Leading medical journal the BMJ published a peer-reviewed article last week by John Appleby, Director of Research at the Nuffield Trust, that draws on ONS data to look at the 2020 England and Wales death toll in a historical context.
In terms of absolute number of deaths, 2020 was the worst year since 1838 except for the Spanish Flu year of 1918 (note that overseas deaths including war casualties are not included). However, as a proportion of population, it was only the worst year since 2003. Furthermore, once you take into account the fact that the population is getting older and standardise the figures by age, 2020 was less deadly than 2008 and every year prior to it. Appleby for his part makes no attempt to downplay the pandemic death toll, pointing out that only in four previous years had there been a sharper increase in percentage terms on the previous year and they were all prior to 1941. It was definitely counter to the decreasing trend.
A point he doesn’t make, however, is that the historically low levels of the previous 11 years would have left an unusually large amount of ‘dry tinder’ for any novel virus to burn through. Plus, 2019 had the lowest age-standardised mortality ever, to the extent that if you took an average of 2019 and 2020 then that average was lower than 2015, 2013, 2012 and every year prior to 2011. While it’s fair to note (as Appleby does) that the coronavirus epidemic continued into 2021, with high excess deaths in January and February, it is hard to regard this as an earth-shattering death toll.
The graphs also make clear that previous similar pandemics, such as in 1957 and 1968, made only a modest impact on mortality and only for a year or two, notwithstanding the lack of vaccines or social interventions. There is nothing about this disease to think the long-term pattern should be any different that would justify some kind of radical, permanent change to the way we interact or organise our lives. It’s important to remember that our immune systems develop and maintain resistance to a host of pathogens through being frequently exposed to them and that social isolation, where it is not merely ineffective, can deprive us of the opportunity to keep our immunity topped up.