CLAIMS:

Covid-19 was downgraded from high-consequence infectious disease (HCID) status by the UK government on 19th March, 2020. Death rates are no higher this year than in a bad flu season. Covid-19 is being put on death certificates fraudulently, without a test having been carried out and when the patient died of something else.

CONCLUSION: A mixture of ACCURATE WITH CONSIDERATION, UNSUBSTANTIATED, and INACCURATE claims that use non-specific phrases, missing context, and words that provoke an emotional reaction to the claims rather than a rational, evidence-based one.

A leaflet, entitled “COVID-19: An Evidence Based Analysis”, has been reported being distributed to households in parts of the Lagan Valley constituency. It makes three central claims.

Claim 1: COVID-19 was downgraded from high consequence infectious disease (HCID) status by the UK government on 19th March, 2020.

ACCURATE WITH CONSIDERATION. COVID-19 was first classified as an HCID in the UK on 16 January 2020, when it was referred to as the “Wuhan novel coronavirus WN-CoV”. It was then downgraded from high consequence infectious disease (HCID) status by the UK government on 19 March 2020, once it was deemed to be better understood, with greater clinical awareness and the availability of testing.

However, important context is missing from this simple-sounding statement. In the UK, a high consequence infectious disease (HCID) is defined according to the following criteria:

acute infectious disease; typically has a high case-fatality rate; may not have effective prophylaxis or treatment; often difficult to recognise and detect rapidly; ability to spread in the community and within healthcare settings; and requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely.



The UK government explained:

“Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.”

The government also stated that cases of COVID-19 were no longer only managed by high consequence infectious disease (HCID) treatment centres.

Claim 2: Death rates are no higher this year than in a bad ‘flu season.

UNSUBSTANTIATED. The imprecision of the claim makes it difficult to prove or disprove.

The term “death rate” usually means the percentage of deaths in a particular period from a specific cause. (It is sometimes used to express the proportion of people who die from, rather than survive, a particular medical condition, or the proportion of the whole population who die.)



FactCheckNI has also written about another related term, “excess deaths”, which are defined as deaths during a given period that are greater than the usual number of deaths in similar historic time periods. Variations in the excess death rate above or below the predicted average may indicate an event, for example a strain of influenza, which resulted in more deaths than usual.

It is unclear precisely what “death rates” mean in the context of this claim.

The latest set of Registrar General Quarterly Tables were published on 17 September 2020 and show “Novel Covonavirus (COVID-19)” was attributed as the underlying cause of 732 deaths during the second quarter (or Q2, covering the period of 1 April–30 June), and 755 deaths in the first half of 2020. This means that COVID-19 was the underlying, primary cause of death in 91.0 percent of all deaths that have COVID-19 mentioned at all on the death certificate.

What defines “a bad ‘flu season”? The Public Health Agency defines a flu season as from week 40 of a given year to week 20 of the following year. Its flu season bulletins focus on respiratory associated infections and provisional data at a point in time. We used more complete, coded data from the Registrar General bulletins, which cover all deaths during given time periods and reflect how COVID-19 has affected excess deaths (explained below).

The overall number of deaths registered in Q2 2020 (4,684) is the highest of any second quarter figures in the last decade. Indeed, it is the second highest figure for any quarter of the year in the last decade, exceeded only by Q1 2018, a winter quarter with 5,045 deaths during what was reported as a severe winter flu across the UK.

Death rates in Q2 2020 were 43% higher than the average of second quarter deaths (3,275) registered between 2009–2019, and 30% higher than the average of deaths during all quarters during 2009–2019. These are clearly exceptional numbers of deaths for springtime.

Looking at excess deaths, a Northern Ireland Statistics and Research Agency (NISRA) bulletin published on 28 July charted the cumulative number of excess deaths and COVID-19 related deaths in Northern Ireland between 1 March and 30 June 2020. This included data from the deaths registered up to 15 July 2020, to reduce the effect of time lags between occurrence and registration of death. Over this four month period, there were:

885 excess deaths (compared with previous five year average) 837 deaths with COVID-19 mentioned on the death certificate.



The following chart shows cumulative excess deaths in Northern Ireland from 2010 to 2020. For 2020, up to week 35, the figure of excess deaths is the highest since 2010.

Source: NISRA: Historical Weekly Deaths, 2009-2019; Cumulative Weekly Deaths, 2020 (Includes COVID-19 deaths).

Claim 3: COVID-19 is being put on death certificates fraudulently, without a test having been carried out and when the patient died of something else.

INACCURATE. It is true that not every patient who is suspected of dying from COVID-19 has been positively tested. A test is not required in order for COVID-19 to be determined as a cause of death. A doctor who has not seen the patient can sign the certificate relying on their knowledge and belief of the cause of death, including cases where the person showed symptoms of COVID-19. The legal provision for this is the Coronavirus Act 2020, which changed death certification in Northern Ireland and enables death certificates to be signed in cases where a patient has died of a natural illness and the doctor who cared for the patient during their last illness is not available.

FactCheckNI previously published an article which explained how the two main sets of figures relating to COVID-19 deaths are counted and presented:

Daily reports (from the Public Health Agency ) on the deaths of people who had previously tested positive for the virus within the last 28 days (mostly dying in hospital, though may include some people discharged to care homes or into the community); and Weekly reports (from the Northern Ireland Statistics and Research Agency ) based on the date and registration of death where COVID-19 is mentioned on death certificates no matter where the person died, whether or not it was the primary underlying cause of death.

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