COVID-19 but to the lockdown, and especially lack of access to critical medical care. The purpose of the lockdown was to “flatten the curve” of coronavirus cases to prevent the National Health Service from being overwhelmed, but any new strategy will need to make sure there’s adequate care for people with other serious conditions too.
Johnson’s government seems to now recognize the need to rapidly impose travel quarantines and partial local lockdowns. On the same day the ONS data were released, the UK had its highest daily total of coronavirus cases for more than a month and it added another country to its quarantine list — Luxembourg joins Spain among the recent additions. Johnson said infection rates were “bubbling up” in 30 areas across the country.
The regional lockdowns, quarantines, mask-wearing orders and other policies show a government desperate to avoid repeating its mistakes from the start of the pandemic, when it fatally ignored the policies that had proved effective in other countries. Johnson’s campaign to tackle obesity and the dysfunctional social care system are other signs that he wants to strengthen the country’s defenses. The ONS data show the tragic price Britain paid for those early lessons to be heeded.