tern Profile picture
Mar 3 90 tweets 22 min read Read on X
What are people dying from?
How do those causes of death change from year to year?
We have a big database here in England that helps catalogue causes of death. The most recent version is for the year 2024.
This dataset contains official ONS annual mortality data for England, based on registered death certificates and coded using 'ICD-10' codes.
Each death is assigned a single underlying cause, attempting to define, as far as they are able to ascertain, the disease or injury that initiated the chain of events leading directly to death.
The figures therefore represent the best attempt at tracking the primary underlying cause per death, not contributing conditions or multiple cause mentions.
Now, if you look at groups of underlying causes and the proportion that those causes are of all deaths, and you track them from year to year... you shouldn't get huge changes in trends.
Think about it.
There are half a million deaths or so a year here.

You'd have to have quite a significant change in circumstances to produce huge changes over a couple of year...
Let's take the example of intestinal infectious diseases.

You're tracking them from year to year.
And you watch the proportion of all deaths that are deaths from intestinal infectious diseases dropping and dropping...

Joy! Image
Until something comes along, and changes everything.

Covid infections shred your ability to fight intestinal infectious diseases. Image
The next funeral I'm taking is someone with this cause on his death certificate.

So I have a strong suspicion that the chart is going to keep climbing in 2025 and 2026.
Now there are lots of ways that this data could be presented.
You could present the total number of deaths, but as the population changes, then it's hard to know if the rise is just to do with how many people there are.
And you could present the deaths as a simple 'mortality rate' - dividing the number of the deaths by the number of people.
But that doesn't take into account the ways in which the age of a population changes or trends in total numbers of deaths.
Presenting deaths from one cause as a proportion of the total deaths also has some of those problems, but it gives a glimpse of the *changing* reasons why people are dying.

Covid infections make you more vulnerable to death from secondary infections, especially in the gut. Image
And, yes, you can say to me 'but that's only one out of every 330 deaths'.

Well, you can dismiss anything if you try hard enough, can't you?

Can't you just look at the graph and acknowledge something has changed?
Besides, this one is a bigger chunk of the pie.

Are you ready for the reveal? Image
Covid infections make you vulnerable to death from bacterial diseases.

It's that simple. Image
Do Covid infections make you vulnerable to death from other viral diseases? Image
Yes.
I mean, we already know this from the simple science.
But there it is in the data, plain as the nose on your face.

Covid infections make you vulnerable to other viral diseases.

And this is *death from other viral diseases*. Image
It gets boring doing the reveals.

Here's deaths from other infectious diseases as a proportion of all deaths. Image
There are some other very significant *bumps* in the data.
This one interests me, because I have long thought that Covid infections make you more vulnerable to the harmful effects of narcotics.

This is *deaths due to mental and behavioural disorders due to psychoactive substance abuse* as a share of all deaths. Image
Bobbling along and then... Image
...JUMP

Deaths from other diseases of upper respiratory tract as a proportion of all deaths. Image
Deaths from suppurative and necrotic conditions of the lower respiratory tract as a share of all deaths.

Not a great way to go.

But more people are choosing it now.
😢 Image
Bobble, bobble, bobble, JUMP.

Deaths from diseases of the appendix as a share of all deaths. Image
Deaths where the underlying cause was hernia as a proportion of all deaths.

Yes, Covid infections make this more likely. Image
Twitter's search function is screwed, so I can't find it, but I wrote a whole thread on hernias. 🙁
Covid infections do a real number on your digestive system.

Covid badly affects the membranes of your body, and your digestive system is one massive membrane.

Deaths from diseases of the digestive system as a proportion of all deaths: Image
LOOK HOW LEVEL THAT WAS BEFORE AND LOOK WHERE IT IS NOW. Image
The increase in treatments for bullous disorders is reflected in the changing proportion of deaths that are from bullous disorders.
Image
This one makes my heart sink. Image
Covid infections cause falls.

Falls now are the principle underlying cause of nearly one in 60 deaths.

Why?

Because covid infections cause falls.
Image
And you might say to yourself "this tern is nuts, how can covid infections cause drowning??"

I've been trying to explain it for years.

That trend is heartbreaking.

Image
Here's an interesting one... people dying from previous causes of harm, so they could have had an earlier accident, or assault, or self-harm event... and then they die from it later.

Which makes absolute sense, because Covid infections make you more vulnerable to *existing problems*.Image
The database on Nomis is huge. You can dive down into an almost obscene level of detail. nomisweb.co.uk
This is a closer level of detail, but it's still not the closest: Image
And it can also be interrogated by *age*.

Not many kids die, so the numbers jump around a lot, but things like this should be a huge red flag.
⛳️ Image
And then some details like this...

Cerebral infarctions going from being the cause of fewer than 1 in 200 deaths, to causing *more than 1 in 100*. Image
This gif again.
I had to go and check the data on this one. It felt too on the nose, almost like the computer was taunting me.
These were deaths in *under ones*.

🚨"DISEASES OF CAPILLARIES" Image
🧐 Image
🧐 Image
This one. Image
🧐 Image
🚨 Image
🤔 Image
🚨🧐 Image
Here's an interesting one.

Death certificates without a cause yet, because the inquest has been adjourned... Image
... But these are massively more likely to be among *teenagers*.

So nearly 6-7% of teenagers deaths are not getting included in each year's cause of death statistics.

👀 Image
Among young adults. Image
Some more among young adults. Image
Image
👀 Image
Problems caused by Covid infections so often fall into the 'other' categories or the 'not elsewhere classified'. Image
Working age. Image
Image
Image
Image
Some of these diseases don't play well together. Image
They really don't. Image
This is one to watch. Image
And we know this is a chicken and egg situation, right?

Covid infection makes you vulnerable to obesity, and obesity makes you vulnerable to the effects of covid infections. Image
Lipos and lipids and proteins and metabolisms... covid loves messing with this stuff. Image
Like I said... they stick a lot of covid effects in the 'other' sections. Image
Covid infections harm your liver and your brain.

So you get this.

These are *deaths* from this cause, not just cases. Image
Worth watching very closely. Image
There are some nasty conditions in here: Image
And here: Image
Hmm... this is in working age remember.

Very low numbers, but it's a sign of a lot more than just this problem. Image
Deaths from cerebral palsy.

Whole new level. Image
This is a tiny number of people... but they don't normally make coding errors with death certificates, it's a serious business.

But death from conjuctivitis.

👀 Image
😬

I mean I know that you've heard about people with problems with multiple valves, but this increase in the proportion of deaths that are caused by their failure... that's quite something. Image
No, I don't know how you die from this either, but I don't want to. Image
Back to this one.

Fark. Image
The next one though...
👀😬🚨 Image
This one does not surprise me in the least.

Covid infections love to screw up those boundaries in the body, membranes, surfaces, interfaces... Image
😔 Image
Working age men dying as a result of inflammation of their genitals. Image
💔 Image
💔 Image
One thing people might forget is that a lot of people who try to self harm survive.

But if your body is more vulnerable because you've had Covid, you may be *less likely to survive self harm*. Image
Older folk are definitely getting hit much harder by sepsis.
This is made so much more likely by covid infections. Image
And bacterial infections in general. Image
Those 'other and unspecified' doing a lot of heavy lifting again. Image
Iron problems.

You know they can kill you, right?

You know that Covid infections cause them, right? Image
Round and round on that cycle again. Image
💔, literally. Image
💔, unspecified. Image
I am fed up of this. Image
This one should be labelled public health failure. Image
Oops... I broke my thread, but I don't have the heart to go back and repost them all...

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More from @1goodtern

Apr 2
When you have a chronic health condition, it can be hard to explain to people without a chronic health condition what it means.
You say, "I have muscle pain", and they say, "oh yes, I did the London marathon and all my muscles hurt for two days".
You say, "I can't sleep", and they say, "oh yes, I was out at a concert last night and didn't get home until two. I only had five hours".
Read 17 tweets
Mar 31
Another quick dive into the NHS staff sickness absence data.

This gets nuts pretty fast...
The NHS shares sickness absence data for different groups of staff.

Most of these staff groups include people of every age. Image
For example you can be a nurse from 22 to retirement age.
Read 50 tweets
Mar 28
You may have thought that the chatter out of schools about kids having developmental problems was bad so far…

But this autumn, Reception will welcome kids born in late 2021… whose mothers caught Covid while pregnant… kids who have themselves caught Covid in every wave since.
I work with three nurseries, and, let me tell you, schools and society are in for an even worse jolt than the ones they've had so far.
I know one family where the mum caught Covid when they were trying for a baby, caught it again when they were expecting, and then the baby caught it when they were just four weeks old.

The most obvious developmental problems in that child are neurological.
Read 7 tweets
Mar 26
And did I post this one already for Core Training...

Covid infections cause a reduction in sets of your immune cells that fight infections... and when you keep catching covid that effect keeps getting worse, so you're increasingly prone to being off sick with cold cough flu. Image
There are over 750 of these charts for the different categories... so I'm just going to pull out a very few of the serious ones for the different groups.
There are pregnancy problems in loads of groups, as well as the ones I've already posted.

Imagine being a midwife and *knowing* this is happening to you and your colleagues.

Again, remember that we have every reason to assume this was not rising before covid. Image
Read 36 tweets
Mar 26
I'm in a lull on twitter without much visibility, so probably hardly anyone will see this, but here's an important thread on "why everyone's sick all the time".

No, you are not imagining it.
Sickness is increasing.
Sickness absence rates are increasing. Image
Let's start with this graph.
The monthly sickness absence rates of staff at the NHS.

They have over a million employees, so this is a massive slice of the population of the country. Image
The graph is *rate*, so it's the proportion of staff who are off sick each month.

So it's not rising "because there are more people working for the NHS". Image
Read 61 tweets
Mar 25
One of the subtle but serious problems in science and health communication at the moment is that people are treating Long Covid like a yes/no thing.

Do you have Long Covid? Yes
Do you have Long Covid? No
It's just not that simple.
I mean even if it were that simple, it's still not that simple.
Read 38 tweets

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