Calls for inquiry as UK reports highest Covid-19 death toll in Europe

Britain has the worst coronavirus death toll in Europe, official figures showed on Tuesday, prompting calls for an inquiry into the handling of the pandemic.

The government’s tally of fatalities across the UK reached 29,427 for those who tested positive for coronavirus, exceeding the 29,029 recorded in Italy – until now Europe’s worst-hit country. Italy’s total does not include suspected cases.

Newly released data from the Office for National Statistics showed that 29,648 deaths were registered in England and Wales with Covid-19 mentioned on the death certificate by 2 May. With the addition of the official death figures for Scotland and Northern Ireland, this was calculated to take the UK’s toll to 32,313.

The true figure is likely to be significantly higher due to missed cases and a lag in reporting.

While experts such as Prof David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at Cambridge University and a member of the government’s Scientific Advisory Group for Emergencies (Sage), have warned of the risks of comparing countries’ death tolls, he said on Tuesday: “We are not doing very well and it’s been another very bad week. I really don’t like this league table of who’s top and who’s not, but there’s no denying that these are really serious numbers.”

Dr Claudia Paoloni, president of the Hospital Consultants and Specialists Association trade union, said Britain having the highest number of deaths in Europe showed that ministers had “searching questions” to answer about their “inadequate” handling of the crisis, and called for a public inquiry.

“This is a very sobering and unwelcome milestone. It’s of extreme concern that the UK now has the largest number of Covid deaths in Europe,” she said. “There will have to be a full investigation of the [government’s] handling of the Covid response in due course – a public inquiry – to understand why we are experiencing such large numbers in comparison to the rest of Europe.

“It puts into question whether the government’s tactics at the start of the pandemic were sufficiently fast, and especially whether the lockdown should have happened earlier and whether we should have been better prepared with increased capacity for viral testing and contact tracing from the start. Both have proven inadequate.”

Dr Chaand Nagpaul, British Medical Association council chair, said the figures were extremely concerning “given that the UK was originally affected by the outbreak later than many other nations, and with the government initially saying that a death toll of 20,000 would be a ‘good outcome’.”

“It’s too early to come to firm conclusions and we need to ensure that figures between nations are comparing like for like,” he said. “However, there will in the future need to be serious scrutiny of the UK’s response and questions asked about what measures were put in when, from imposition of lockdown to our approach to testing, and whether this may have contributed to the loss of more lives.”

The shadow health secretary, Jonathan Ashworth, said: “Today’s confirmation we have the highest official death rate in Europe is a tragic reminder of the severity of this horrific disease. The public will rightly ask why our death rate is so high.”

Speaking at the daily Downing Street coronavirus briefing, the first secretary of state, Dominic Raab, repeated previous warnings by ministers and experts against making international comparisons, describing it as “speculation” to say the UK had the highest death toll in Europe.

“I don’t think we’ll get a real verdict on how well countries have done until the pandemic is over and particularly until we’ve got comprehensive international data on all cause of mortality,” he said.

“We now publish data that includes all deaths in all settings and not all countries do that so I’m not sure that the international comparison works unless you reliably know that all countries are measuring in the same way.”

Italy quickly became a centre of the coronavirus outbreak in Europe, with the first deaths coming in late February, and it was the first European country to move into lockdown.

As the death toll rose, so did the number of theories about what went wrong. Italy’s large ageing population, culture of close social interactions and densely populated cities, as well as a lack of time to prepare and a slow initial response to the virus were among the reasons cited as why the country was so badly hit.

The UK, it was said, should learn from Italy. Now, it seems it could be at least as badly struck.

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The latest ONS figures show that 21,997 people died from all causes in the week ending 24 April, which is 11,539 more than the average for that week.

That total was 354 fewer than the record level of 22,351 the week before, however. This was the first decrease in weekly deaths since the start of the outbreak and supports other figures showing that the UK is past the peak of coronavirus infections.

The increase in Covid-19 deaths only partly explains the unprecedented levels in total deaths. The reasons behind an extra 3,312 deaths in the week ending 24 April remain unclear, with speculation that they could have been caused by delayed hospital admissions for other life-threatening conditions and other factors such as economic hardship, and mental health problems.

Spiegelhalter said: “Well over 3,000 [of the excess deaths] weren’t labelled as Covid. So nearly a third were from something else. There is a continuing anxiety that many of these are due to the lockdown itself.

“The one thing we do know is that the health service has been hugely disrupted, not just in terms of routine care, cancelled chemotherapies and radio therapies and elective surgeries, but also of people with symptoms not going to hospital.”

Prof James Naismith, director of the Rosalind Franklin Institute at the University of Oxford, called for an urgent review into deaths caused indirectly by the virus. “We urgently need to identify the cause of these deaths. There are many plausible theories as to their cause, however, we need real data on this urgently,” he said. “As we go forward, we want to minimise all deaths, not just those tagged as Covid-19.”

The latest figures also show that total care home deaths were 595 higher than the week before, at 7,911, whereas hospital deaths were 1,191 lower, at 8,243.

Of the coronavirus deaths registered up to 1 May in England and Wales, 6,686 took place in care homes, which was 22.5% of all the deaths from the virus at that point, the ONS figures show.

Provisional charts shared with journalists by Spiegelhalter showed coronavirus deaths in care homes now exceeding deaths in hospitals. He said: “I can be pretty confident that these [lines representing deaths in care homes and hospitals] have actually crossed a week or so ago with more Covid deaths happening out of hospital than in hospital.” He added that it was too early to tell whether deaths in care homes had peaked.

For the first time last week, the government began including data on deaths outside hospitals in cases where people had tested positive for coronavirus, in the daily death toll figures for the virus. By contrast the ONS figures include all deaths where Covid-19 is mentioned on death certificates.