Why are excess deaths still so high? We can't just blame a failing NHS

And yet, despite this stark discrepancy, there has been a notable lack of public acknowledgement of the non-Covid mortality crisis — let alone any meaningful explanation as for what’s driving it. Earlier this month, Health Secretary Steve Barclay told Sky News that “it’s extremely complicated as to what the drive of those excess deaths are”. Meanwhile, health experts say the causes could include anything from ambulance delays, long waits in A&E and major backlogs for routine NHS care to high flu rates and long Covid. Indeed, the consensus seems to hold that the general breakdown of the NHS is largely to blame for the increase in excess deaths.

But there is a hole in this argument: excess deaths are a problem in a number of other high-income countries, where the “NHS is broken” argument doesn’t hold. According to EuroMOMO, a European mortality monitoring activity supported by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO), many European countries are showing elevated levels of excess mortality in all age groups — around 35% above average — and did so throughout 2022. In fact, despite relatively low Covid death rates, overall excess deaths in all age groups in Europe in 2022 were as high as in 2020 and higher than 2021 — even in the oldest cohorts. Beyond Europe, the situation is much the same: Australia and New Zealand recorded, respectively, 16% and 9% more excess deaths than the historical average in 2022, while in the United States, CDC data shows that the rate of non-Covid excess deaths in the first half of 2022 was even higher than in 2020 or 2021.

In short, a significant number of Western countries are experiencing a surge in excess deaths across all age groups. And there is no single explanation for this. Rather, each country seems to have its own theory — none of which have anything to do with the NHS. In Portugal, December saw excess deaths which beat all records of the previous 13 years, including during Covid-19, which the press attributes to an ageing population, and the resurgence of other respiratory viruses alongside the summer heat waves. In France and Spain, the summer heat waves are also seen as a clear cause of the excess deaths, while in Chile one additional cause of the surge in mortality was seen as “deaths avoided during the pandemic owing to the lower risk of certain events, like traffic accidents or injuries at work”.

Where countries share one phenomenon — in this case, excess deaths — and attribute it to different causes, it is reasonable to ask some questions; the problem today seems to be that our public-health experts are not asking the right ones. At the end of last month, for instance, the UK’s Chief Medical Officer (CMO) Chris Whitty suggested that a lack of access to statins during the pandemic may have caused an upsurge in coronary heart disease, which has been the main driver of excess deaths. People did not attend medical services as much as usual, and the shortfall was having devastating consequences. However, as Carl Heneghan and Tom Jefferson pointed out shortly afterwards, it takes roughly five years for statins to have a notable impact on mortality reduction — so reduced medication since 2020 cannot have led to these outcomes.

So, what explains the rise in heart disease? The collapse in routine healthcare appointments (due to the single-minded focus on Covid at the expense of all other pathologies) is fairly obviously one part of the story, but is there anything else at play? One potential explanation is the impact of lockdowns on people’s physical health. After all, Whitty himself noted in March last year that lockdowns had increased young people’s obesity, which could lead to lowering life expectancy. Moreover, the political and social intrusion of the state into peoples’ emotional well-being, and the consequent breakdown of the pre-existing social contract, is also known to affect a citizen’s health. After the collapse of the Soviet Union, for example, there was a significant increase in mortality in Russia, much of which was triggered by vascular disease. There is a clear precedent in living memory, then, for immense social and economic shocks leading to surges in heart disease.

Also relevant to the elderly is the increase in isolation produced by lockdown policies. According to the WHO factsheet on dementia, “risk factors include depression, social isolation [and] cognitive inactivity”, all of which were widely increased by the lockdown response; one 2015 study even found that social isolation increased the risk of mortality by between 26-32%. The lockdowns therefore are almost certainly a contributing factor to what we are currently seeing, particularly as the UK government itself has noted that those who die from dementia often have proximate additional causes of death in strokes or heart disease.

Finally, there is one possible explanation that has to be considered, at least as a contributing factor for the rise in non-Covid excess deaths: the role of the vaccines, in particular those from Pfizer and Moderna that use the new mRNA technology. This is a hyper-polarising issue, so let’s start with what we know: the Pfizer and Moderna vaccines are associated with a higher risk of developing myocarditis (heart inflammation), especially in younger males (possibly due to the spike protein generated by the vaccine circulating in the blood), and other serious adverse events such as blood clots. This is confirmed by a number of studies (see, for example, here, here, here, here, and here) and even by the CDC’s own data. There is quite a lot of variability between the studies, but they appear to suggest that, with young people, the risk from the vaccine may well outweigh the risk from Covid or from post-Covid myocarditis.

That said, proving a connection between vaccine-related harms and the disproportionately high number of young people dying at the moment is not straightforward. However, a number of studies — such as a recent analysis by Martin Neil, professor of computer science and statistics at Queen Mary University in London, and Norman Fenton, a mathematician and leading expert on risk assessment and statistics — do show a statistically significant correlation between vaccination rates and excess mortality.

To what extent this correlation actually implies causation does, of course, remain unclear. But just as lockdowns are clearly a factor, it seems unwise to rule out the vaccines as a contributing factor without proper investigation — the point is that we simply don’t know, as we don’t have enough data to establish or disprove a link. Ultimately, the causes of the excess deaths are probably varied, and involve a combination of factors. This shouldn’t be surprising, since lockdowns and vaccines were always connected in the pandemic response. But we shall never know for sure if we don’t start asking these uncomfortable questions — especially when our politicians and public-health experts seem reluctant to do so themselves.

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Thomas Fazi is an UnHerd columnist and translator. His latest book is The Covid Consensus, co-authored with Toby Green.

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