Covid-19 pandemic may have indirectly accelerated other causes of death

The figures suggest evidence of a phenomenon called ‘mortality displacement’.

22 March 2022

Covid-19 may have indirectly accelerated mortality in certain causes of death including dementia and Alzheimer’s disease, with more deaths than usual in the early stage of the pandemic but fewer in more recent months, new analysis suggests.

Most leading causes of mortality, including liver disease, diabetes and old age, saw a similar proportion of deaths that were above the pre-pandemic average – known as “excess deaths” – in both 2020 and 2021.

But deaths due to dementia and Alzheimer’s disease showed a “notably different trend”, according to the Office for National Statistics (ONS).

From March to December 2020, deaths in England and Wales due to these causes were 9.7% higher than usual, with a total of 4,990 excess deaths.

By contrast, in 2021, deaths due to dementia and Alzheimer’s disease were 4,417 below average, representing a 6.7% decrease.

There was a “similar trend” in deaths due to prostate cancer, with 352 extra deaths from March to December 2020 (a 4.0% increase) followed by 312 deaths below average in 2021 (a 2.9% decrease).

The figures offer “cautious evidence that the indirect effects of the coronavirus pandemic may have accelerated mortality in certain causes of death, thereby causing deaths to be below average later in the pandemic,” the ONS said.

This could be an example of “mortality displacement”, which occurs when vulnerable people, such as the elderly or those with pre-existing medical conditions, die sooner than expected.

Because they are not dying in the following days, weeks or months when they would likely have died, this can lead to a lower-than-average period of mortality.

“Further investigation is required to understand this,” the ONS added.

The trend is not evident in other figures, with most causes of death seeing similar proportions of excess deaths in both periods.

For example, excess deaths due to “symptoms, signs and ill-defined conditions” – often linked to old age and frailty – remained high in both March-December 2020 and in 2021.

This was the leading cause of death with the highest number of excess deaths in England and Wales across the whole period from March 2020 to December 2021 (7,085 – a 30.6% increase).

It was driven by people aged 80 and over, among whom 7,123 excess deaths were registered – 34.4% above average.

Cirrhosis and other diseases of the liver had the second largest number of excess deaths across the same period, with 3,061 more deaths, up 20.4%.

Diabetes also saw an excess of 2,696 deaths, representing a 24.7% increase.

All figures for excess deaths were calculated by the ONS using an average for the five pre-pandemic years of 2015 to 2019.

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