Public Health England has changed its definition of deaths: here’s what it means
August 12, 2020
Carl Heneghan, Jason Oke
Public Health England has changed its definition of deaths. The new definition is now death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date will now be reported
The new data can be accessed here.
What this means is that England has had 36,695 deaths using this definition as opposed to the previous reported 42,072 – a difference of 5,377.
When you observe this difference you can see it is more marked in June, July and August.
For example, under the old PHE system, 2,086 deaths were reported in England in July by date of death, with the 28 days cut off this number is 574 – nearly a quarter of what was previously reported.
The last two days illustrate the difference this change makes to the deaths by reporting date. As opposed to 100 deaths on the 11th of August, 11 would now be reported; today, whereas 72 were reported, only 15 will be reported under the new system.
||Ever had a positive test
||Test with 28-day cut-off
We have illustrated this effect on the 7-day moving average for July.
The change in definitions means the current moving average, as of the 12 August, is down to approximately ten deaths per day.
In terms of total deaths, the UK (and England) remain in the same position above Italy.
When it comes to deaths per million (ie., adjusting for the population size) it means the UK’s death rate is similar to Italy and Spain and above France, whereas England’s death rate per million remains higher.
Data source: https://www.worldometers.info/coronavirus/
PHE uses two definitions of death in a person with COVID-19 in England, one broader measure and one measure reflecting current trends:
1) A death in a person with a laboratory-confirmed positive COVID-19 and either: died within 60 days of the first specimen date or died more than 60 days after the first specimen date, only if COVID-19 is mentioned on the death certificate
2) A death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date.
In terms of the definition with a longer time frame – beyond 28 days – we consider this is important but should be used to perform in-depth analyses of the long term problems caused by COVID.
The 28-day definition brings the definitions into line with the other UK countries and provides a more accurate, and sensitive measure, of the immediate impact of COVID on deaths. This will allow us to better determine if deaths related to COVID are trending up or down.
Jason Oke is a Senior Statistician at the Nuffield Department of Primary Care Health Sciences and Module Coordinator for Statistical Computing with R and Stata (EBHC Med Stats), and Introduction to Statistics for Health Care Research (EBHC), as part of the Evidence-Based Health Care Programme.
Carl Heneghan is Professor of Evidence-Based Medicine and Director of Studies for the Evidence-Based Health Care Programmes (Full bio and disclosure statement here)
Disclaimer: the article has not been peer-reviewed; it should not replace individual clinical judgement, and the sources cited should be checked. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care.