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

Analysis of excess deaths
How does COVID 29 work again ? (Sarcasm)

Breakdown by ages and conditions Direct effects of
COVID noted in excess deaths during acute phase of pandemic and notes shift in main ages affected now broken down into causes - cardiovascular being the most significant across all age groups but mostly on 20-64 year olds ( 2 groups) - so workforce

Kind of politely saying we've got a problem .....


"The greatest numbers of excess deaths in the acute phase of the pandemic were in older adults. The pattern now is one of persisting excess deaths which are most prominent in relative terms in middle-aged and younger adults, with deaths from CVD causes and deaths in private homes being most affected. Timely and granular analyses are needed to describe such trends and so to inform prevention and disease management efforts. Leveraging such granular insights has the potential to mitigate what seems to be a continued and unequal impact on mortality, and likely corresponding impacts on morbidity, across the population.


Not something which will surprise anyone here

https://twitter.com/user/status/1731580524236280077

 

There are % relative to some conditions,( heart failure, diabetes etc) but there could potentially be more detail.

 

For those who can't see the tweet, it is to this,

Excess mortality in England post Covid-19 pandemic: implications for secondary prevention, 2023, Pearson-Stuttard et al

"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 2021.1,2 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 based on comparison with the five-year average (excluding 2020).1 This persisted into 2023 with 8.6% or 28,024 more deaths registered in the first six months of the year than expected.1 The Continuous Mortality Investigation (CMI) found a similar excess (28,500 deaths) for the same period using different methods.3 Several methods can be used to estimate excess deaths, each with limitations which should be considered in interpretation, however the overall trends tend to be consistent across the various methods.

The causes of these excess deaths are likely to be multiple and could include the direct effects of Covid-19 infection,1 acute pressures on NHS acute services resulting in poorer outcomes from episodes of acute illness,4 and disruption to chronic disease detection and management.5 Further analysis by cause and by age- and sex-group may help quantify the relative contributions of these causes."

Open access, https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(23)00221-1/fulltext

 

In the UK there is a rhetoric that the increase in numbers economically inactive reflects personal choice, that it is a behavioural issue, however that we continue to see an excess mortality would seem to counter this and suggest attempts to change behaviour by whatever means is unlikely to be an adequate solution.

 

https://nitter.net/ActuaryByDay/status/1731580524236280077

 

One thing that might help reduce excess deaths in the UK is actually allowing people to buy helpful treatments for Covid without prescription from pharmacies.

https://www.nhs.uk/conditions/covid-19/treatments-for-covid-19/

In the link above, four possible treatments are listed, of which three have no listed serious side effects, apart from the possibility of allergy. The one with a mention of possible serious side effects is remdesivir which could slow the heart down a lot, or could affect blood clotting, the liver or the kidneys. So, why not allow the three which are safest to be bought in pharmacies without prescription?

 

Ah, I hadn't noticed the drip issue.

I still think the advice on how to treat oneself when trying to get through Covid needs to be a lot better than it has been.

 

How do you give advice ethically when you have no idea what to advise?

There is no reason to think that there are any treatments that are other than an expensive waste of time.

The excess deaths is almost certainly down to failure to prevent illness and to provide a meaningful health service in terms of emergency hospital care.

 

When I first had Covid (November 2021) I had a small number of 30mg codeine tablets left over from having had surgery. I had also read before getting Covid that some people found codeine to be helpful in coping with it because it helped to suppress coughing. I found the codeine helpful and finished it off over the first week of my illness. I realise it could have been a placebo effect and I'm not saying that taking codeine is a good idea for everyone.

But this is what annoys me. I am not aware that any self-help options for the effects of Covid have been tested or made available to find out what works best. My cough with round one of Covid was very severe and I was also very breathless. My O2 saturation went down to 80% one afternoon. It would have been nice to know which of the over the counter products available to sick people was actually the best, and since cough was the worst symptom for many people it would have been nice to know what was considered best to cope with it. But in the end there was only the standard type of advice for any virus infection e.g. flu.

P.S. My lungs have never completely recovered from having Covid. They aren't back to baseline.