More deaths than expected

The UK currently has the third highest number of recorded coronavirus deaths in the world. Only the United States and Brazil have had more, and both countries have far bigger populations.

But while the UK has been hit hard, how does it really rank alongside other countries?

Just comparing Covid-19 deaths doesn’t give the full picture as countries have different ways of recording deaths. Scientists and ministers say it’s better to look at total deaths, even the ones that aren’t caused by coronavirus.

So what can we learn about the UK’s toll if we look at it this way?

‘Coronavirus deaths’ can miss many of the victims

Peru has registered very few coronavirus deaths so far compared with the UK. But the total number of deaths tells a different story.

Both countries have seen a huge spike in deaths, with the weekly number peaking at more than double what would be expected had there not been a pandemic. That expected number of deaths is shown by the dashed line.

There is a similar pattern in Chile and Ecuador – a large rise in the total number of deaths that is missed if you look only at “Covid deaths”.

Total deaths give a clearer picture

Since the total number of deaths registered in a week normally follows a predictable pattern, scientists use the extra deaths seen during the pandemic to estimate mortalities caused by the pandemic.

This captures the misdiagnosed deaths, but it also includes the deaths caused by the strain the virus puts on a society.

“These deaths likely would not have happened if the pandemic had not happened and they should be counted in the death toll,” says Stéphane Helleringer, a demographer at Johns Hopkins University.

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Media captionBBC Reality Check explains what “excess deaths” reveal about Covid-19

Some countries have had a better first wave

While Peru’s death rates have not started to fall, in some countries they have reverted to normal or near-normal levels. This allows us to start to assess who has been worst hit in the first wave of the epidemic.

Countries such as Denmark, Norway or Germany have had a very different first wave of the epidemic to the UK.

The pattern of deaths in those countries doesn’t have the same spike as in the UK. Comparisons based on total death figures are “not definitive”, says Dr Veena Raleigh, of the King’s Fund health think tank. “But the caveats are unlikely to alter radically the relative standing of countries like the UK compared to those who have seen far fewer deaths.”

But what causes the differences?

Norway and Denmark are smaller countries. And population density, or how crowded and global a country’s cities are, will affect the spread of a virus. Also, the age and health of those infected will make a difference to how many people die.

But the actions taken make a difference too.

“The speed and strength of each country’s response to control initial spreading events and develop the testing capacity needed for operational surveillance seem to have played an important role,” says Royal Statistical Society president-elect Sylvia Richardson.

But, she adds: “It will not be easy to disentangle the effect of a specific measure.”

The UK is in an unhappy club

The UK is not alone in being hit hard. Italy, Spain and Belgium have also seen at least a third more deaths than they would have expected.

And that means many tens of thousands of deaths for each of the UK, Italy and Spain.

Who is the worst?

It is easy to change the rankings of these countries by using slightly different methods.

In the first four weeks, for example:

  • Italy has the most deaths above normal
  • Spain has the highest percentage of deaths above normal
  • the UK has the highest number of deaths per million people

But by any measure, the UK consistently appears in this unhappy club of countries hardest hit so far. Even before the pandemic, the UK’s life expectancy was lower than in many other western European countries and showed the least improvement from 2011 to 2018.

And the UK “risks a further slide down life-expectancy tables”, according to Dr Raleigh, underlining the need to make comparisons with other countries, even with imperfect data.

“You work with what you’ve got, provided you know the cautions that come with it,” she says.

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