Generated on 2021-02-23

Introduction

Monitoring excess mortality provides understanding of the impact of COVID-19 during the course of the pandemic and beyond. Excess mortality in this report is defined as the number of deaths throughout the pandemic which are above the number expected based on mortality rates in earlier years.

In this report the expected number of deaths is modelled using five years of data from preceding years to estimate the number of deaths we would expect on each week through the course of the pandemic. Excess deaths are estimated by week and in total since 21 March 2020, based on the date each death was registered rather than when it occurred. Excess deaths are presented by age, sex, region, ethnic group, level of deprivation, cause of death and place of death.

All Persons

Weekly excess deaths by date of registration, England.‎

Figure 1: Weekly excess deaths by date of registration, England.‎

The trend in total excess deaths by week, in England, since week ending 27 March 2020 is shown in Figure 1. Numbers above each of the columns show the total number of excess deaths and how these compare with the expected number based on modelled estimates for 2015 to 2019. For example, in week ending 24 April 2020 there were 10,004 excess deaths and this was nearly two times (1.92 times higher) the expected number of deaths in this week. When fewer deaths than expected occur in a week, the column is coloured grey.

Excess deaths where COVID-19 was mentioned on the death certificate are shown in orange. If the number of deaths is not shown in the orange part of the column, that means the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected in these weeks.

The number of excess deaths without COVID-19 mentioned on the certificate (shown in the white part of the column) may be due to an increase in deaths from other causes during the period of the pandemic but may also reflect under-reporting of deaths involving COVID-19.

Cumulative deaths since 21 March 2020, by date of registration, England.

Figure 2: Cumulative deaths since 21 March 2020, by date of registration, England.

The trend in the total cumulative number of excess deaths in England since 21 March 2020 is shown in Figure 2.

Age Group Males

0-14

Weekly excess deaths by date of registration, Males, 0-14.‎

Figure 3: Weekly excess deaths by date of registration, Males, 0-14.‎

15-44

Weekly excess deaths by date of registration, Males, 15-44.‎

Figure 4: Weekly excess deaths by date of registration, Males, 15-44.‎

45-64

Weekly excess deaths by date of registration, Males, 45-64.‎

Figure 5: Weekly excess deaths by date of registration, Males, 45-64.‎

65-74

Weekly excess deaths by date of registration, Males, 65-74.‎

Figure 6: Weekly excess deaths by date of registration, Males, 65-74.‎

75-84

Weekly excess deaths by date of registration, Males, 75-84.‎

Figure 7: Weekly excess deaths by date of registration, Males, 75-84.‎

85+

Weekly excess deaths by date of registration, Males, 85+.‎

Figure 8: Weekly excess deaths by date of registration, Males, 85+.‎

Total

Weekly excess deaths by date of registration, Males, Total.‎

Figure 9: Weekly excess deaths by date of registration, Males, Total.‎

The trend in excess deaths for males by age group is shown in Figures 3 to 9, which allows the extent of the excess each week to be compared over time and between age groups.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by age group, males, England.

Figure 10: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by age group, males, England.

Figure 10A for males can be used to compare the cumulative total of excess deaths since 21 March 2020 between age groups.

Figure 10B compares the cumulative total of excess deaths among males with the number which would have been expected based on the modelled estimates for earlier years. Where the ratio of observed to expected is less than 1, this is shown in grey. The proportion of the excess where COVID-19 was mentioned on the death certificate is shown in yellow.

Table 1 - Males
Age group (years) Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
0-14 1,498 1,701 0.88 −203 5 -
15-44 8,629 7,667 1.13 962 762 79.2%
45-64 39,775 30,388 1.31 9,387 7,325 78.0%
65-74 52,337 41,754 1.25 10,583 11,331 >100%*
75-84 86,285 69,837 1.24 16,448 21,788 >100%*
85+ 88,868 72,275 1.23 16,593 22,704 >100%*
Total 277,392 223,622 1.24 53,770 63,915 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected



Why ratios are important

Ratios can be useful for comparing between groups when the expected number is very different between groups.

For example, if group A had 5 excess deaths and group B had 10, it could appear that the impact was twice as high in group B. However, if the expected number of deaths was 1 in group A and 5 in group B, and the registered numbers of deaths were 6 and 15 respectively, then the ratios would show that group A experienced 6 times the number of deaths compared to expected, while group B experienced 3 times the number expected. Therefore, the actual relative impact is higher in group A.

The ratios presented in this report are relative to historical trends within each group, and not in relation to another group. For example, in the ethnicity section the ratio for the Asian group is the ratio between deaths in this group registered in 2020 and the estimate of expected deaths in the Asian group based on the preceding 5 years. It is not the ratio between the Asian group and another ethnic group.

Age Group Females

0-14

Weekly excess deaths by date of registration, Females, 0-14.‎

Figure 11: Weekly excess deaths by date of registration, Females, 0-14.‎

15-44

Weekly excess deaths by date of registration, Females, 15-44.‎

Figure 12: Weekly excess deaths by date of registration, Females, 15-44.‎

45-64

Weekly excess deaths by date of registration, Females, 45-64.‎

Figure 13: Weekly excess deaths by date of registration, Females, 45-64.‎

65-74

Weekly excess deaths by date of registration, Females, 65-74.‎

Figure 14: Weekly excess deaths by date of registration, Females, 65-74.‎

75-84

Weekly excess deaths by date of registration, Females, 75-84.‎

Figure 15: Weekly excess deaths by date of registration, Females, 75-84.‎

85+

Weekly excess deaths by date of registration, Females, 85+.‎

Figure 16: Weekly excess deaths by date of registration, Females, 85+.‎

Total

Weekly excess deaths by date of registration, Females, Total.‎

Figure 17: Weekly excess deaths by date of registration, Females, Total.‎

The trend in excess deaths for females by age group is shown in Figures 11 to 17, which allows the extent of the excess each week to be compared over time and between age groups.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by age group, females, England.

Figure 18: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by age group, females, England.

Figure 18A for females can be used to compare the cumulative total of excess deaths since 21 March 2020 between age groups.

Figure 18B shows the ratio of the observed to the expected deaths by age group among females since 21 March 2020. This chart can be used to compare the relative excess mortality between age groups.

Table 2 - Females
Age group (years) Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
0-14 1,170 1,332 0.88 −162 5 -
15-44 4,962 4,213 1.18 749 499 66.6%
45-64 25,297 20,559 1.23 4,738 4,077 86.1%
65-74 35,925 29,919 1.20 6,006 6,597 >100%*
75-84 71,708 60,433 1.19 11,275 15,526 >100%*
85+ 128,520 106,664 1.20 21,856 26,969 >100%*
Total 267,582 223,120 1.20 44,462 53,673 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected

Ethnic Group Males

Asian

Weekly excess deaths by date of registration, Males, Asian.‎

Figure 19: Weekly excess deaths by date of registration, Males, Asian.‎

Black

Weekly excess deaths by date of registration, Males, Black.‎

Figure 20: Weekly excess deaths by date of registration, Males, Black.‎

Mixed

Weekly excess deaths by date of registration, Males, Mixed.‎

Figure 21: Weekly excess deaths by date of registration, Males, Mixed.‎

Other

Weekly excess deaths by date of registration, Males, Other.‎

Figure 22: Weekly excess deaths by date of registration, Males, Other.‎

White

Weekly excess deaths by date of registration, Males, White.‎

Figure 23: Weekly excess deaths by date of registration, Males, White.‎

The trend in excess deaths for males is shown in Figures 19 to 23, which allows the extent of the excess each week to be compared over time and between ethnic groups.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by ethnic group, males, England.

Figure 24: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by ethnic group, males, England.

Figure 24A for males can be used to compare the cumulative total of excess deaths since 21 March 2020 between ethnic groups.

Figure 24B shows the ratio of the observed to the expected deaths by ethnic group among males since 21 March 2020. This chart can be used to compare relative excess mortality between ethnic groups.

Table 3 - Males
Ethnic group Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
Asian 11,733 6,496 1.81 5,236 4,713 90.0%
Black 5,971 3,347 1.78 2,624 2,088 79.6%
Mixed 1,300 859 1.51 441 336 76.2%
Other 3,835 2,595 1.48 1,239 1,207 97.4%
White 247,101 204,809 1.21 42,291 52,650 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected

Ethnic Group Females

Asian

Weekly excess deaths by date of registration, Females, Asian.‎

Figure 25: Weekly excess deaths by date of registration, Females, Asian.‎

Black

Weekly excess deaths by date of registration, Females, Black.‎

Figure 26: Weekly excess deaths by date of registration, Females, Black.‎

Mixed

Weekly excess deaths by date of registration, Females, Mixed.‎

Figure 27: Weekly excess deaths by date of registration, Females, Mixed.‎

Other

Weekly excess deaths by date of registration, Females, Other.‎

Figure 28: Weekly excess deaths by date of registration, Females, Other.‎

White

Weekly excess deaths by date of registration, Females, White.‎

Figure 29: Weekly excess deaths by date of registration, Females, White.‎

The trend in excess deaths for females is shown in Figures 25 to 29, which allows the extent of the excess each week to be compared over time and between ethnic groups.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by ethnic group, females, England.

Figure 30: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by ethnic group, females, England.

Figure 30A for females can be used to compare the cumulative total of excess deaths since 21 March 2020 between ethnic groups.

Figure 30B shows the ratio of the observed to the expected deaths by ethnic group among females since 21 March 2020. This chart can be used to compare relative excess mortality between ethnic groups.

Table 4 - Females
Ethnic group Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
Asian 8,296 5,247 1.58 3,049 2,740 89.9%
Black 4,678 2,901 1.61 1,777 1,323 74.5%
Mixed 1,162 702 1.66 460 256 55.7%
Other 3,151 1,853 1.70 1,297 808 62.3%
White 243,175 206,890 1.18 36,285 46,004 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected



Ethnicity coding

Ethnicity is not collected at death registration, so these estimates were made by linking death records to hospital records to find the ethnicity of the deceased. This approach has some limitations. Ethnicity is supposed to be self-reported by the patient in hospital records, but this may not always be the case. Patients may also report different ethnicities in different episodes of care. For this analysis the most recent reported ethnic group was used. Population estimates have been used to calculate mortality rates to estimate the expected numbers of deaths, and these were based on the 2011 Census. This may lead to a mismatch between ethnicity reported in hospital records and self-reported ethnicity in the census. It appears, for example, that more people are assigned to the ‘Other’ group in hospital records than in the 2011 Census.

Deprivation

Quintile 1 - most deprived

Weekly excess deaths by date of registration, Quintile 1 - most deprived.‎

Figure 31: Weekly excess deaths by date of registration, Quintile 1 - most deprived.‎

Quintile 2

Weekly excess deaths by date of registration, Quintile 2.‎

Figure 32: Weekly excess deaths by date of registration, Quintile 2.‎

Quintile 3

Weekly excess deaths by date of registration, Quintile 3.‎

Figure 33: Weekly excess deaths by date of registration, Quintile 3.‎

Quintile 4

Weekly excess deaths by date of registration, Quintile 4.‎

Figure 34: Weekly excess deaths by date of registration, Quintile 4.‎

Quintile 5 - least deprived

Weekly excess deaths by date of registration, Quintile 5 - least deprived.‎

Figure 35: Weekly excess deaths by date of registration, Quintile 5 - least deprived.‎

The trend in excess deaths among deprivation quintiles is shown in Figures 31 to 35, which allows the extent of the excess each week to be compared over time and between deprivation quintiles.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by deprivation quintile, England

Figure 36: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by deprivation quintile, England

Figure 36A can be used to compare the cumulative total of excess deaths since 21 March 2020 between deprivation quintiles.

Figure 36B shows the ratio of the observed to the expected deaths by deprivation quintile since 21 March 2020. This chart can be used to compare relative excess mortality between deprivation quintiles.

Table 5
Deprivation quintile Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
Quintile 1 - Most Deprived 115,122 91,818 1.25 23,304 26,826 >100%*
Quintile 2 109,919 89,369 1.23 20,550 25,103 >100%*
Quintile 3 111,233 92,127 1.21 19,106 23,102 >100%*
Quintile 4 108,112 90,432 1.20 17,680 22,239 >100%*
Quintile 5 - Least Deprived 100,588 83,310 1.21 17,278 20,318 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected

Region

North East

Weekly excess deaths by date of registration, North East.‎

Figure 37: Weekly excess deaths by date of registration, North East.‎

North West

Weekly excess deaths by date of registration, North West.‎

Figure 38: Weekly excess deaths by date of registration, North West.‎

Yorkshire and The Humber

Weekly excess deaths by date of registration, Yorkshire and The Humber.‎

Figure 39: Weekly excess deaths by date of registration, Yorkshire and The Humber.‎

East Midlands

Weekly excess deaths by date of registration, East Midlands.‎

Figure 40: Weekly excess deaths by date of registration, East Midlands.‎

West Midlands

Weekly excess deaths by date of registration, West Midlands.‎

Figure 41: Weekly excess deaths by date of registration, West Midlands.‎

East of England

Weekly excess deaths by date of registration, East of England.‎

Figure 42: Weekly excess deaths by date of registration, East of England.‎

London

Weekly excess deaths by date of registration, London.‎

Figure 43: Weekly excess deaths by date of registration, London.‎

South East

Weekly excess deaths by date of registration, South East.‎

Figure 44: Weekly excess deaths by date of registration, South East.‎

South West

Weekly excess deaths by date of registration, South West.‎

Figure 45: Weekly excess deaths by date of registration, South West.‎

The trend in excess deaths by region is shown in Figures 37 to 45, which allows the extent of the excess each week to be compared over time and for selected regions.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by region, England.

Figure 46: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by region, England.

Figure 46A can be used to compare the cumulative total of excess deaths since 21 March 2020 between regions.

Figure 46B shows the ratio of the observed to the expected deaths by region since 21 March 2020. This chart can be used to compare relative excess mortality between regions.

Table 6
Region Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
North East 30,161 24,933 1.21 5,228 6,378 >100%*
North West 78,953 63,802 1.24 15,151 18,532 >100%*
Yorkshire and the Humber 55,958 46,595 1.20 9,363 11,602 >100%*
East Midlands 49,253 40,774 1.21 8,479 10,297 >100%*
West Midlands 61,847 49,168 1.26 12,679 13,736 >100%*
East of England 62,548 51,927 1.20 10,621 13,446 >100%*
London 60,395 44,587 1.35 15,808 17,515 >100%*
South East 88,938 73,670 1.21 15,268 18,710 >100%*
South West 56,921 51,287 1.11 5,634 7,372 >100%*

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected

Deaths by Underlying Cause

Ischaemic heart diseases

Weekly excess deaths by date of registration, ischaemic heart diseases, England.‎

Figure 47: Weekly excess deaths by date of registration, ischaemic heart diseases, England.‎

Stroke (cerebrovascular diseases)

Weekly excess deaths by date of registration, cerebrovascular diseases, England.‎

Figure 48: Weekly excess deaths by date of registration, cerebrovascular diseases, England.‎

Other circulatory diseases

Weekly excess deaths by date of registration, other circulatory diseases, England.‎

Figure 49: Weekly excess deaths by date of registration, other circulatory diseases, England.‎

Cancer

Weekly excess deaths by date of registration, cancer, England.‎

Figure 50: Weekly excess deaths by date of registration, cancer, England.‎

Acute respiratory infections (including flu/pneumonia)

Weekly excess deaths by date of registration, acute respiratory infections, England.‎

Figure 51: Weekly excess deaths by date of registration, acute respiratory infections, England.‎

Chronic lower respiratory diseases

Weekly excess deaths by date of registration, chronic lower respiratory diseases, England.‎

Figure 52: Weekly excess deaths by date of registration, chronic lower respiratory diseases, England.‎

Other respiratory diseases

Weekly excess deaths by date of registration, other respiratory diseases, England.‎

Figure 53: Weekly excess deaths by date of registration, other respiratory diseases, England.‎

Dementia and Alzheimer’s disease

Weekly excess deaths by date of registration, dementia and Alzheimer's, England.‎

Figure 54: Weekly excess deaths by date of registration, dementia and Alzheimer’s, England.‎

Diseases of the urinary system

Weekly excess deaths by date of registration, diseases of the urinary system, England.‎

Figure 55: Weekly excess deaths by date of registration, diseases of the urinary system, England.‎

Cirrhosis and other liver disease

Weekly excess deaths by date of registration, cirrhosis and other liver diseases, England.‎

Figure 56: Weekly excess deaths by date of registration, cirrhosis and other liver diseases, England.‎

Parkinson’s disease

Weekly excess deaths by date of registration, Parkinson's disease, England.‎

Figure 57: Weekly excess deaths by date of registration, Parkinson’s disease, England.‎

Other causes (excluding COVID-19)

Weekly excess deaths by date of registration, all other causes (excl. COVID-19), England.‎

Figure 58: Weekly excess deaths by date of registration, all other causes (excl. COVID-19), England.‎

The trend in excess deaths for selected underlying causes of death (UCOD) is shown in Figures 47 to 58 which allow the extent of the excess to be compared over time for each cause. For each cause, the number of excess deaths without COVID-19 mentioned on the certificate (shown in the white part of the column) may be due to an increase in deaths from this cause during the period of the pandemic, but may also reflect under-reporting of deaths involving COVID-19.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by underlying cause of death, England

Figure 59: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B) by underlying cause of death, England

Figure 59A shows the total cumulative excess deaths by UCOD since 21 March 2020. The chart can be used to compare the number of excess deaths for each UCOD.

This chart can be used to compare the cumulative total of excess deaths since 21 March 2020 between underlying causes.

Figure 59B shows the ratio of the observed to the expected deaths by UCOD since 21 March 2020. This chart can be used to compare relative excess mortality between underlying causes of death.

Table 7
Underlying cause of death Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
Ischaemic Heart Diseases 46,455 44,026 1.06 2,429 1,269 52.2%
Cerebrovascular Diseases 24,643 23,201 1.06 1,442 930 64.5%
Other Circulatory Diseases 39,725 37,998 1.05 1,727 1,149 66.5%
Cancer 122,586 125,249 0.98 −2,663 2,918 -
Acute Respiratory Infections 17,079 22,883 0.75 −5,804 11 -
Chronic Lower Respiratory Diseases 21,141 26,918 0.79 −5,777 352 -
Other Respiratory Diseases 6,898 9,308 0.74 −2,410 142 -
Dementia and Alzheimer's 57,715 58,514 0.99 −799 2,132 -
Diseases of the Urinary System 7,067 6,505 1.09 562 341 60.7%
Cirrhosis and Other Liver Diseases 8,131 7,337 1.11 794 345 43.4%
Parkinson's Disease 6,149 6,727 0.91 −578 243 -
All Other Causes (Excl. COVID-19) 81,493 79,471 1.03 2,022 1,865 92.2%

Deaths with a Mention of Specific Causes

Dementia and Alzheimer’s disease

Weekly excess deaths by date of registration, all mentions of dementia and Alzheimer's disease, England.‎

Figure 60: Weekly excess deaths by date of registration, all mentions of dementia and Alzheimer’s disease, England.‎

Acute respiratory infections (including flu/pneumonia)

Weekly excess deaths by date of registration, all mentions of acute respiratory infections, England.‎

Figure 61: Weekly excess deaths by date of registration, all mentions of acute respiratory infections, England.‎

Diabetes Mellitus

Weekly excess deaths by date of registration, all mentions of diabetes mellitus, England.‎

Figure 62: Weekly excess deaths by date of registration, all mentions of diabetes mellitus, England.‎

Figures 60 to 62 show weekly excess deaths where a specific cause was mentioned anywhere on the death certificate. These causes will have contributed to the death but not necessarily been the underlying cause.

Place of Death

Own home

Weekly excess deaths by date of registration, own home, England.‎

Figure 63: Weekly excess deaths by date of registration, own home, England.‎

Care home (nursing or residential)

Weekly excess deaths by date of registration, care home (nursing or residential), England.‎

Figure 64: Weekly excess deaths by date of registration, care home (nursing or residential), England.‎

Hospital (acute or community, not psychiatric)

Weekly excess deaths by date of registration, hospital (acute or community, not psychiatric), England.‎

Figure 65: Weekly excess deaths by date of registration, hospital (acute or community, not psychiatric), England.‎

Hospice

Weekly excess deaths by date of registration, hospice, England.‎

Figure 66: Weekly excess deaths by date of registration, hospice, England.‎

Other places

Weekly excess deaths by date of registration, other places, England.‎

Figure 67: Weekly excess deaths by date of registration, other places, England.‎

Figures 63 to 67 show the weekly total excess registered deaths by place of death since week ending 27 March 2020. These charts can be used to understand the trend in excess deaths by place of death. This analysis should be interpreted as excess deaths within each place of death compared to what would have been expected based on data over the past five years.

Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B), by place of death, England.

Figure 68: Cumulative excess deaths (A) and the ratio of registered deaths to expected deaths (B), by place of death, England.

Figure 68A shows the total cumulative excess deaths in each place of death since 21 March 2020. The chart can be used to compare the numbers of excess deaths in each place of death. This chart can be used to compare the cumulative total of excess deaths since 21 March 2020 between places of death.

Figure 68B shows the ratio of the observed to the expected deaths in each place of death since 21 March 2020. This chart can be used to compare relative excess mortality between places of death.

Table 8
Place of death Registered deaths Expected deaths Ratio registered / expected Excess deaths COVID-19 deaths COVID-19 deaths as % excess
Care Home (Nursing or Residential) 127,066 99,559 1.28 27,507 28,012 >100%*
Home 149,180 110,457 1.35 38,723 6,247 16.1%
Hospice 22,015 27,191 0.81 −5,176 1,745 -
Hospital (Acute or Community, not Psychiatric) 233,323 198,399 1.18 34,924 80,792 >100%*
Other Places 13,390 11,438 1.17 1,952 792 40.6%

* the total excess was less than the number of deaths with a mention of COVID-19, indicating fewer deaths from other causes than expected

Comparisons to other measures of excess deaths in England

The Office for National Statistics also publishes a weekly report on excess deaths in England & Wales. The numbers reported by ONS are broadly in line with the overall excess death figures in this report but there are some differences as the ‘expected’ numbers in this report are not just the simple five-year average for 2015 to 2019, as used by ONS. As explained in the Methods, they are instead modelled estimates which adjust for factors such as the ageing of the population and the underlying trend in mortality rates from year to year.

EuroMOMO is a European mortality monitoring programme that aims to measure excess deaths related to seasonal influenza and other public health threats that uses a standardised methodology across 24 European countries. The methodology used by EuroMOMO is similar to that used by the PHE model, however, the EuroMOMO model looks at deaths by date of occurrence, and the PHE model looks at deaths by date of registration. Because there is a time lag between date of occurrence of death and date of registration, analysis of excess deaths by date of occurrence requires a delay correction, the reliability of which improves over time. These two models produce very similar results but with small differences due to the delay correction applied by EuroMOMO.

The PHE Daily GRO mortality model is used in PHE’s COVID-19 surveillance report for all-cause mortality. It uses a 5-year average to estimate expected deaths, similar to that used by the ONS but with a trend included. It looks at deaths by date of occurrence based on rapidly reported deaths from the General Register Office and uses a registration delay correction, the reliability of which improves over time. Overall, the excess deaths are similar in the COVID-19 surveillance report and this report, but may show some differences in specific weeks due to use of occurrence date compared with registration date, and in recent weeks due to the delay corrections.

Updates to Excess Mortality Methodology, December 2020

Several changes to the models were introduced in the report for the week ending 18 December 2020 and subsequent reports:

The methodology document has been updated to reflect these changes.

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