Rhun ap Iorwerth, Plaid Cymru Member of Senedd for Ynys Môn and Plaid Cymru Shadow Health Minister
The world is in the grip of a brand new virus, and even before it was declared a global pandemic, anyone who could, started to take measurements. Data is king, after all.
As the infection spread around the globe, the demand increased for knowledge on testing volumes, infection levels, and ultimately, death rates. But, when some death rates published only include cases where there’s been a positive Covid-19 test, have you ever stopped to consider if we really know the true cost of the pandemic to Wales?
The overall impression of the response to the pandemic in Wales is a pretty positive one. Welsh Government wants you to think so, clearly. Ministers have cited that good public adherence to lockdown rules can be taken as approval for their cautious approach.
Indeed, this was backed up in a recent Welsh Barometer opinion poll, which saw public confidence in the government rise from 29% in March to 62% in June in response to the question ‘COVID-19: Is Welsh Government handling the crisis well?’
Welsh Government itself has publicised the fact it has seen “fewer deaths in Wales than in the UK as a whole… and fewer than most parts of England.” No matter what your stance is on testing strategy, when it comes to death rates, the consensus is clear – the lower your death rate, the better your response to the pandemic. (Unless you’re Donald Trump, who chooses less robust data analysis!)
Not surprisingly, in the same Welsh Barometer poll, by contrast to their increased confidence in the Welsh Government, we find that the public lost confidence in the UK Government.
This contrast with the rest of the UK is a crucial point. Before we put Wales on too high a pedestal, just because statistics for England are worse, it’s important to understand how all four nations of the UK fared against the rest of the world. If it’s just that we’re standing next to a bad example, perhaps it’s not so hard to look good?
I’ve already mentioned that some classifications need a positive test for the death to be included. Public Health Wales (PHW), for example, only counts deaths where COVID-19 was confirmed with a positive laboratory test. As of Thursday 6 August, PHW reported 1,571 deaths from COVID-19 in Wales.
But what about the people who have died from coronavirus without ever getting a test? The Office for National Statistics (ONS) include cases where COVID-19 was the underlying cause or was mentioned on the death certificate as a contributory factor. As at 24 July, ONS reported 2,504 deaths from COVID-19 in Wales.
Yet coronavirus can cause death indirectly – what about when operations are cancelled as hospitals deal with the pandemic, or illnesses go undiagnosed for months while GP services are interrupted? Or, more simply, when coronavirus is the cause, but it isn’t mentioned on the death certificate?
This is where a measurement known as ‘excess deaths’ comes in – or, to use World Health Organization terminology – excess mortality. This describes the number of deaths above what would be expected in normal times, and can show the true human cost of the pandemic. It gives us a greater understanding of how deadly the impact of the virus has been on a country, even where the extent of testing has been generally low – as is the case in Wales.
ONS recently published a comparison between 29 European countries. For the first time, we had a clear view just how good Wales’ response to the pandemic has been compared to our European neighbours. And it wasn’t good news.
When these 29 European countries are ranked by excess death rate, England had the highest levels of excess deaths, with Wales in fifth place.
Suddenly, we call into question the Welsh Government’s cautious approach – was it cautious enough? According to this measure, the answer is “no”. By this measure, 24 other countries in Europe did better. Only England, Spain, Scotland and Belgium had higher excess deaths.
What also stands out is that 3 of the 4 UK nations are included in the “top 5.” Wales looked good when we only compared ourselves with England, but compare ourselves to the rest of Europe and it’s a different picture.
Plaid Cymru has previously said that Wales should have listened to the world rather than Westminster. When the World Health Organization called for “test, test, test”, Welsh Government followed Westminster’s lead in scrapping community testing.
The Welsh Government’s blind commitment to the four-nation approach at the start delayed an early lockdown, resulted in Wales being cheated out of crucial Covid-19 testing kits, and even affected our ability to get PPE for care homes.
Back in June, a report by Dr Camilla Ducker, GP and World Health Organisation Consultant questioned whether an earlier divergence from the four-nation approach would have been in the best interest of the Welsh population and suggested that “could have in fact, saved many lives”.
The recent ONS excess deaths rates suggest that the Welsh Government’s reluctance to choose its own advice, to follow its own strategy early on, has indeed cost lives.