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Thousands more people die than usual … but it’s not from Covid


The entrance to one of five Covid-19 wards at Whiston Hospital in Merseyside – Peter Byrne / PA Wire

While the focus remains firmly on Covid-19, a second health crisis is slowly emerging in Britain. Since early July, there have been thousands of excess deaths that were not caused by the coronavirus.

According to health experts, this is very unusual for the summer. Although excessive deaths are expected during the winter months, when the cold and seasonal infections combine to put pressure on the NHS, summer is generally seen lull.

This year is a disturbing outlier.

According to the Office for National Statistics (ONS), since July 2, there have been 9,619 additional deaths in England and Wales, of which 48% (4,635) were not caused by Covid-19.

So if all of these extra people aren’t dying from the coronavirus, what’s killing them?

Data from Public Health England (PHE) show that during this period, there were 2,103 additional deaths with ischemic heart disease, 1,552 with heart failure, as well as an additional 760 deaths with cerebrovascular diseases such as heart disease. strokes and aneurysm and 3,915 with other circulatory diseases.

Acute and chronic respiratory infections also increased with 3,416 more mentions on death certificates than expected since early July, while there were 1,234 additional urinary system disease deaths, 324 from cirrhosis and liver disease. and 1,905 by diabetes.

Alarmingly, many of these conditions saw the biggest drops in diagnosis in 2020, as the NHS struggled to deal with the pandemic.

A report released last week by the government detailing the direct and indirect health impacts of the pandemic said there were around 23 million fewer GP visits – both in person and online, in 2020 compared to 2019.

The diagnosis of chronic obstructive pulmonary disease (COPD) was reduced by 51%, atrial fibrillation by 26%, heart failure by 20%, diabetes by 19%, coronary heart disease by 17%, and strokes and heart disease. 16% transient ischemic attacks.

Struggling to access the NHS

Since the start of the pandemic, charities and health organizations have warned people are struggling to access care as the NHS moves on to tackle the pandemic.

Now 18 months of delayed treatments can start to take its toll.

Dr Charlotte Summers, intensive care consultant at Addenbrookes Hospital, Cambridge, said this week at a Royal Society of Medicine (RSM) event that patients were arriving at A&E with serious conditions that had worsened during the pandemic.

“There is an increase in non-Covid emergencies arriving at hospital gates due to all the delays the pandemic has already created. Things like people later having tumors, and therefore having intestinal perforations and aneurysms and a lot of other things that have been delayed, ”she said.

“We have a massive elective backlog … and we are potentially susceptible to having influenza at increased levels this year because immunity to influenza will have waned.”

“It’s already winter”

“Last winter there was almost no RSV (respiratory syncytial virus) and pediatric intensive care was almost empty and could help us. Now they’re absolutely overflowing, as are our RSV adult and children’s emergency departments.

“We have the impression that winter is already here, rather than coming. It’s worse this year than I remember in the past 20 years.

NHS England data suggests around five million people are currently waiting to start treatment, and Health Secretary Sajid Javid has warned the figure could rise to 13 million.

Elective operations decreased by 3.5 million between March 2020 and February 2021, as the NHS prioritized Covid-19 care, and there has been an increase in staff absences due to illness and necessity to isolate oneself.

Delayed treatment, poor health outcomes

Between October and December 2020, around a quarter of all surgical activity in Britain was lost, with one in five operating theaters closed and one in eight anesthetist staff absent from their normal duties.

Emergency admissions also fell by 1.6 million as people did not seek help for fear of overwhelming the NHS, or for fear of catching Covid-19.

A government report, prepared by the Department of Health and Social Affairs and the ONS, found that while admissions recovered during the year, elective admissions in mid-July were still below the level pre-pandemic for all cancers except colorectal cancer.

The authors cautioned that: “Although it is not possible to quantify the full impact of delays in the presentation, consultation, and diagnosis stages at this stage, the literature shows that these delays in treatment are likely to occur. lead to poorer health outcomes for patients. “

Blockages removed Covid, but may lead to other problems

The country also suffers from a lack of immunity. While lockdowns, social distancing, isolation and masks have kept Covid-19 down, it has also kept other diseases from circulating.

In the 52 weeks through the week ending July 11, 2021, there was a decrease in the number of infectious diseases reported for diseases such as mumps (-72 percent), rubella (-84 percent ) or yellow fever (-100 percent) compared to the five-year average before the pandemic.

Last year, the ILI rate peaked at 3.8 per 100,000, compared to a peak of 59 per 100,000 in 2017-18.

While it has undoubtedly saved lives, we are starting to experience an increase in infectious diseases that could hit us harder than ever this winter because we have less protection than normal.

The danger is that this additional pressure on the NHS will force the government to lock down the country again this winter, imposing masks and work-from-home rules.

If so, we could find ourselves in a perpetual state of low immunity in winter that will be difficult to escape. Covid-19’s response may have inadvertently created an ongoing health crisis from which there is no way to turn back the clock.