England might have reached its peak of daily COVID-19 deaths in hospitals on 8 April, according to new analysis of NHS figures published on Monday.
Researchers from the London School of Hygiene & Tropical Medicine analysed data, published daily by the NHS, on patients who died in hospital after testing positive for the coronavirus.
They found that there has been a clear downward trend in numbers of people dying from coronavirus in hospitals in England since 8 April, with London seeming to have the clearest pattern of decline compared to the rest of the country.
The researchers suggest that the current emphasis on the numbers of deaths reported to the NHS on the previous day gives a misleading impression about the real trend in deaths of when they occurred.
This is because the numbers announced daily relate to deaths that occurred over an extended period of days in the past, they claim, and that the current daily reporting overestimates the maximum numbers of deaths occurring on any particular day.
For example, the maximum number of COVID-19 hospital deaths on any one day was 800 on 8 April, but the maximum number of daily deaths announced was 866 on 10 April.
More importantly, they concluded that the real trend in the number of deaths was obscured by the daily figures of hospital deaths reported each day at the Downing Street coronavirus briefing.
The research, posted on Monday on health and science site MedRxiv, said that we should be focusing on trends in numbers of deaths occurring five or more days previously, which would give a more meaningful impression of both when the peak has occurred and also whether deaths are declining.
David Leon, who worked on the team, said: “It is inevitable that there are delays in reporting COVID-19 deaths in hospital.
“During this crisis, staff at all levels will be stretched to the limit. However, government officials and scientific advisers would be advised to focus on more meaningful trends that are much less subject to big fluctuations driven by the ups and downs of the reporting systems.”
“There is strong evidence that people who are below the age of 60 years who become very ill are much more likely to be admitted to critical care units than older people. As a result, they will survive slightly longer even if sadly they do eventually die.”
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Determining if and when the mortality peak of the current COVID-19 epidemic has been reached in is key for governments around the world in their health service planning and public health strategy.
It is also crucial information to communicate to the public, who in most countries have been subject to varying degrees of limitation and restriction on social interaction, work and movement.
Politicians and scientific experts regularly highlight the inevitable delay between the point at which social distancing, individual protection and lock-down measures are imposed and the point when this may result in declining mortality.
Finally, the authors conclude that their recommended simple approach to analysing trends in hospital COVID-19 deaths will also provide a more sensitive way to help detect indications of a resurgence or second wave earlier.
A total of 21,092 hospital patients have now died in the UK after testing positive for COVID-19, the Department of Health said on Monday.
In England, 329 more coronavirus patients were confirmed to have died in hospitals, taking the country's total to 18,749.
This paper was the result of a collaboration between the London School of Hygiene & Tropical Medicine, UCL London and the Max Planck Institute for Demographic Research in Rostock, Germany.