Covid: Scotland will see 'long-term impact' of pandemic on non-Covid deaths, experts warn

The impact of the Covid pandemic on excess deaths in Scotland will continue to be felt for a “long time to come”, experts have warned.

Non-Covid deaths were lower than usual up to mid-2021, but from July onwards mortality rates for almost all causes of death, including cancer, circulatory conditions and dementia, were higher than expected, according to Public Health Scotland.

In an evidence session to the Scottish Parliament’s Covid-19 recovery committee, panellists warned delays to screening programmes have led to many non-Covid illnesses being identified at a later stage when they are more difficult to treat.

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Delays are also caused by patients not seeking help early enough, they said, either through a fear of catching Covid or because they do not want to burden the already-stretched NHS.

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Dr Lynda Fenton, public health medicine consultant at Public Health Scotland (PHS), said deaths were consistently above average in the past six months of 2021, rising to more than 20 per cent above average at some points.

“My interpretation is that this is a substantial issue, there’s a range of causes of deaths and age groups affected,” she told MSPs.

“I think we need to recognise that in view of that breadth, there’s likely to be both health service factors and also factors that are related to the determinants of health.”

There is “no debate whatsoever” that people with cancer are being diagnosed later than pre-pandemic, Peter Hastie, policy manager at Macmillan Cancer Support said.

“We know that means more advanced treatments, poorer prognosis and more likelihood of death,” he said.

“The cancer system was not good before the pandemic, and all of the problems that we knew existed have been exacerbated.”

He added: “Clearly the long-term issues on cancer diagnosis being late and poorer prognosis will last for years.”

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Lawrence Cowan, director of communications at the charity Chest Heart & Stroke Scotland, said he was “really worried” by the continued delays in patients coming forward.

He said: “What we're talking about in terms of excess deaths, but also in terms of further complexity of cases and having a greater impact on people’s everyday lives because of seeking medical help later, will have a long-term impact on our health service beyond just a few years.

“This is something that is going to be with us for a long time.”

He echoed Mr Hastie’s view that systems and services must be improved.

“I think it is about making sure that we do things differently to improve service rather than manage pressure,” he said.

“And on service delivery, in terms of stroke in particular, time after time targets have been missed.

“While when you do get to hospital, you get exemplary care, there are real warning signs of pressure in the system that we are incredibly concerned about.”

In a written submission to the committee, PHS said: “The lower than expected number of non-Covid-19 deaths up until summer 2021 reduced the total excess deaths substantially.

“However, from July 2021 onwards, the pattern changed with almost all causes of death being in excess.

“Although Covid-19 deaths continued to represent the largest single cause of excess crude deaths (and respiratory deaths remained similar to the long-term average), ‘other’ causes of death, circulatory deaths, dementia/Alzheimer’s deaths and cancer deaths all were higher than expected.”

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