Monday 15 March 2021

Excess Deaths, Grievable Death

Detail from Bruegel's The Triumph of Death

Excess deaths is a key figure which has been used over the past year as part of the government strategy to manage the Pandemic. The term "excess" implies something about the character of these deaths; that they should not have taken place; that they were avoidable. This is the tone in which the UK media has consistently used the term, encouraging shock and dismay, and emphasising the continual - indeed likely permanent - need to comply with biosecurity restrictions to avoid more unnecessary, excess deaths. In reality excess deaths is a purely statistical abstraction, devoid of explanatory content. The figure is the total number of recorded deaths above the previous five year average.

Accordingly the current estimates for excess deaths in the UK in 2020 (the figures for last year are still provisional according to the ONS) is in the region of 75 to 85 thousand. This will include all those registered as Covid deaths (which as we know has a very low bar) and also those that died prematurely as a result of the pandemic response. The government has not shown any interest in distinguishing between these two groups and so we are encouraged to think of every excess death as caused by Covid. However, Matthew Reed, of the end-of-life care charity Marie Curie noted in January that during the pandemic there had been a "silent crisis" of deaths at home, unrelated to the disease.

In isolation the figure of 75 to 85 thousand sounds appalling, and indeed the propagandistic use of such statistics is grounded on using them in the abstract. The greatest abstraction here is the hidden assumption in the notion of "excess deaths" of an acceptable rate of mortality. This is an illusion since the "excess" here is derived from a rolling five year average and does not contain any normative notion of mortality.  Quite what that mythical figure might be is never discussed. However the ONS data does at least afford us a historical comparison.

The UK Office for National Statistics makes most of its data sets publically available on easy to use Excel spreadsheets, which affords anyone the opportunity to dig into the numbers and find out the recent history of excess deaths and how that figure relates to other key death statistics such as Crude and Age-standardised mortality rate. The first thing that jumps out is that since the 1960s there had been a steady decline in excess deaths in the UK. Indeed since 1980 the figure was rarely above zero. That all changed after the Tories came to power in 2010 and began a decade of austerity which has gutted the public services - most notably those of health and social care - on which the nation's health depends. As a result the total number of excess deaths from 2010 to 2019 according to the ONS is 121,798. In the previous decade it was zero. Given that this number far exceeds even the worst estimates for 2020 could we not argue that the election of a conservative government is at least as great a threat to public heath as SARS-CoV-2? To bring the winter of 2020/21 into similar context the ONS report from 2018 highlights that in the 2017 to 2018 winter period, there were an estimated 50,100 excess winter deaths in England and Wales alone. That figure was the highest recorded since the winter of 1975 to 1976. Where was the declaration of a public health emergency then? Indeed why was it not headline news in 2015 when excess deaths were the highest since the early 60s?


These excess deaths - which apparently were not worthy of massive state intervention or blanket media coverage - were not the result of a virus which until recently we had no treatment, but were the direct result of political decisions. In contrast, in January this year the media - which has never tired of making the analogy with a state of war - loudly exclaimed the highest number of excess deaths since World War 2. Now, remember, excess deaths is the total number of recorded deaths above the previous five year average. With this in mind it's hardly surprising that the transition from a state of relative peace to one of mass slaughter in the five years from 1935 to 1940 would yield such a figure. In fact the crude mortality rate for 1940 was 1457.9 (per 100,000 population), compared to 1016.2 for 2020. This latter figure is lower than the corresponding mortality rate for 2003. And what terrible events were happening in the UK in 2003 to account for such an awful mortality rate? Really, I'd like to know. If we take the more informative Age-standardised mortality rate - which we should given how much more lethal Covid-19 is to the elderly - we find the 2020 rate of 1043.5 is comparable with the figure recorded in 2009 (1033.8). In fairness the media haven't shied away from stating this counterintuitive fact, perhaps hoping for hazy memories of a Gordon Brown governed UK in the grip of the financial crisis; the countless dead going unburied.

None of what I've written here is "disputing" the facts. The numbers are what they are; the political significance, however, cannot be determined from these figures alone. What we can say is that in response to a mortality rate comparable to a decade ago we have abandoned all political and social life and voluntarily subjected ourselves to restrictions that surpass even the most invasive forms of totalitarianism.

In practice we've got used to being managed according to these statistical abstractions, viewing ourselves and our futures as tied to a mass of transmission rates, risk curves, and mortality figures. In doing so we evacuate our lives of all political and ethical significance and instead end up identifying with a purely abstract biological existence, one to which we are expected to sacrifice everything that makes life worth living. It is on account of this logic that Giorgio Agamben has described the cultic practices associated with the religion of science, which he argues has superseded the previous religions of Christianity and capitalism in the West.

Critics would say that such statistics allow us to see the pandemic's real impact. I disagree. What they do is to efface the lives of the countless thousands that make up those deaths, all of whom are lumped into bare facts that we consume daily without any depth of understanding. Rather than encouraging us to identify with the individuals who make up those numbers, we end up treating them as faceless "generic" persons.

This has not been the case with one particular death this month. On a night in early March Sarah Everard was abducted from the Clapham Common area. Her body was recovered from woods in Kent a week later. A serving police officer has been charged with her kidnap and murder. If any death deserves to be treated as excess and avoidable in the fully ethical sense then it is this one. The murder has led to an outpouring of grief and of anger at the levels of gender based violence women are continuing to suffer at the hands of men. If anything, the apparently random nature of the attack has contributed to greater identification with the victim. As one caller to LBC radio said "she could have been any one of us".

On Saturday women and their supporters across the country defied police restrictions to hold vigils for Sarah, coming together in a show of solidarity and to demand an end to the epidemic of gender based violence. The vigil on Clapham Common was attended by several hundred people, diligently obeying social distancing regulations, wearing masks amid the flowers and tributes. The contrast with the way we have been encouraged to react to Covid deaths could not be more stark. Here, instead of abandoning our ethical and political responsibilities, the death of a single person was the catalyst for a spontaneous, politically engaged, and very public show of solidarity. The people who defied Covid regulations (which have effectively banned all forms of protest) did so because they recognised that there was something more important at stake, an ethical/political response to a single death that implicates everyone. 

It was an intensely moving scene, even when predictably the Neanderthals of the Metropolitan Police moved in to break up the vigil. The images of young women being dragged away in handcuffs from a peaceful event organised for the sake of a murdered woman have focussed attention on how pandemic restrictions are normalising the erosion of many rights; and also how that erosion disproportionately affects women, just as the lockdowns have contributed to a spike in domestic violence and domestic servitude. It couldn't be more timely as the government have submitted a bill which if approved would lock-in many of the restrictions on protest which were brought in to manage the pandemic. One can only hope that this Spring will finally bring the belated push back against the biosecurity state.