The UK had one of the worst increases in death rates of major European economies during the Covid pandemic, BBC analysis has found.

By Robert Cuffe & Libby Rogers www.bbc.co.uk 

Death rates in the UK were more than 5% higher on average each year of the pandemic than in the years just before it, largely driven by a huge death toll in the first year.

That was above the increase seen in France, Spain or Germany, but below Italy and significantly lower than the US.

Comparing death rates across countries

Back in April and May 2020, the UK was seeing one of the worst waves of Covid deaths in the world.

But Prof Sir Chris Whitty, England’s chief medical officer, warned against international comparisons of Covid deaths too early in the pandemic.

Instead, he recommended looking at deaths for any reason, since they do not depend on what a country calls a Covid death.

And he said analyses should take account of the age profile of each country, which can explain a lot of differences in death rates.

We have built a database of those figures, collecting data for the last eight years from a range of European countries, as well as the US and New Zealand.

Now the UK’s long-awaited Covid inquiry is under way and Sir Chris is about to give evidence for the first time.

And as the World Health Organization has declared an end to the global health emergency, we have looked back at three years of pandemic deaths, starting in March 2020.

We compared countries by measuring how much their death rates rose from those seen in the five years before the pandemic.

Over the three years to February 2023, the UK’s death rates went up by more than 5%, which is more than France, Germany and Spain (all up between 3% and 4.5%), but by less than Italy’s (up more than 6%).

The US and Eastern European countries like Poland were even harder hit, with death rates more than 10% above their pre-pandemic levels over the three years to February 2023.

In contrast, death rates fell in countries like Sweden and Norway and also New Zealand, who contained the virus successfully before its vaccination programme took off.

The year-by-year figures tell different stories for each country.

For the UK, they point to early losses followed by significant success in 2022.

How do the UK’s deaths compare each year?

The UK was one of the worst-hit countries in the first year of the pandemic, with death rates running 15% above those before it started.

The combination of a terrible first wave and the rapid spread of the alpha (or Kent) variant just as the vaccine rollout was getting going contributed to a huge death toll.

Many eastern European countries like Poland avoided the spring 2020 wave but overtook the UK in numbers of deaths in the winter of 2020-21.

The US continued to have steadily increasing death rates during the summer of 2020 and by the end of the year, it passed the UK’s total.

Death rates fell in many European nations in the second year of the pandemic as vaccine programmes got under way.

The UK’s vaccine rollout is regarded as a “global exemplar”, says Prof Devi Sridhar of University of Edinburgh.

That is not just number of doses, it was also getting them to the people most at risk.

And the UK looked better than any major European economy bar Spain in that second year – with death rates below historical averages.

In the third year, death rates rose in many countries as they opened up again.

Some of the largest rebounds we found were in countries like Germany, New Zealand and Norway, who had fared better in the first two years of the pandemic (and well overall).

Norway had far fewer deaths than Sweden in the first year of the pandemic but over the three years the two countries look more similar.

It is hard to read straight across from Scandinavian countries to the UK, cautions Prof Sridhar, arguing “we’d never look like either Sweden or Norway”, and describing them as “healthier, wealthier and more equal” countries that are very different to the UK.

Lessons for the UK

It would take many inquiries to tease apart the effect of all the possible reasons behind every nation’s pandemic outcomes: preparedness, population health, lockdown timing and severity, social support, vaccine rollout and health care provision and others.

But some argue that there are lessons for the UK that need to be learned even before we think about future pandemics.

The UK’s heavy pandemic death toll “built on a decade of lacklustre performance on life expectancy” says Veena Raleigh, of the King’s Fund, a health think tank. She argues that government action to improve population health and turn that around has “never been more urgent”.

Methods

We collected data on deaths in five-year age groups and population estimates/projections from Eurostat, the Office for National Statistics, National Records of Scotland, the Northern Ireland Statistics Research Agency, the Centre for Disease Control, United States Census Bureau and Stats NZ.

We calculated the death rate in each age group and combined them to form an age-adjusted death rate using the 2013 European Standard Population.

Some nations did not have the full set of age bands. For example, US figures used 10-year age bands between five and 24 and above 55. Broader age bands can exaggerate excess mortality figures like the ones we calculated, in the order of a percentage point.

Additional journalism by Callum Thomson, Isabella Worth, Jana Tauschinski, Liana Bravo and Wesley Stephenson

“He respects the view of the House that was taken on Monday and it’s right that members (of Parliament), whoever they are and whatever position they have held, are held to account for their actions.” – PM Press Secretary.

Gnomic! – Owl

Kate Devlin www.independent.co.uk 

Rishi Sunak has finally given his verdict on Boris Johnson’s Partygate lies, saying it is right the disgraced former prime minister has been held to account.

In a final humiliation on Monday MPs backed a damning report which found Mr Johnson had lied to Parliament over and over again – stripping him of his Westminster pass.

But Mr Sunak missed the vote citing a prior engagement.

He faced accusations he was “too weak” to stand up to his predecessor and his “sycophants” within their fractious party.

Since them No 10 has refused to be drawn on the prime minister’s personal view or how he would have voted.

After he was asked about Mr Johnson at PMQs, the Prime Minister’s press secretary said: “He respects the view of the House that was taken on Monday and it’s right that members (of Parliament), whoever they are and whatever position they have held, are held to account for their actions.”

She would not set out whether or not he agreed with the committee’s report, however, saying he “respects” the view of the House.

Mr Johnson dodged the recommended 90-day suspension by quitting his Uxbridge and South Ruislip seat.

In the end 354 MPs backed the Partygate report, while just seven voted against it – a majority of 347.

Tory MPs who supported Mr Johnson included Sir Bill Cash, Nick Fletcher, Adam Holloway, Karl McCartney, Joy Morrissey and Heather Wheeler.

Mr Sunak was accused of “running scared” of the showdown in parliament on Mr Johnson, with No 10 claiming he had been too busy hosting the Swedish prime minister to attend.

The PM said at the weekend that he did not want to “influence anyone” when pressed on how he would vote on the report, which found Mr Johnson lied to parliament and undermined the committee’s work with personal attacks.

One former prime minister, Theresa May, did turn up to condemn Mr Johnson – arguing that her successor had been “found wanting” and urging all Tory MPs to back the report to help “restore faith in our parliamentary democracy.”

Height is an extremely sensitive indicator of general living conditions, with factors including illness and infection, stress, poverty and sleep quality alongside the quality and quantity of diets.

“Wider data on the height of 19-year-olds suggested that growing up in the 2010s which happens to coincide with the period of austerity . . . tells me that austerity has clobbered the height of children in the UK”: [Professor Tim Cole, an expert in child growth rates at the Great Ormond Street Institute of Child Health, University College London.]

The indelible mark of austerity – owl

Kat Lay www.thetimes.co.uk

Five-year-olds in Britain are on average up to seven centimetres shorter than their peers in other wealthy nations, in a trend described as “pretty startling”.

A poor national diet has been highlighted as a major culprit in Britain’s fall down international rankings of child height.

The average five-year-old boy in the UK is 112.5cm tall, against 119.6cm in the Netherlands — the comparable country with the tallest children. The average girl is 111.7cm tall, while her Dutch counterpart would be 118.4cm tall.

The data is taken from national measurement programmes, collated by the Non-Communicable Diseases Risk Factor Collaboration, a global network of health scientists.

In 1985 British boys and girls ranked 69 out of 200 countries for average height aged five. At the time they were on average 111.4 and 111 cm tall respectively. British boys are now 102nd, and girls 96th.

“They’ve fallen by 30 places, which is pretty startling,” said Professor Tim Cole, an expert in child growth rates at the Great Ormond Street Institute of Child Health, University College London. “The question is why?”

The professor, who was not involved in the most recent study, said wider data on the height of 19-year-olds suggested that growing up in the 2010s “which happens to coincide with the period of austerity . . . tells me that austerity has clobbered the height of children in the UK”.

Cole said height was an extremely sensitive indicator of general living conditions, with factors including illness and infection, stress, poverty and sleep quality all “piled up in there” alongside the quality and quantity of diets.

“It’s quite clear we are falling behind, relative to Europe,” he added. “But it’s telling that at age five, we are looking further behind than we are at age 19, which suggests to me that the last 14 years from age five to 19 has been particularly rough for UK children.”

Henry Dimbleby, the former government food adviser, highlighted height discrepancies between Britain and other countries in his National Food Strategy, published in 2021 and again in his new book, Ravenous.

He said: “In modern Britain, the way we eat is one of the clearest markers of inequality. You can actually see it with the naked eye. A diet of cheap junk food has the peculiar quality that it can make you simultaneously overweight and undernourished.

“Children in the poorest areas of England are both fatter and significantly shorter than those in the richest areas at age ten to eleven. This is a big enough problem to have an impact at an international level. The average five-year-old in the UK is shorter than their peers in nearly all other high-income countries.”

In France the average five year old boy is 114.7cm tall and the average girl 113.6cm. In Germany they are 114.8 and 113.3 respectively. Danish boys are on average 117.4cm tall, and Danish girls 118.1cm.

Dimbleby said that GPs in poorer areas have reported an “extraordinary” resurgence of Victorian diseases such as rickets and scurvy, “largely caused by nutritional deficiencies”.

NHS data shows that about 700 children a year are admitted to hospital with malnutrition, rickets or scurvy in England.

Separate annual surveys of diet and nutrition show that children from the poorest fifth of families consume about a third less fruit and vegetables, 75 per cent less oily fish, and a fifth less fibre than children from the most well off families.

The Food Foundation, a nutrition charity, said the disparities “raise questions about the nutritional quality of food that children are able to access”, and that height was “likely [to be] representative of broader development of the child”.

Anna Taylor, the charity’s executive director, said figures from the 2021-22 national child measurement programme showed that white British children living in the most deprived areas in England continued to be shorter than those living in the least — 0.6cm for girls and 1.3cm for boys by age ten to eleven.

She added: “There are several factors that contribute to a child’s height including genetics, ethnicity, smoking and diet. However, academic studies indicate that infancy is most influenced by external factors rather than genetics.”

Dietary inequalities also appeared to drive higher rates of problems such as obesity, type 2 diabetes and dental decay in children from poorer backgrounds, Taylor said.

“It’s essential that healthy food is accessible and affordable for all, particularly during the cost of living crisis when budgets are stretched and food prices are increasing. We need strong, preventive policies that can improve access and affordability to nutritious food and shape healthy food environments.”

A government spokesman said: “There are a range of factors that can impact children’s growth, which are not just limited to diet, and we’re taking steps to support families by providing record financial support to families who need it most — a £94 billion cost of living support package worth around £3,300 per household.

“We are supporting the NHS to tackle some of the key root causes of poor nutrition, and our Healthy Food Schemes help more than three million children get the nutrition they need.

“We’re also promoting healthier lifestyles for children by investing over £600 million in school sport over the next two years, while our sugar reduction programme has seen dramatic reductions in the sugar content in foods eaten by children.”

Lord Moylan, Tory chairman of the Lords built environment committee, condemned the “total ban” on homebuilding yesterday, saying that “people do not have enough houses to live in”.

However, bosses at Natural England, the agency within the Department for Environment, Food and Rural Affairs responsible for protecting the environment, told peers that it must take all actions to protect damaged rivers.

The Home Builders Federation has called for water companies to be forced to pay to upgrade sewage treatment plants and for farmers’ handling of animal manure and fertiliser to be more tightly regulated.

Tom Witherow www.thetimes.co.uk 

The green quango accused of blocking 120,000 homes with rules to keep rivers clean has admitted the pollution from new developments is “very small”.

Last year Natural England extended guidance to 74 councils that led planners to block new homes unless developers could prove they would not pollute water courses. Homebuilders claimed they had been unfairly targeted, given that 96 per cent of pollutants come from existing homes and farmers.

Lord Moylan, Tory chairman of the Lords built environment committee, condemned the “total ban” on homebuilding yesterday, saying that “people do not have enough houses to live in”.

However, bosses at Natural England, the agency within the Department for Environment, Food and Rural Affairs responsible for protecting the environment, told peers that it must take all actions to protect damaged rivers.

Housebuilding will be a dividing line at the next election after Sir Keir Starmer, the Labour leader, promised to build on the green belt just as Rishi Sunak ditched his government’s target of 300,000 homes per year.

Alan Law, deputy chief executive of Natural England, admitted: “The proportion of pollution arising from new housing stock is very small but the question being asked from us is, ‘Is it OK to take an already polluted system, and make it worse?’ It’s not, ‘Is the new development more polluting than existing homes or the existing agriculture?’ and the legal framework is clear.” The Environment Agency was largely responsible for regulating farming, he said, leaving Natural England with limited powers to change farmers’ behaviour.

The Home Builders Federation has called for water companies to be forced to pay to upgrade sewage treatment plants and for farmers’ handling of animal manure and fertiliser to be more tightly regulated.

The “nutrient neutrality” guidelines originated from a 2018 European Court of Justice ruling in the Netherlands, and effectively halted housebuilding in large areas of the country, including the Wye Valley, Somerset Levels and the Tees Valley.

Natural England has helped to set up credit schemes, allowing housebuilders to pay to mitigate the impact of new homes, which have unlocked thousands of homes in the Solent and Tees Valley. A larger credits scheme, backed by £30 million of government funding, is being developed. Law said “the approach for nutrient neutrality is by necessity a temporary one . . . the solution is better agricultural standards and better water treatment services.”

Moylan said: “We seem to have this screeching of the brakes in terms of development while [someone] works out what the 20-year solution is.”

The leakage rate from Thames Water pipes is the highest for five years and the company will not meet its target to plug them this year, according to information released under freedom of information laws.

Sandra Laville www.theguardian.com 

The company, which serves 15 million customers across London and Thames Valley, has to have regular meetings with the environment secretary because it is considered to be lagging in its performance.

Details of letters released under freedom of information laws between the CEO, Sarah Bentley, and Rebecca Pow, the environment secretary, reveal that Thames is not fixing its leaks as it has promised.

Bentley told Pow: “Right now, we have the highest leakage rate since 2018. Consequently, we have already signalled to Ofwat that we are behind on our 2022/23 leakage performance and our target this year will now be very challenging to achieve.

“As annual leakage targets are based on a three-year rolling average, the impact of this year will be felt, not just this year but for the next two years’ performance.”

Thames is proposing controversial measures to tackle drought in the future, including a “recycling” scheme in which up to 100m litres of treated sewage from the Mogden sewage works will be pumped into the River Thames at Teddington, south-west London. This will replace 100m litres abstracted from the Thames to tackle water shortages.

The project raises environmental concerns including increased water temperatures and a change in the salinity of the river, which will affect fish and biodiversity.

It also involves digging three to four 10.5-metre shafts within a protected nature reserve, Ham Lands, a site of importance for nature conservation (SINC), according to Thames documents.

The company is also proposing to transport 155m litres of water a day from Wales, in another sensitive policy to try to tackle water shortages in London and the south-east.

But its failure to fix its own leaks – which are estimated to be 630m litres a day – is likely to make it more difficult for Thames to get approval for these proposals in its draft water resources management plan.

Bentley blamed the hot, dry weather last summer, followed by a wet winter, for exacerbating leaks from the network and from customers’ homes.

“The hot and dry summer created an unprecedented ‘soil moisture deficit’, with ground drying out and causing leaks in our pipes and customers’ pipes,” she said. “It also led to large increases in demand from our customers [in some areas and at sometimes up to 50% more during the summer]. This drove up ‘unmeasured consumption’ and the need for us to pump more water through our pipes at higher pressure to satisfy demand that in turn also led to more leaks from our pipes.

“The re-wetting of the ground later in the autumn then caused further movement and more leaks in our pipes and customers’ pipes. More recently, the freezing temperatures before Christmas, followed by a speedy thaw, has resulted in a new surge of leaks – both on our water supply network and on our customer’s pipes.”

Thames, like other water companies, has a target to cut its leaks by 50% by 2050. But the Environment Agency has called for the company to increase this target. The EA says the company needs to do more to tackle leaks before suggesting schemes including the Teddington water recycling plan and the transport of water from Wales.

It has said the security of water supply to the south-east and London will be at risk if the company does not tackle its leaks and reduce customer demand for water.

Bentley told Pow in her letter dated January this year that Thames was running a £1m communications campaign to highlight the challenges “we all face” and educate customers on what they can do to help make sure there is enough water for everyone.

The government has set a target of reducing individual daily water use from about 144 litres a day to 110 litres a day by 2050.

On its website, Thames Water admits it is not acceptable that so much water is being lost. It said it is doing all that is reasonably practical to reduce leakage but it will miss its 22/23 target, and that will affect future years. However, the company is working to improve its “leakage transformation plan”.

A Defra spokesperson said: “We have been very clear to water companies that we expect them to deliver on their commitments – including targets to reduce leakage by 30% by 2032.

“The government is taking a number of actions to improve water supply through our Plan for Water, as well as taking action to clean up our water through more investment, stronger regulation and tougher enforcement.”