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Rise in elderly deaths blamed on flu and cold weather

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The national public health oversight body has said excess deaths during winter 2012-13 “would seem to be” due to “a combination of circulating influenza and cold weather”, LGC’s sister title Health Service Journal reports.

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Public Health England published the conclusions alongside a letter explaining its decision to halt production of a regular series of deaths analyses which was leaked to HSJ, drawing attention to higher than expected mortality among older people since the start of 2012.

The letter said there were “potential methodological weaknesses” with the deaths analyses, and they did not add anything to work “already being carried out elsewhere in PHE”.

The public health body’s new report,Excess winter mortality 2012-13, concludes that “2012-13 has seen the largest excess all-cause mortality in England since 2008-09” and that this was “predominantly in the elderly and in deaths coded as resulting from respiratory causes”.

It adds: “Excess mortality in 2012-13 coincided with influenza, RSV [respiratory virus] and cold weather, with an unusually prolonged influenza season and late cold period reported.”

The report focuses on deaths during winter and employs a different methodology and interpretation of statistics than was used in the leaked deaths analyses, which were produced by one of PHE’s regional analysis teams.

One of those analyses had said there was “rapidly increasing mortality for both males and females [over 75], presenting throughout 2012, and continuing into 2013”.

HSJ’s revelation of the findings sparked debate about their causes and prompted the Labour party to call for an “urgent investigation”. Experts have variously suggested weather, viruses, or to cuts to support services as possible reasons for the rise in deaths.

An email sent by one PHE regional analyst in July said “possible links to current [accident and emergency] pressures and reductions in access to adult social care” were “undoubtedly worth further investigation”, but added it was “premature to suggest that they are supported in the data”.

PHE stopped production of the deaths reports shortly after their findings were revealed by HSJ.

A letter from PHE chief knowledge officer Professor John Newton was circulated last week. It said PHE had reviewed the regional reports and decided “it was clear that there were potential methodological weaknesses” and that “the scope of the analysis did not add anything to that already being carried out elsewhere in PHE… The analyst was therefore asked to stop circulating the reports.”

However, it added that PHE would in future publish a new series of weekly mortality reports, extracted from the reports it currently publishes on influenza.

The letter said it had “decided to publish the mortality data [reports] separately from the [existing] flu reports in the future so they more readily accessible to a wider audience”.

The letter continued: “There have been more deaths than expected but the explanation would seem to be a combination of circulating influenza and cold weather.

“Many of these deaths are preventable and these data illustrate the need to work harder to protect vulnerable people from both flu and extremes of weather. The number of excess deaths this year is greater than in the past two years but is by no means exceptional when compared to the last 12 years.”

 

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