Figures that include non-hospital deaths are still thought to undercount the true scale of the pandemic, say experts.

Reaching a milestone that will be celebrated by no one, the United Kingdom now has Europe‘s second-highest official coronavirus death toll, raising questions about Prime Minister Boris Johnson’s response to the outbreak.

Some 26,097 people in the UK have died after testing positive for COVID-19 as of April 28 at 16:00 GMT, Public Health England (PHE) said on Wednesday, for the first time citing daily figures that included deaths outside of hospital settings.

The figure included an extra 3,811 deaths added to the most recent total announced – mostly incorporating deaths in care homes between March 2 and April 28 – on Tuesday.

Foreign Secretary Dominic Raab, who in recent weeks had been standing in for Johnson during the prime minister’s absence due to his own battle with the virus, said there were 756 more deaths in all settings reported on Tuesday compared with the day before.

That means the UK has suffered more COVID-19 deaths than either France or Spain have officially reported, though fewer than Italy, which has Europe’s highest death toll and the second-worst in the world after the United States.

“We must never lose sight of the fact that behind every statistic there are many human lives that have tragically been lost before their time,” Raab told reporters. “We are still coming through the peak and… this is a delicate and dangerous moment in the crisis.”

The UK government has been fiercely criticised over its handling of the crisis, not least over the provision of personal protective equipment to medical personnel.

“We also pay tribute, of course, to those caring for the sick, and yesterday at 11am the whole country observed a minute’s silence, a moment to reflect on the sacrifice of all of our front-line workers who have died whilst dedicating themselves to caring for others and serving others,” Raab said.

Such a high UK death toll increases the pressure on Johnson, who celebrated the birth of a baby son on Wednesday. It is the first child for the prime minister’s partner, Carrie Symonds.

Opposition Labour Party leader Keir Starmer criticised Johnson’s response to the world’s worst public health crisis since the 1918 influenza outbreak after Johnson had spoken of Britain’s “apparent success” in tackling coronavirus in a speech to the nation as he returned to work on Monday.

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“We are possibly on track to have one of the worst death rates in Europe,” Starmer told Parliament. “Far from success, these latest figures are truly dreadful,” he added, referring to previously published data.

In mid-March, the government’s chief scientific adviser said keeping Britain’s death toll below 20,000 would be a “good outcome”. Having already exceeded that, and a daily death toll in the high hundreds, Yvonne Doyle, Public Health England’s director of health protection, said the trend had become “quite flat”.

“It may begin to decline, but we are not convinced of that yet,” she said.

UK and Italy

Johnson initially resisted introducing the lockdown, but changed course when projections showed a quarter of a million people could die.

Doyle said the new figures put the UK roughly in line with its peers in Europe, when adjusted for population.

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Although international comparisons are difficult, the updated figures confirm Britain’s place among the European countries worst hit by the viral pandemic.

Italy said on Wednesday that its death toll had risen to 27,682. Like those in the UK, its figures are based on deaths following positive coronavirus tests in all settings.

Spain reported 24,275 deaths at the last count, less than Britain’s new toll published on Wednesday. Spain’s population is around 20 million smaller, so it has a higher prevalence of deaths per capita.

Still, early evidence for “excess deaths” – the number of deaths from all causes that exceed the average for the time of year – suggest Britain has fared poorly in comparison to other countries.

Although it takes a long time to form a full picture, academics prefer this measure to gauge the impact of an epidemic and the measures taken by countries to control it, since it is easier to compare across countries.

Official data published this week offered a flavour of the true human cost of the pandemic in Britain: 22,351 people died from all causes in England and Wales in the week to April 17, the biggest total since comparable records began in 1993.

While this was 11,854 more than average for the week, only 8,758 cases mentioned COVID-19 in death certificates, suggesting even this more comprehensive data may be undercounting the true toll.