UK/Wales Undercounting

[Kathianne]

They are not alone. Most criticism has been on counting every death as virus. Seems to me though that undercounting is more likely.

https://www.cnn.com/2020/04/28/uk/uk-death-toll-statistics-ons-gbr-intl/index.html

[Drummond]

They are not alone. Most criticism has been on counting every death as virus. Seems to me though that undercounting is more likely.

https://www.cnn.com/2020/04/28/uk/uk-death-toll-statistics-ons-gbr-intl/index.html

This is a little more complicated than it might appear to be.

To slightly update: the reported Covid-19 deaths are a higher total than the article shows. Reported today from the Government's daily briefing .... the latest UK total stands at 26,097.

So, for a bit of detail ...

That the ONS (& that's Office FOR National Statistics, not OF National Statistics ..) manages to get anything-like-accurate death data out for public circulation as it currently is, is a minor miracle. Here's how things stand: the ONS is the body in charge of all birth, marriage and death records ... but with limits. The range of civil registration records within its 'orbit' covers just England and Wales, which is why the CNN article mentions England and Wales ! So, the ONS can only reflect in data it produces that information it holds responsibility for.

This means that Scotland and Northern Ireland won't be reflected in ONS-produced data, unless it's fortunate enough to get cooperation from its counterparts in Belfast and Edinburgh. That's an important point, because the quality of the data has three sources.

Civil registration happens locally, in the town, village, city, holding a Superintendent Registrar's office. Records are kept locally. Collation is undertaken, to transmit then order copies of these records into a centralised registration that the ONS upkeeps. Updates are typically collated on a quarterly basis, and such is the volume of data being re-ordered into centralised form that delays in public presentation of it are usually anything from six months to a year after the registrations took place (so if you wanted to check on a death happening one week previously, you'd not use the central indexes, but inquire locally).

Yet, here we are, with the ONS coughing up death data meant to be correct to the day ! They must be busting a collective gut to manage it.

But given that they're managing this, they still have to wait for New Register House in Edinburgh to do their own breakneck-speed collating and to send the Scottish results back to ONS. ONS has to rely on them. It has no direct jurisdiction over the Edinburgh office.

It gets worse, though.

Civil servants moving at unaccustomed warp speed isn't the entirety of the issue. Also, there's the question: what constitutes a Covid-19 death ?

A death certificate may mention it. But, as THE cause of death ? Or, as a factor that helped hasten a death by another, 'underlying', cause ?

You might have a situation where even the doctor certifying the death wasn't entirely sure.

ONS therefore operates a shorthand to deal with this. If Covid-19 is mentioned, then the death automatically is Covid-19 related. Meaning, it gets included in the total.

You could therefore argue that there is potential for a significant OVER-counting.

Balance out the indeterminate cases counted as Covid, the dependence on secondhand information emanating out of Scotland and N Ireland that ONS can't directly control, and any timelag between registration and collation .. and it's a miracle they get the accuracy they do ...

... whatever that precisely is. Undercounting, overcounting ? Both are possible, and it's next to impossible to wheedle out any definite conclusion on either.

So, you do what you can. You accept ONS data as the best that can be provided ... for the very good reason that IT IS.

Those people are currently going into overdrive to get their data out FAR quicker than they usually need to do.

One other point: the locations of deaths. Government data was dependent on hospital data .. but care homes have proven to be a major source of deaths from Covid-19. The data on those is, now, being picked up by the ONS, and is forming a part of the overall, reported, picture .. finally.

It's been isolated out from the other data to identify what it is. So it is that around 6,000 extra deaths are now said to have come from care homes. That's a fact determined by ONS data, not specifically by Government. The Government is now relaying theirs, as a part of a more complete picture.

[Kathianne]

This is a little more complicated than it might appear to be.

To slightly update: the reported Covid-19 deaths are a higher total than the article shows. Reported today from the Government's daily briefing .... the latest UK total stands at 26,097.

So, for a bit of detail ...

That the ONS (& that's Office FOR National Statistics, not OF National Statistics ..) manages to get anything-like-accurate death data out for public circulation as it currently is, is a minor miracle. Here's how things stand: the ONS is the body in charge of all birth, marriage and death records ... but with limits. The range of civil registration records within its 'orbit' covers just England and Wales, which is why the CNN article mentions England and Wales ! So, the ONS can only reflect in data it produces that information it holds responsibility for.

This means that Scotland and Northern Ireland won't be reflected in ONS-produced data, unless it's fortunate enough to get cooperation from its counterparts in Belfast and Edinburgh. That's an important point, because the quality of the data has three sources.

Civil registration happens locally, in the town, village, city, holding a Superintendent Registrar's office. Records are kept locally. Collation is undertaken, to transmit then order copies of these records into a centralised registration that the ONS upkeeps. Updates are typically collated on a quarterly basis, and such is the volume of data being re-ordered into centralised form that delays in public presentation of it are usually anything from six months to a year after the registrations took place (so if you wanted to check on a death happening one week previously, you'd not use the central indexes, but inquire locally).

Yet, here we are, with the ONS coughing up death data meant to be correct to the day ! They must be busting a collective gut to manage it.

But given that they're managing this, they still have to wait for New Register House in Edinburgh to do their own breakneck-speed collating and to send the Scottish results back to ONS. ONS has to rely on them. It has no direct jurisdiction over the Edinburgh office.

It gets worse, though.

Civil servants moving at unaccustomed warp speed isn't the entirety of the issue. Also, there's the question: what constitutes a Covid-19 death ?

A death certificate may mention it. But, as THE cause of death ? Or, as a factor that helped hasten a death by another, 'underlying', cause ?

You might have a situation where even the doctor certifying the death wasn't entirely sure.

ONS therefore operates a shorthand to deal with this. If Covid-19 is mentioned, then the death automatically is Covid-19 related. Meaning, it gets included in the total.

You could therefore argue that there is potential for a significant OVER-counting.

Balance out the indeterminate cases counted as Covid, the dependence on secondhand information emanating out of Scotland and N Ireland that ONS can't directly control, and any timelag between registration and collation .. and it's a miracle they get the accuracy they do ...

... whatever that precisely is. Undercounting, overcounting ? Both are possible, and it's next to impossible to wheedle out any definite conclusion on either.

So, you do what you can. You accept ONS data as the best that can be provided ... for the very good reason that IT IS.

Those people are currently going into overdrive to get their data out FAR quicker than they usually need to do.

One other point: the locations of deaths. Government data was dependent on hospital data .. but care homes have proven to be a major source of deaths from Covid-19. The data on those is, now, being picked up by the ONS, and is forming a part of the overall, reported, picture .. finally.

It's been isolated out from the other data to identify what it is. So it is that around 6,000 extra deaths are now said to have come from care homes. That's a fact determined by ONS data, not specifically by Government. The Government is now relaying theirs, as a part of a more complete picture.

Not that complicated, if under hospital care and covid is present, it's Covid. If at home or in nursing care, likely not to be counted as Covid. That is exactly what has been happening in US, Italy that I know of. Likely what is happening is overcounting in hospital, severe undercounting elsewhere.

[Drummond]

Not that complicated, if under hospital care and covid is present, it's Covid. If at home or in nursing care, likely not to be counted as Covid. That is exactly what has been happening in US, Italy that I know of. Likely what is happening is overcounting in hospital, severe undercounting elsewhere.

I think I take your point. One thought occurs ... if a person goes into lockdown at home, gets ill (or is ill anyway) .. then duly dies, alone at home ... quite apart from any delay there might be in discovering the body, how about the issue of post-mortems ?

With hospitals already backed up to hell from the Covid-19 cases swamping them (way, way worse with any country going the 'herd immunity' route, of course) ... how long would it take to get around to post-mortem examinations ? Would those performing them be tempted to be less than thorough, just to try and cope with a crippling workload ?

Not quite the same issue, but there's - here, anyway - a problem with having to sideline even serious illness in favour of getting through Covid cases. We've many people diagnosed with cancer who should be getting treatment ... operations, etc ... and these are being cancelled and pushed back.

I heard on the radio quoted of an expected 18,000 additional deaths from cancer that could've been avoided if the proper treatments had been performed, but hadn't been, because everything had been poured into caring for Covid-19 cases.

You could argue that they were really Covid cases, if that disease led to termination of life because healthcare couldn't spare them time or attention.

Now, how about this .. how many contract Covid-19 because of their weakened, compromised state, and it tips the balance towards far quicker death ? But, what if the cancer has progressed enough to be taken as the cause of death, when really it's not ?

How many cases might be so finely balanced that diagnosis of death can go either way ?

[Kathianne]

I think I take your point. One thought occurs ... if a person goes into lockdown at home, gets ill (or is ill anyway) .. then duly dies, alone at home ... quite apart from any delay there might be in discovering the body, how about the issue of post-mortems ?

With hospitals already backed up to hell from the Covid-19 cases swamping them (way, way worse with any country going the 'herd immunity' route, of course) ... how long would it take to get around to post-mortem examinations ? Would those performing them be tempted to be less than thorough, just to try and cope with a crippling workload ?

Not quite the same issue, but there's - here, anyway - a problem with having to sideline even serious illness in favour of getting through Covid cases. We've many people diagnosed with cancer who should be getting treatment ... operations, etc ... and these are being cancelled and pushed back.

I heard on the radio quoted of an expected 18,000 additional deaths from cancer that could've been avoided if the proper treatments had been performed, but hadn't been, because everything had been poured into caring for Covid-19 cases.

You could argue that they were really Covid cases, if that disease led to termination of life because healthcare couldn't spare them time or attention.

Now, how about this .. how many contract Covid-19 because of their weakened, compromised state, and it tips the balance towards far quicker death ? But, what if the cancer has progressed enough to be taken as the cause of death, when really it's not ?

How many cases might be so finely balanced that diagnosis of death can go either way ?
I don't know about UK, but both Italy and US have pretty much stopped post-mortems, unless foul play is suspected. Easy to do with the elderly.

Not being skeptical as much as practical, mostly old people. Especially if family isn't around, who is going to create problems? All involved, save family, to keep the numbers looking 'hopeful,' to having this under control. It's not a 'one country' problem, as I noted with the thread I started last night with similar info from US.