In the week after the schools went back in England and Wales, an extra 538 people died (77 a day). Over the previous five years, an average of 8720 people had died that week in September, but this year the number surged to 9258. How many more would be dead by Christmas?

The next week there was a lull: only 289 excess deaths. But then the universities returned, and the excess mortality count doubled. In the week ending 25 September, 574 more people had died each day. There was a drop to 319 excess deaths the following week, and then a rise to 678 (97 a day). On and on it went, week after week after week. Almost five thousand excess deaths were recorded between the schools going back and the start of December. The year was 2015 and most people weren’t paying attention. No one read the numbers out.

The rise in mortality in autumn 2015 had little to do with the schools or universities returning. It wasn’t due to the onset of winter. It wasn’t because of a second wave of a new virus. It was business as usual. After five years of swingeing cuts to health and social services, many more people died each day than had in the five previous years – which were themselves not particularly good times, but the depths of recession.

Imagine if in autumn 2015 you had been told how many people were dying each day. Would you have been fearful? Or would you have said to yourself: ‘They are mostly old, or poor; this is all very unfortunate, but I won’t be in that grisly rising aggregate’? It can be hard to imagine what effect the relentless reporting of the excess deaths in autumn 2015 might have had. Imagine now, however, that the figures had been read out all year and you had already heard much higher numbers in January and February, along with front-page stories of the health service falling apart and undertakers running out of mortuary space.

The mortality surge lasted for weeks at the start of 2015. It went up suddenly. In one week in January, as the hospitals became overwhelmed, the number of excess deaths rose from 448 to 4050, then 3721, 3220, 2408, 1719, 1470, not dipping below 1000 until mid-March. It rose again to 1973 in the worst week in April, and to 1290 in the worst week of June. Had every newspaper been reporting the weekly (never mind daily) figures in 2015, we could even have imagined five waves by the autumn. All those earlier figures were far higher than the autumn of 2015; and – so far – the excess deaths for autumn 2015 are far higher than in autumn 2020. The major difference, of course, is that five years ago there was no talk of the numbers soaring exponentially out of control. The pool of potential victims appeared limited, and didn’t include government ministers, newspaper editors, or most of their voters and readers.

The most common listed causes of the excess deaths in 2015 were Alzheimer’s and dementia; but there was no biological reason these diseases should have been killing people earlier than they had before. The most important reasons were neglect, underfunding and the system becoming overwhelmed. For younger adults the causes were described as diseases of despair (drug overdose, suicide, alcoholic liver disease). Influenza played a small part, but in nearby countries it was dealt with by better funded health services and far fewer died.

If we had reported mortality in 2015 as we report it today, would something have been done about a problem that was far easier to fix than a new pandemic? Might the 2015 election have turned out differently? Or would we then, as now, have been paralysed by fear? As it is, we now have not only Covid-19 to deal with, but the continued legacy of austerity, and Brexit to come, not to mention the climate crisis. The long-term solutions, once we have a vaccine, are the same as were needed five years ago. Whether or not we will reach for them is less clear.

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