COVID-19 Deaths in Scotland

Are there really no deaths involving COVID-19 in Scotland?

Many media outlets report there are no new deaths involving COVID-19 in Scotland. For example, The Scotsman wrote on 1st August:

No Covid-19 deaths in Scotland for 16 days as 18 new cases confirmed

On 29th July, The National had the headline:

Covid-19: Scotland records 12th day with no virus deaths

These statements refer to the daily measure produced by Public Health Scotland. In contrast, there are still deaths which mention COVID-19 on the certificate. This article looks at the differences in these two measures.

The two measures

There are different ways to count deaths involving COVID-19 in Scotland. There are daily figures from Public Health Scotland. In addition, there are weekly stats from National Records Scotland.

  • Public Health Scotland: deaths in all settings registered with National Records Scotland. The death must occur within 28 days of the first positive test result for SARS-CoV-2.
  • National Records of Scotland: the death certificate mentions COVID-19. This mention is either as a causal link or a contributory factor.

I look at what Medical Certificates of Cause of Death show in another article.

We could also compare NRS-recorded deaths from all causes to a baseline. Statisticians call that constructed measure ‘excess deaths’. The Office for National Statistics have compared all-cause deaths across European countries.

Why are these two measures different?

Since the PHS measure uses NRS daily file, we eliminate the possibility of unregistered deaths. There are three reasons why the two counts could differ:

  • Unrelated deaths: the person dies within 28 days of their first positive result. The death does not mention COVID-19 on the certificate. Doctors did not believe COVID-19 was a contributory or causal factor.
  • Suspected deaths: the person is untested for SARS-CoV-2, or only has false negative results. Doctors suspect COVID-19 has contributed or caused the death. This suspicion does not need lab-confirmation.
  • Timed-out: the person dies some time after 28 days of their first positive test. Doctors believe COVID-19 was a contributory or causal factor.

As the NRS states:

As a result these weekly totals are likely to be higher than the daily figures — because the daily updates only include those who tested positive for the virus.

Public Health Scotland uses the NRS daily file. (Image: National Records of Scotland)

How big is the difference between the PHS and NRS counts?

National Records of Scotland processed 4,203 certificates involving COVID-19 in Scotland. These deaths occurred between 12th March and 26th July. The registrations were up to 2nd August. The NRS registered five deaths involving COVID-19 occurring on or after 27th July.

For recorded deaths up to 5th August, the Public Health Scotland number was 2,491. That is a difference of over 1,700 deaths. The PHS count is 59% of the NRS figure.

The NRS count is 69% higher than the PHS figure. (Image: R Pubs)

With low testing volumes, some diagnoses did not have lab-confirmation. Around the peak in deaths, this is the most plausible explanation of that difference.

The Public Health Scotland measure showing no confirmed deaths may be due to low testing. It could also be that a long time in hospital means the death ‘times out’ from the count.

Between 27th July and 2nd August, NRS registered seven new deaths involving COVID-19. In that period, recorded deaths from PHS was zero.

There are still deaths involving COVID-19 in Scotland.

The R Code for the graph is available on GitHub and R Pubs. I have also updated the graphs for England and Wales.

This blog looks at the use of statistics in Britain and beyond. It is written by RSS Statistical Ambassador and Chartered Statistician @anthonybmasters.

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