Deaths registered weekly in England and Wales, provisional: week ending 20 November 2020

• The number of deaths registered in England and Wales in the week ending 20 November 2020 (Week 47) was 12,535; this was 281 more deaths than in Week 46.

• In Week 47, the number of deaths registered was 20.8% above the five-year average (2,155 deaths higher).

• Of the deaths registered in Week 47, 2,697 mentioned "novel coronavirus (COVID-19)", accounting for 21.5% of all deaths in England and Wales; an increase of 231 deaths compared with Week 46.

• Of the 2,697 deaths involving COVID-19, 2,361 had this recorded as the underlying cause of death (87.5%).

• Of the 2,605 deaths that involved Influenza and Pneumonia, 280 had this recorded as the underlying cause of death (10.7%).

• The number of deaths in hospitals, care homes and private homes was above the five-year average but deaths in other locations were below the five-year average in Week 47.

• In England, the total number of deaths increased from 11,495 (Week 46) to 11,675 (Week 47); all English regions had a higher number of deaths than the five-year average for the second week in a row.

• In Week 47, there were 2,471 deaths involving COVID-19 in England while the number of deaths involving COVID-19 increased in all English regions except the East of England.

• In Wales, the number of deaths involving COVID-19 increased from 190 deaths (Week 46) to 223 deaths (Week 47), while the total number of deaths in Week 47 was 195 deaths higher than the five-year average.

• We estimate that the number of deaths actually occurring (rather than registered) in Week 47 in England and Wales was between 11,343 and 14,052.

• The number of deaths registered in the UK in the week ending 20 November 2020 was 14,276, which was 2,473 deaths higher than the five-year average; of the deaths registered in the UK in Week 47, 3,038 deaths involved COVID-19, 199 deaths higher than in Week 46.

Figure 1: The number of deaths was above the five-year average in Week 47

Number of deaths registered by week, England and Wales, 28 December 2019 to 20 November 2020

Notes:

1. Figures exclude deaths of non-residents.

2. Based on date a death was registered rather than occurred.

3. All figures for 2020 are provisional.

4. The number of deaths registered in Weeks 19, 20, 22, 23, 36 and 37 were affected by the Early May, Late May and August Bank Holidays (Friday 8 May 2020 in Week 19, Monday 25 May 2020 in Week 22 and Monday 31 August 2020); the impact of the Early May Bank Holiday was analysed in our Week 20 bulletin.

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The provisional number of deaths registered in England and Wales increased from 12,254 in Week 46 (week ending 13 November 2020) to 12,535 in Week 47 (week ending 20 November 2020). The number of deaths was 20.8% above the five-year average (2,155 deaths higher).

In England, the number of deaths increased from 11,495 in Week 46 to 11,675 in Week 47, which was 1,974 deaths (20.3%) higher than the Week 47 five-year average (Figure 1).

In Wales, the number of deaths increased from 742 in Week 46 to 848 in Week 47, which was 195 deaths (29.9%) higher than the Week 47 five-year average (Figure 1).

Figure 2: The number of deaths involving COVID-19 continued to increase

Deaths involving and due to the coronavirus (COVID-19) and Influenza and Pneumonia, England and Wales, deaths registered in 2020

Notes:

1. Figures include deaths of non-residents.

2. Based on date a death was registered rather than occurred.

3. All figures for 2020 are provisional.

4. The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U07.1 and U07.2) and Influenza and Pneumonia (J09-J18).

5. A death can be registered with both COVID-19 and Influenza and Pneumonia mentioned on the death certificate. Deaths where both were mentioned have been counted in both categories.

6. We use the term “due to COVID-19” or “due to Influenza and Pneumonia” when referring only to deaths where that illness was recorded as the underlying cause of death. We use the term “involving COVID-19” or “involving Influenza and Pneumonia” when referring to deaths that had that illness mentioned anywhere on the death certificate, whether as an underlying cause or not.

7. The number of deaths registered in Weeks 19, 20, 22, 23, 36 and 37 were affected by the Early May, Late May and August Bank Holidays (Friday 8 May 2020 in Week 19, Monday 25 May 2020 in Week 22 and Monday 31 August 2020); the impact of the Early May Bank Holiday was analysed in our Week 20 bulletin.

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The number of death registrations in England and Wales involving the coronavirus (COVID-19) increased, from 2,466 in Week 46 to 2,697 in Week 47 – a 9.4% increase. Of all deaths registered in Week 47, 21.5% mentioned COVID-19. This was the highest percentage since Week 20 (week ending 15 May 2020).

In England, the number of deaths involving COVID-19 was 2,471, 21.2% of all deaths. In Wales, 223 deaths involved COVID-19, 26.3% of all deaths.

Of the 2,697 deaths that involved COVID-19, 2,361 had this recorded as the underlying cause of death (87.5%, Figure 2). Of the 2,605 deaths that involved Influenza and Pneumonia, 280 had this coded as the underlying cause of death (10.7%).

Deaths that involved both COVID-19 and Influenza and Pneumonia have been included in both categories for consistency when comparing with the underlying cause of death. Influenza and Pneumonia has been included for comparison, as a well-understood cause of death involving respiratory infection that is likely to have somewhat similar risk factors to COVID-19. More detailed analysis is available in our Deaths due to coronavirus (COVID-19) compared with deaths from influenza and pneumonia release.

We have developed an experimental statistical model to estimate the number of deaths that actually occurred in a given week, rather than the number registered. For Week 46, we estimate that 12,446 deaths occurred in England and Wales, with a 95% confidence interval of 12,102 to 12,871. Based on an incomplete count of registrations in Week 47, we estimate that the number of deaths occurring in Week 47 is likely to be 12,566 with a 95% confidence interval of 11,343 to 14,052.

These are provisional estimates that assume the pattern of occurrences can be predicted based on experience in previous years. The estimate for the most recent week always has a wider margin of error than for earlier weeks, so it should be treated with caution.

Figure 3: Deaths not involving COVID-19 remained below the five-year average in Week 47

Number of deaths registered by week, England and Wales, 28 December 2019 to 20 November 2020

Notes:

1. Figures include deaths of non-residents.

2. Based on date a death was registered rather than occurred.

3. All figures for 2020 are provisional.

4. The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U07.1 and U07.2).

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Between Weeks 1 and 12, 138,916 deaths were registered, which was 4,822 fewer than the five-year average for these weeks. However, between Weeks 13 and 47, 403,547 deaths were registered, which was 67,460 more than the five-year average.

Using the most up-to-date data we have available, the number of deaths up to 20 November 2020 was 542,440, which is 62,615 more than the five-year average. Of the deaths registered by 20 November 2020, 63,852 mentioned COVID-19 on the death certificate. This is 11.8% of all deaths in England and Wales.

In England, the number of deaths up to 20 November 2020 was 508,780, which is 60,415 (13.5%) more than the five-year average. Of these, 60,308 (11.9%) mentioned COVID-19. In Wales, the number of deaths up to 20 November 2020 was 32,909, which is 2,832 (9.4%) more than the five-year average; of these, 3,464 deaths (10.5%) mentioned COVID-19.

In Week 47, the number of deaths involving the coronavirus (COVID-19) in England and Wales increased or remained similar across all age groups compared with Week 46. The biggest increase was seen in those aged 90 years and over (79 more deaths). Three-quarters of deaths involving COVID-19 were in people aged 75 years and over.

Across Weeks 1 to 47 of 2020, 55.4% of all deaths involving COVID-19 were in males. There were more deaths in females aged 85 years and over (14,301) than males aged 85 years and over (12,288). However, these numbers do not account for the population structure where there are more women aged over 85 years than men.

Looking at excess deaths by age group, the number of deaths up to 20 November 2020 was above the five-year average for all age groups above 14 years. While the number of deaths for age groups under 15 years was below the five-year average (Figure 4).

Figure 5: The number of deaths in Week 47 was higher than the five-year average in all English regions and Wales

Number of deaths in Wales and regions in England, registered between 28 December 2019 and 20 November 2020

Notes:

1. Based on area of usual residence. Geographical boundaries are based on the most up-to-date information available at the time of publication.

2. Figures exclude deaths of non-residents.

3. Based on date a death was registered rather than occurred.

4. All figures for 2020 are provisional.

5. The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U07.1 and U07.2).

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In Week 47 (week ending 20 November 2020), there were 223 deaths involving the coronavirus (COVID-19) registered in Wales – a 17.4% increase. Across the English regions, the North West continued to have the largest number of deaths involving COVID-19 (629 deaths). The highest proportion of deaths involving COVID-19 was seen in Yorkshire and The Humber.

Deaths involving COVID-19 increased in Week 47 in eight out of nine English regions and Wales, with the largest increase seen in the East Midlands. More detailed geographic analysis between 1 March and 31 July 2020 can be found in our Deaths involving COVID-19 by local area and socioeconomic deprivation release.

The year-to-date analysis shows that, of deaths involving the coronavirus (COVID-19) up to Week 47 (week ending 20 November 2020), 65.9% (42,110 deaths) occurred in hospital, with the remainder occurring in care homes (17,319 deaths), private homes (3,072 deaths), hospices (870 deaths), other communal establishments (251 deaths) and elsewhere (230 deaths).

Between Weeks 46 and 47, the number of deaths involving COVID-19 increased in hospitals (146 deaths higher), care homes (42 deaths higher) and private homes (27 deaths higher). Deaths involving COVID-19 in hospitals as a proportion of all deaths in hospitals increased to 35.5% in Week 47 – the highest since Week 19 (week ending 8 May 2020). Deaths involving COVID-19 in care homes as a proportion of all deaths in care homes increased to 18.9% in Week 47, the highest since Week 23 (week ending 5 June 2020).

Detailed analysis on deaths of care home residents is available in Deaths involving COVID-19 in the care sector, England and Wales: deaths occurring up to 12 June 2020 and registered up to 20 June 2020.

As well as Office for National Statistics (ONS) data, the Care Quality Commission (CQC) provides numbers of deaths involving COVID-19 in care homes in England that are based on the date the death was notified to the CQC. From 10 April (the first day when data were collected using the CQC's new method of identifying deaths involving COVID-19) to 27 November 2020, there were 16,575 deaths of residents in care homes involving COVID-19. Of these deaths, 465 were notified in the week up to 27 November. More information on the data provided by the CQC can be found in our joint transparency statement.

In Wales, the Welsh Government publishes the number of deaths of care home residents involving COVID-19 notified to the Care Inspectorate Wales (CIW). Between 1 March and 20 November 2020, there were 934 deaths of residents in care homes involving COVID-19.

More information on how these numbers have compared throughout the pandemic can be found in our previous Comparison of weekly death occurrences in England and Wales release.

Figure 6: Excess deaths in hospitals, care homes and private homes continued to rise

Number of excess deaths by place of occurrence, England and Wales, registered between 7 March 2020 and 20 November 2020

Notes:

1. Based on area of usual residence. Geographical boundaries and communal establishments are based on the most up-to-date information available.

2. Figures include deaths of non-residents.

3. Based on date a death was registered rather than occurred.

4. All figures for 2020 are provisional.

5. The International Classification of Diseases, Tenth Edition (ICD-10) definitions are as follows: coronavirus (COVID-19) (U07.1 and U07.2).

6. "Other" includes deaths in communal establishments other than hospitals and care homes, in hospices, and that occurred "elsewhere". More information on the place of death definitions used is available in the accompanying dataset.

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In Week 47, the numbers of deaths in private homes, hospitals and care homes were above the five-year average (1,001, 993 and 180 deaths respectively), while the number of deaths in other locations was below the five-year average (18 deaths lower) (Figure 6).

Looking in more detail at deaths in private homes in Week 47, males accounted for 552 excess deaths, compared with 449 for females. Overall, 76.2% of the excess deaths in private homes were of those aged 70 years and over (763 excess deaths); this has decreased from 80.1% (786 excess deaths) in Week 46. The Deaths in private homes release provides analysis for deaths registered from 28 December 2019 to 11 September 2020. In addition, more detailed analysis of excess deaths in England is produced by Public Health England (PHE) on a weekly basis.

Figure 7 is based on date of death for deaths registered up to 28 November 2020, rather than date of registration. As more deaths are registered, deaths per day are likely to increase, especially for later dates. Looking at the number of deaths that occurred in Week 47, 76.6% of deaths occurred in hospitals, and care homes accounted for 17.4% of all deaths involving COVID-19; this may change as more deaths are registered.

A death of a man aged 80 to 84 years was registered in the week ending 4 September 2020 (Week 36) that occurred in the week ending 31 January 2020 (Week 5). This is the earliest known death involving COVID-19 in the UK. There was also a death of a man aged 55 to 59 years registered in the week ending 21 August 2020 (Week 34) that occurred in the week ending 7 February (Week 6), and a death of a female aged 30 to 34 years that was registered by 24 October 2020 and occurred in the week ending 28 February 2020 (Week 9).

Across the UK, there were 14,276 deaths (all causes) registered in Week 47 (week ending 20 November 2020), which was 2,473 deaths higher than the UK five-year average and 295 more deaths than in Week 46. Of these deaths, 3,038 involved the coronavirus (COVID-19), 199 deaths higher than in Week 46 (a 7.0% increase).

In Week 47, England had the highest number of deaths involving COVID-19 with 2,471 deaths, followed by Scotland with 244 deaths, Wales with 223 deaths and Northern Ireland with 100 deaths.

We previously published this section as a separate article on the Office for National Statistics (ONS) website, which provided a more thorough description of the differences between different data sources. This section will look at the number of deaths by date of death produced by the ONS compared with death notifications reported by the Department of Health and Social Care (DHSC). For Wales, we can also compare the reconciled DHSC data by date of death released by Public Health Wales (PHW).

On 12 August 2020, Public Health England (PHE) revised their data series to include two measures: deaths of positively tested individuals where the death occurred within 28 days and deaths within 60 days of a positive test. More information on these changes can be found in their technical summary.

In England, including deaths that occurred up to 20 November 2020 but were registered up to 28 November 2020, of those we have processed so far, the number involving the coronavirus (COVID-19) was 61,389.

The comparative number of death notifications reported by the DHSC on GOV.UK (based on data from PHE) where the deaths occurred within 28 days of testing was 47,842 and the number of deaths by date of death showed 49,001.

In Wales, including deaths that occurred up to 20 November 2020 but were registered up 28 November 2020, of those we have processed so far, the number involving COVID-19 was 3,536. The comparative number of death notifications reported by the DHSC on GOV.UK (based on data from PHW) where the death occurred within 28 days of testing was 2,365 and the number of deaths by date of death was 2,432 deaths.

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Coronavirus (COVID-19) deaths

Coronavirus (COVID-19) deaths are those deaths registered in England and Wales in the stated week where COVID-19 was mentioned on the death certificate. A doctor can certify the involvement of COVID-19 based on symptoms and clinical findings – a positive test result is not required. Definitions of COVID-19 for deaths in Scotland and Northern Ireland are similar to England and Wales.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the Mortality statistics in England and Wales QMI.

To meet user needs, we publish very timely but provisional counts of death registrations in England and Wales in our Deaths registered weekly in England and Wales, provisional dataset. These are presented by sex, age group and regions (within England) as well as for Wales as a whole. To allow time for registration and processing, these figures are published 11 days after the week ends. Because of the rapidly changing situation, in this bulletin we have also given provisional updated totals based on the latest available death registrations, up to 21 November 2020.

Because of the coronavirus (COVID-19) pandemic, our regular weekly deaths release now provides a separate breakdown of the number of deaths involving COVID-19: that is, where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions. If a death certificate mentions COVID-19, it will not always be the main cause of death but may be a contributory factor. This bulletin summarises the latest weekly information and will be updated each week during the pandemic.

From the bulletin dated 3 November, we have added two additional analyses.

Previously, we gave a breakdown of deaths involving COVID-19 into those where COVID-19 was the underlying cause of death ("due to COVID-19") and those where it was a contributory factor ("involving COVID-19") in the monthly mortality analysis; because of high public interest, this distinction is now shown in Figure 2 of the weekly bulletin.

This bulletin is based mainly on the date deaths are registered, not the date of death, because of the time taken for a death to be registered. Deaths in England and Wales are normally registered within five days, but there can be a considerably longer delay in some circumstances, particularly when the death is referred to a coroner. We have developed a statistical model to estimate the number of deaths likely to have occurred in each week, based on previous experience of the pattern of registration delays, including the effects of bank holidays. The method is described in the article Predicting total weekly death occurrences in England and Wales: methodology and the results are shown in the tab, "Estimated total deaths 2020", of the accompanying dataset.

These figures are different from the daily surveillance figures on COVID-19 deaths published by the Department of Health and Social Care (DHSC) on the GOV.UK website, for the UK as a whole and its constituent countries. Figures in this report are derived from the formal process of death registration and may include cases where the doctor completing the death certificate diagnosed possible cases of COVID-19, for example, where this was based on relevant symptoms but no test for the virus was conducted.

From 29 April 2020, the DHSC started to publish as their daily announced figures on deaths from COVID-19 for the UK a new series that uses improved data for England produced by Public Health England (PHE). These figures provide a count of all deaths where a positive test for COVID-19 has been confirmed, wherever that death has taken place, a change from previously reporting only confirmed COVID-19 deaths in hospitals. Figures for Scotland, Wales and Northern Ireland had already begun to include deaths outside hospitals, so this change ensured that the UK-wide series had a shared and common definitional coverage. A statement was published by the Office for National Statistics (ONS), which provides more detail of the changes.

On 12 August 2020, the PHE data series was revised to include two measures: deaths of positively tested individuals where the death occurred within 28 days and deaths within 60 days of a positive test. More information on these changes can be found in their technical summary (PDF, 854KB).

In contrast to the GOV.UK figures, we include only deaths registered in England and Wales, which is the legal remit of the ONS. Tables 2 and 3 provide an overview of the differences in definitions between sources.

We will publish accompanying articles periodically, giving enhanced information such as age-standardised and age-specific mortality rates for recent time periods and breakdowns of deaths involving COVID-19 by associated pre-existing health conditions.

There is usually a delay of at least five days between occurrence and registration. More information on this issue can be found in our impact of registration delays release.

Our User guide to mortality statistics provides further information on data quality, legislation and procedures relating to mortality and includes a glossary of terms.

Figures are based on the date the death was registered, not when it occurred. There is usually a delay of at least five days between occurrence and registration. More information on this issue can be found in our impact of registration delays release.