An additional 40 previously unreported coronavirus deaths occurred in England and Wales earlier this month, according to new official backdated figures that suggest almost one in five coronavirus deaths are occurring outside hospitals.

The Office for National Statistics (ONS) figures, which are based on death certificates, show there were 210 deaths where Covid-19 was listed as a cause by 20 March, 40 more than the 170 announced by the NHS at that stage.

The figure is higher because it includes deaths outside hospitals, including those in homes and care homes, and includes patients who have not tested positive for the virus but are suspected of having the disease. It suggests that there were almost 24% more coronavirus deaths than had previously been reported in government figures.

David Leon, professor of epidemiology at the London School of Hygiene and Tropical Medicine, said the figures help provide a more accurate record of the true extent of the impact of the virus. He said: “What ONS has done is important as it starts to provide a more complete picture of the impact of Covid-19 on mortality. The value of these data will increase with time.”

Quick guide What are coronavirus symptoms and should I go to a doctor? Show Hide What is Covid-19? Covid-19 is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. The World Health Organization (WHO) has declared it a pandemic. What are the symptoms this coronavirus causes? According to the WHO, the most common symptoms of Covid-19 are fever, tiredness and a dry cough. Some patients may also have a runny nose, sore throat, nasal congestion and aches and pains or diarrhoea. Some people report losing their sense of taste and/or smell. About 80% of people who get Covid-19 experience a mild case – about as serious as a regular cold – and recover without needing any special treatment. About one in six people, the WHO says, become seriously ill. The elderly and people with underlying medical problems like high blood pressure, heart problems or diabetes, or chronic respiratory conditions, are at a greater risk of serious illness from Covid-19. In the UK, the National health Service (NHS) has identified the specific symptoms to look for as experiencing either: a high temperature - you feel hot to touch on your chest or back

a new continuous cough - this means you’ve started coughing repeatedly As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work, and there is currently no vaccine. Recovery depends on the strength of the immune system. Should I go to the doctor if I have a cough? Medical advice varies around the world - with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities. In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

The ONS also found that Covid-19 deaths accounted for 1% of the UK’s total deaths in the week ending 20 March.

The figures are the first set of backdated Covid-19 deaths, which the ONS will now announce every Tuesday morning.

A spokeswoman for the ONS said the figures were based on registered deaths. She said: “It is based on mentions of Covid-19 on death certificates. It includes suspected cases of Covid-19 where someone has not been tested positive for Covid-19.”

Until now the only death rate figures available in the UK have been the daily count from hospitals of patients who have tested positive.

The ONS spokeswoman said: “If the coroner or doctor has written there was suspected coronavirus or coronavirus on a death certificate, that will be counted in this bulletin.”

Explaining the different methodologies used by the ONS and NHS in counting coronavirus deaths, the spokeswoman said: “Both sets of data have got their different merits, which we will outline in the bulletin. There are different reasons as to why both sets of data are being collected. The data from the NHS are the quickest, whereas with our data, we have to wait for the deaths to be registered.”

She added: “Future analysis will look at where Covid-19 is an underlying cause of death or a contributory factor.”

Sir Patrick Vallance, the UK’s chief scientist, conceded that both sets of data would need to be reconciled.

Speaking at the daily Downing Street briefing on Monday, he said: “The ONS data will pick up also those people who didn’t die in hospital, but may have died from coronavirus in the community. So that will lead to some extra numbers. Don’t expect those to be large, and it is important going forward that we have this reconciliation between all of the numbers.”

Sarah Caul, head of mortality analysis at the ONS, said the new data was slower to put together than daily figures released by the NHS, but more accurate.



In an ONS blogpost on the new figures, she said: “Numbers produced by ONS are much slower to prepare, because they have to be certified by a doctor, registered and processed. But once ready, they are the most accurate and complete information.

She added: “We include all deaths where Covid-19 was mentioned on the death certificate, even if only suspected; the government figures are only those deaths where the patient had a positive test result.

“We include deaths that happened anywhere in England and Wales, for example some might be in care homes: the government figures are only those that happened in hospital.”

Tuesday’s release by the ONS also provides the first detail about the age, gender and place of residence of some of the first people to have died with coronavirus in England and Wales, detailing 108 deaths registered before 20 March.

To date 64 were male, 59% of the total. This is in keeping with indications from China, France, Germany, Iran, Italy, South Korea and Spain that men are more likely to die from the disease.

The older age categories are hardest hit: 42% of deaths occurred among those aged 85 and over, while almost a third (31%) were between 75- and 84-years-old. Almost one in five were aged between 65 and 74.

The majority of deaths occurred in London and the south-east, at 41% and 18% respectively. A further 15% of deaths were among those living in the West Midlands, while 12% were from the north-west.

Because the ONS figures are based on registrations, some of these deaths have already been covered by the Department of Health and Social Care’s daily figures which, to date, have listed all deaths involving coronavirus that have occurred in hospitals in the UK.

But because of the nature of how deaths are registered, (it takes at least five days for most deaths to be certified by a doctor, registered and the data processed) it is likely that more deaths have occurred which have not yet been counted by the ONS.

Separately, there have been some significant delays in counting hospital deaths appearing in the NHS England figures. One death reported on Monday actually occurred on 13 March in Mid Essex hospital services NHS trust, a 17-day lag. Another, first reported on Saturday, actually occurred in Sandwell and West Birmingham hospitals NHS trust on 13 March.

At least 33 deaths reported by NHS England between Thursday and Sunday actually occurred more than a week earlier.

“There are various reasons why a hospital trust might delay reporting a death, including contact tracing, the internal validation processes and staff absences. For sheer capacity reasons, it’s occasionally necessary for some trusts to report over a longer time period,” an NHS spokesperson said.

• This article was amended on 1 April 2020. An earlier version said the ONS figures suggested nearly one in four coronavirus deaths were occurring outside hospitals; that should have said one in five deaths. The new data also suggests there were almost 24% more coronavirus deaths than previously reported in government figures, not that “24% of coronavirus deaths had gone unreported” as the earlier version expressed it.

