Covid-19 in Scotland – what does the data really tell us?

WITH SCOTTISH EXCESS DEATHS approaching 6,000 for 2020 it is critically important we identify the causes of excess mortality. Historically, this has been an unprecedented year. Never before has so much infrastructure (including healthcare) been withdrawn by governments from their people as part of a political decision to mitigate a particular health risk. The predictions that the mitigation measures themselves would cause excess mortality came in early with the pandemic.

I have taken a look at the data in the National Records for Scotland (NRS) and done a little straightforward investigation, the results of which are outlined below.

Here are two tables summarising all the results, which are illustrated in the graphs which follow. (Excess Deaths are defined against the five year weekly averages in NRS.)

Table 1. Excess Deaths by Cause for 2020

Table 2. Number of Excess Deaths by Cause Whole of 2020

Discrepancies in the totals for these deaths above (you might have noticed) have arisen due to rounding in the calculations for average death counts from the previous five years. Numbers are presented as they appear on the NRS spreadsheets.)

Graph 1 Excess Deaths by Cause 

There was a period of very high excess mortality in spring, as we know, overwhelmingly due to Covid. All other-cause deaths also increased during the ‘first wave’, so excess deaths exceeded Covid deaths. But in the ‘second wave’, Covid deaths have apparently been the sole contributor to excess deaths (or indeed exceeded the excess due to other causes being reduced).

Could it be that in the ‘second wave’ there has not been the same disruption to other services that we saw in the ‘first wave’?

Or it could be that the number of Covid deaths are being overestimated due to errors in the PCR testing process, or errors in testing strategy, such as over-testing the dying?

Respiratory deaths have been lower than normal throughout this year, while ‘other’ deaths have also been consistently higher – more later.

The data in Graph 1 certainly seem to imply that excess deaths are being caused by Covid. But where are the excess deaths happening?

Graph 2 Excess Deaths by Setting

The majority of the excess deaths we saw in the ‘first wave’ of the Covid epidemic were (in order): 1. care homes, 2. home, 3. hospital.

Excess deaths in the home have remained elevated since the epidemic in spring, but they have been offsetting deaths in hospital over the summer when we had very low – or zero – excess. Deaths in hospitals have been consistently lower than average all year, except during the first and second ‘waves’, but even at those times excess deaths were higher in the home.

By the end of week 49, deaths at home are contributing the most to the excess deaths, by a considerable margin.

If Covid was the sole contributor to the excess deaths as the correlation in Graph 1 appears to show, we could conclude that the majority of Covid deaths occurring in the home.

Where are Covid deaths happening?

Graph 3 Covid Deaths by Setting

Only a very small proportion of Covid deaths are happening at home. The overwhelming majority are happening in care homes and hospitals.

Here we see what we already knew: there was lots of death from Covid in the spring and we have a comparatively small second peak in autumn. This implies that infection levels must have been very much greater in spring than they are now, or that we are artificially inflating the number of infections with a great many false positive PCR test results in this ‘second wave’. This might result in us over-counting Covid deaths too.

The graph shows that in the ‘second wave’, proportionally more Covid deaths are happening in hospitals than in care homes, which was not true in the ‘first wave’. But in both ‘waves’, Covid deaths have been overwhelmingly occurring in care homes and in hospitals.

Covid deaths have not happened in the home in either wave, and yet deaths in the home are accounting for the biggest excess throughout the year. Home was the second most common location for excess death even in the ‘first wave’ and yet this graph shows these were not Covid deaths.

What are the causes contributing to excess deaths in the home?

Graph 4 Excess Cancer Deaths by Setting

As shown in Table 2, the overall excess for cancer deaths is low for this year at 33.

In the graph, we see clearly that cancer deaths have shifted from care homes and hospitals to the home.

So cancer deaths at home are contributing significantly to the excess deaths in the home, even if not much to excess deaths overall.

Graph 5 – Excess Dementia/Alzheimers Deaths by Setting

There has been an increase in dementia/Alzheimers deaths this year; it is a significant rise at around 300 but nothing like as big as ‘Other’ causes or Covid. Throughout the year, there has been an excess in the home and a very consistent deficit in hospitals. They have been reduced in care homes too after the ‘first wave’ of Covid.

Dementia/Alzheimer deaths are contributing to excess deaths overall, and to excess deaths in the home.

Graph 6 Excess Circulatory (Heart Disease & Strokes) Deaths by Setting

These deaths are not contributing to excess deaths greatly overall at 133 for the year, but they have shifted to the home from hospital.

Excess circulatory deaths are contributing to excess deaths in the home.

Graph 7 Excess Respiratory Deaths by Setting

The situation with respiratory deaths is very different to the other causes of death because it is the only cause in significant deficit at 1415 fewer than average for the year. These deaths have been elevated in the home, but in care homes and hospitals they have been consistently very much in deficit.

In a year when all other causes of deaths are in excess, it seems unlikely that there could be this cause of death truly in such deficit.

Could it be there have been misdiagnoses of other respiratory viruses and conditions as Covid and/or Covid deaths have directly replaced other respiratory deaths?

Misdiagnoses of Covid might have occurred due to an over-reliance on the PCR tests in diagnosis, which it is suspected by a growing number of scientists, could be mis-identifying other viruses as Covid.

Graph 8 ‘Other’ Excess Deaths (excluding those causes explored above) by Setting

‘Other’ deaths have been a very significant contributor to the excess death count for Scotland this year, second only to Covid. What is striking about Graph 8 is that it shows that in all settings except hospitals, ‘other’ cause deaths have been elevated this year, but more in the home than in other settings.

‘Other’ deaths are contributing more to excess deaths than any single cause this year except Covid and are occurring in the home more than in other settings in this ‘second wave’ of elevated mortality.

In Summary

The findings from the data show:

1. Covid labelled deaths are matching in number almost all the excess deaths in Scotland in the ‘second wave’ – and have even exceeded the net excess at times.
2. The majority of excess deaths in the ‘second wave’ are occurring in the home.
3. Covid deaths overwhelmingly occur in hospitals and care homes and NOT in the home.
4. Cancer and circulatory deaths are in excess in the home and in deficit in other settings.
5. Dementia/Alzheimers deaths are in excess in the home and in care homes but in deficit in hospitals.
6. Meanwhile, in a year of excess deaths, there is a large deficit in respiratory deaths.
7. The biggest contributor to excess deaths is ‘other’ causes and these are occurring most frequently in the home.

Conclusions

Summary points 1, 2 and 3 are incongruous and cannot make sense together. There is clearly a mismatch between excess deaths and Covid deaths, when looking at the data in more depth and as a whole dataset. If excess deaths are due to Covid, they cannot be happening in the home. And if they are happening in the home, they cannot be due to Covid.

Covid deaths are occurring overwhelmingly in care home and hospital settings.

‘Other’ causes are the biggest contributor to excess deaths (other than Covid) and these are occurring overwhelmingly in the home than anywhere else and not matched by deficits in other settings. Meanwhile respiratory deaths are in extraordinary deficit across settings (except the home).

My conclusion is that Covid is not the cause of the current excess deaths: which means other causes are.

These other causes are likely to be caused by Covid restrictions, since they are so high and occurring at home and not in care settings.

As more and more concerns are raised about the efficacy and accuracy of the PCR tests and testing strategy – and we see anomalies in death counts, it is hard not to link these two observations. What we observe in anomalies in deaths we would see if there were over-counting of Covid deaths in hospitals and care homes.

Are we identifying other respiratory viruses as Covid because the PCR is not fit for purpose?

Are we over-testing the dying, returning distorted positive results, thereby artificially inflating Covid deaths?

We must urgently move on from current testing practices. If we do not establish and correct for the false positive rate for the discredited PCR test, we will continue to see incongruity in the data, which merely muddies the clinical picture and keeps Scotland in a state of perpetual epidemic.

Coronavirus visual by freshidea from Adobe Stock