Place and Underlying Cause of Death During the COVID-19 Pandemic: Retrospective Cohort Study of 3.5 Million Deaths in England and Wales, 2014 to 2020

ObjectiveTo describe the place and cause of death during coronavirus disease 2019 (COVID-19) pandemic to assess its impact on excess mortality.MethodsThis national registry included all adult (aged ?18 years) deaths in England Wales between January 1, 2014, June 30, 2020. Daily COVID-19 were compared against expected daily deaths, estimated with use Farrington surveillance algorithm for historical data 2014 2020 by death.ResultsBetween March 2 2020, there was an mortality 57,860 (a proportional increase 35%) which 50,603 (87%) related. At home, only 14% (2267) 16,190 related COVID-19, 5963 due cancer 2485 cardiac disease, few involved COVID-19. In care homes or hospices, 61% (15,623) 25,611 5539 respiratory most these (4315 deaths) hospital, 16,174 fewer than that did not involve 4088 1398 expected.ConclusionThe has resulted a large poorly characterized likely be result undiagnosed There smaller but important ongoing at particularly from suggesting public avoidance hospital non–COVID-19 conditions.