So far, it has been difficult to come close to an answer to these questions. Obviously, this is an ongoing pandemic, with thousands still dying every week. We don’t know the final toll yet, and it will take some time to do so.
This applies, by the way, to the economic and direct consequences of mortality. We can be pretty sure that, in at least one sense, this pandemic was like no other in history: While other diseases have triggered sporadic restrictions and behavioral changes, we have never known the types of lockdowns implemented in the past year. Never. It is totally unprecedented.
With all of this in mind, however, we are now able to draw some initial conclusions on the scale of what we experience (or even die). It is not a pleasant exercise, but it is important.
Some have suggested that COVID-19 is little more dangerous than the flu – and others say it poses a danger of an order we’ve rarely seen before.
Now that we have pretty much all the data for the first calendar year of the pandemic, we can begin to make meaningful comparisons.
In this case, we are looking at data for England and Wales, collected by the Office for National Statistics (ONS) since 1960 and contained in the Human Mortality Database between 1841 and 1960.
It should be noted that the figures for Scotland were broadly similar, although slightly less severe than for England and Wales. And note that we are not talking about ‘COVID-19 deaths’ here but all deaths from all causes in England and Wales in any given year.
However, there is no single definitive measure of mortality – especially when trying to compare different periods of history. But let’s start with the simplest of all numbers: the sum of people who died in 2020.
In the 52 weeks leading up to Christmas Day, 604,045 deaths have been recorded in England and Wales. It’s worth saying that this almost certainly underestimates the probable total for 2020, as it includes a few days from the end of 2019, when deaths were at levels well below those this winter.
Even so, this number is almost unprecedented. If you look at civilian deaths, the only other year in which over 600,000 people died in England and Wales was 1918, when the last year of World War I coincided with the Spanish flu.
In other words, it’s more than in any year of World War II or any other pandemic – ever. (The Black Death records are very precarious, but with the exception of years of military conflict which might be the only other competitor in terms of death tolls.)
However, it should be emphasized that these historical figures are just civilian deaths – therefore do not reflect the enormous military loss of life during the world wars.
You’ve probably already realized the main problem with comparing these two numbers: Britain’s population is much larger today than it was in 1918, or even any year in a century before.
To get a more comparable number, we need to divide the number of deaths by the total population in England and Wales. When we do, we come up with a less terrifying number. In fact, the number of deaths per 1,000 is 10.2. That’s considerably higher than levels in previous years (in 2019, for example, it was 8.9), but it’s still only the highest crude death rate since 2003.
That doesn’t sound so bad, does it? Fewer people dying per 1,000 population than in 2003, and just about any year before. But there’s a clue here as to why that’s not a particularly meaningful comparison.
Crude death rates, which we are talking about here, have declined for most of the 20th and 21st centuries as medical science has advanced and people have lived longer. So tossing that number like telling us “it’s as bad as 2003” isn’t quite correct.
A much better yardstick (since we’re trying to judge this year against similar years) is to see how that crude death rate compares to previous years. Are things getting better or worse, in other words? These are what the ONS calls excess mortality rates (a term you are no doubt familiar with), and when you look at these population-adjusted excess mortality rates, a very different picture presents itself.
In 2020, the number of excess deaths, as a proportion of the population, increased by 12.1% compared to the average of the previous five years.
To put that in perspective, it’s the biggest jump in a year since 1940. Bigger than in the flu epidemic of 1951. Bigger than in the Asian flu in the 1950s or the Hong flu Kong in the 1960s. In fact, the only other years that come close – except 1940 – are 1929, in which there was a global influenza pandemic in addition to an economic crash; 1918, year of the Spanish flu; and 1915, during the First World War.
It should be emphasized that these are not projections and they are not numbers dependent on diagnoses – these are very hard numbers of those who died from any cause. And they point out that while this pandemic is still not over, it has already come at an extraordinary cost in terms of lives lost.
However, the excess deaths is not really the most comprehensive way to compare these deaths, because while we have adjusted for the growing size of the population, we have not adjusted it for the fact that the population is aging.
It really matters. Consider two imaginary countries: one where the majority of the population is over 80, the other where the majority is under 30. Now, one would still expect the country with an older population to see more people die each year – even though the people there are comparatively healthier and have comparatively longer lifespans than those in the country. younger.
So actuaries designed a measure called age-standardized mortality. This may be the gold standard for mortality measures – so what happens when you look at 2020 in terms of standardized mortality?
Well, according to analysis done for Sky News by the Institute and Faculty of Actuaries Continuing Mortality Survey, the deterioration in mortality in 2020 was almost unparalleled.
In this case, we’re measuring improvements in mortality, so anything in negative territory is bad. And the decline in mortality in 2020, compared to the previous year, was the largest annual drop since 1929. In fact, if you were to make a list of the worst years for annual changes in mortality going back to 1842, 2020 would be the third largest annual decline in mortality, after the Great Freeze of 1895 and the influenza pandemic of 1929 (and somewhat worse than in 1847, in which there was a severe cholera epidemic, and 1915, in the middle of the Great War).
It’s worth emphasizing again: it’s just a lens through which to view these numbers. None is quite definitive. And annual numbers like these sometimes downplay pandemics that straddle more than a year – or even that occur amid other periods of human loss, such as world wars. However, it is clear, even with much of this pandemic still ongoing, that this is already a time of almost unprecedented loss of life.
The fact that this has happened despite some of the toughest lockdown restrictions this country has ever endured makes these numbers doubly striking. Some will wonder if they would have been several times higher without the restrictions. Others will argue that mortality could be affected by these indirect decisions for many years to come. Either way, the toll of COVID-19 is becoming clearer and the numbers are completely depressing.