By 7 June 2020 there had been 4,290 excess deaths in Scotland in 2020. But what are excess deaths? Excess deaths are the number of deaths that have been registered compared to a five-year average of the number of deaths registered over the same period.
This blog uses data published by the National Records of Scotland to look at excess deaths by sex, age and location. We don’t look at ethnicity as when a death is registered in Scotland, information about the ethnicity of the deceased person is collected on a voluntary basis. This means that an accurate figure for COVID-19 deaths broken down by ethnic group categories cannot be produced from the registration data. We also do not look at deprivation because there is no publicly available data available that would allow us to perform such an analysis.
Public health Scotland have produced an information tool which looks at the wider impacts on the health care system from COVID-19.
A word of caution
When comparing figures against an average it is important to consider the variation within the data that the average is created from. The below figure shows how weekly deaths so far this year compare to each of past five years. We can see that up until week 14 of this year, the week starting 30 March, weekly deaths in Scotland were similar to the previous years. Since then weekly deaths have been significantly higher than in previous years, although they have now returned to a similar level. As we drill down into the data, we need to be careful how we interpret excess deaths as small changes may not be statistically significant.
Total deaths from the start of March 2020
Since the start of March, when Scotland recorded its first positive case of Coronavirus (COVID-19), until 7 June, there have been 4,853 excess deaths. Data published by the National Records of Scotland allow us to look at the breakdown by age, sex, and location. When we look at how deaths from the start of March compare to the five-year average, we can see that:
- Deaths in care homes and at home/non-institutions have seen substantial increases, 68% and 53% respectively, while deaths in hospitals have increased 3%.
- Deaths have increased in every age group except for those aged 1 to 14.
- Deaths of males have increased more than deaths of females.
When we look at excess deaths from the start of March to the week starting 1 June we see that:
- Three quarters those who died were aged 75 and over.
- 95% of excess deaths occurred in care homes (50%) or at home or in a non-institution setting (45%).
- 54% of those who died were male.
How does this look over time?
When comparing excess deaths by sex we can see that the number of excess deaths peaked for men in the week starting 6 April. The peak for females was two weeks later, in the week starting 20 April.
For the two age groups that have seen the largest number of excess deaths, 75-84 and 85 and over, both peaked in the first half of April.
- Excess deaths for those aged 85 and over peaked in week 16 (starting 13 April), with 402 deaths.
- Excess deaths for those aged 74-84 peaked in week 15 (starting 6 April), with 334 deaths.
- Excess deaths for those aged 65-74 also peaked in week 15, with 129 deaths.
- Excess deaths for those aged 45-64 peaked in week 14 (starting 30 March) with 75 deaths.
When looking at excess deaths by location:
- Excess deaths in Hospital and at Home peaked in the week starting 6 April.
- Excess deaths in Care homes peaked two weeks later in the week starting 20 April.
Deaths by sex, age and location
This section looks at excess deaths are broken down by sex, age and location between the week starting 2 March and 1 June. It focuses on those aged 45 and over.
- Excess deaths for females are highest in the 85 and over age bracket while for males it is in the 75 to 84-year-old age bracket. One potential explanation for this is that there are more females aged 85 and over in Scotland than males. The latest population statistics from the NRS show there were 82,000 females aged 85 and over in Scotland compared to 45,000 men in 2019.
- A higher proportion of female excess deaths occurred in care homes than for males.
- Males aged 45-64 have seen more of an increase in excess deaths than females. The ONS have looked at Coronavirus (COVID-19) related deaths by occupation  for the working age population (those aged 20 to 64 years) in England and Wales. Of the nine major occupation groups it was found that for men five of the nine groups had statistically higher age-standardised mortality rates of death involving COVID-19 than the rate of death involving COVID-19 among men of the same age in the general population, while for women there was only one. This would suggest, in the working age, men of working age were more exposed to contracting COVID-19 than women.
Conclusion
Since the start of March this year there has been little fluctuation in deaths in hospitals while deaths in care homes and at home or in non-institutions have increased significantly, particularly for those aged 75 and over.
Andrew Aiton, Data Visualisation Manager