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Looking back 11 years, not 130.

Today, headlines proclaimed that we have not seen excess mortality in peacetime in Scotland of the scale we witnessed last year since the 1891 influenza outbreak. The analysis is not flawed. The message is powerful. It is excellent that the focus has firmly switched to excess mortality. The problem is however a simple one.

Not many will appreciate from the headlines the relative nature of excess mortality, that we are making comparisons against recent mortality experience and not absolute comparisons. Not for 130 years have we seen a change of this magnitude over the previous 5 years. But the message that some might take away is rather that there is some similarity between the level of mortality in 2020 and that in 1891. That we are seeing numbers of deaths that we haven't seen since the Victorians.

Let us address that comparison directly. When did we last see adult mortality rates at the level that was suffered last year? Looking at data from the ONS in respect of England and Wales, the answer is not that long ago. Thanks to year or year improvements in risk behaviours and medical treatment, even despite the effects of austerity, the answer is 2009 - as the figure below highlights.

This is no way diminishes the terrible magnitude of what happened last year. To lose 11 years of cumulative improvements in a single year is a terrible reversal, and thanks to the vaccinations and improvements in medical treatment, we hope and expect to see mortality improvements in 2021. It is our collective duty to be clear and transparent in our imagery - and to consider carefully what each of us takes away from the headlines. The reality does not need to be hyped. It is bad enough already.

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