UK ambulances
© ANDY RAIN/EPA-EFE/REX/ShutterstockEver since the Covid pandemic, excess deaths have fluctuated wildly month on month, tumbling well below the five-year average or spiking far above it.
Tens of thousands more Brits were dying than expected and experts aren't quite sure why that is.

From May to December last year, there were 32,441 excess deaths in England and Wales, excluding deaths from Covid.

Excess deaths are defined as the number of people who died above the five-year average - worked out excluding 2020 due to how Covid spiked death figures that year.

This means that over 32,000 Brits would've been expected to be alive, but died according to Office for National Statistics (ONS) figures across this period.

These shocking figures raised a number of important questions about what is happening to the country's populations, how it's changing, and why so many more people are dying.

Professor David Coleman, Emeritus Professor of Demography at Oxford University, told the Mirror that no one knew for certain what had caused so many deaths throughout last year.

He pointed out that, post Covid, the UK's population had been changed through the deaths of a significant proportion of elderly due to the virus.

He explained: "Once those poor people have been packed off, the remaining population should be healthier, there should be a period afterwards where deaths are lower than usual but that hasn't happened."

But he highlighted two key reasons that could contribute towards spiking excess deaths, the fact Britain's getting older, and gaining a larger average body-mass index.

"The population is getting older, and also the population in Britain is the fattest in Europe and rather vulnerable to diseases notably heart disease and diabetes; some people have been forecasting separately from Covid that death rates would continue to get worse because the country is so unhealthy," he said.

One of the noted causes behind a number of the excess deaths were ischaemic heart diseases - which would track with the professor's warnings of a fatter population.

Comment: It would track with other things too...

Similarly, when looking at the leading cause of death across much of 2022, it's dementia and Alzheimers - further supporting theories of an increasingly greying, and dying, population.

Dementia and Alzheimers often aren't the leading cause of excess deaths, when that data is available, according to ONS figures, it's often pneumonia and influenza during the winter or symptoms, signs and ill-defined conditions in other parts of the year.

"If you look at the detail and the reasons on death certificates, it's a bit unsatisfactory as symptoms, signs and ill-defined is one of the biggest components of these excess deaths and that's something associated with old age really," Professor Coleman told the Mirror.

This then brings up another problem, in that a lot of Brits are dying, but not necessarily of a specific cause.

Comment: We beg to differ, at least in part...

So whilst a heavily ageing population may be throwing up yet another problem, it doesn't quite explain why over 30,000 more people than usual died from May to December last year.

For March and February of this year, symptoms, signs and ill-defined is the leading cause of excess deaths, before that in January it was influenza and pneumonia.

And throughout the year, other causes emerge dramatically as the leading cause of excess deaths.

Heat in particular persistently returns during the summer, and given climate change will only continue to pose such a fatal threat.

Comment: Wrong again, with average temperatures generally being lower in many places...

On the country's hottest days there is inevitably a spike in excess deaths as thousands succumb to it.

As previously mentioned, excess deaths are measured against the five-year average of deaths - going from 2016-19, and 2021.

But this has been criticised because it fails to take into account population changes of age, size, and more, in that time.

In short, the population in 2016, is different to that of 2023, and Professor Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, is one of a number who have pointed this out.

Using age-standardised mortality rates (ASMR) does account for these changes, and when used goes some of the way to perhaps explaining the huge numbers of deaths.

It offers the percentage for which a specified time period is above or below the five-year average.

For December 2022, the number of excess deaths, 5,900, is 13.5 per cent above the five-year average.

But the ASMR is only 5.8 per cent above the five-year average - this explains that perhaps some of the tens of thousands of deaths should've been more expected, but still doesn't quite explain why they happened in the first place.

When you look across 2022, the ASMR usually gives a lower percentage than the percentage of straight excess deaths, but not far enough to eliminate the deaths or explain them away entirely.

However, ASMR has its own issues, as Professor McConway pointed out.

He said: "To calculate the ASMRs, you need to know the population size in each age group.