Scotland: Flu caused more deaths than Covid last winter

This is the highest number of deaths since the winter of 1989/90, when there were 25,497 deaths, and a year-on-year increase of 11%.

The most common causes of excess winter deaths were dementia or Alzheimer's disease, followed by coronary heart disease, which claimed 610 and 490 extra lives respectively compared to the non-winter period.

READ MORE: NHS preparing for 'significant excess deaths' this winter 

However, influenza was the main underlying cause of for 340 of the additional winter deaths in Scotland compared to 310 for Covid.

The weeks running up to Christmas saw an "extraordinary" surge in influenza to the highest levels in more than a decade as the virus began circulating widely for the first time since 2019, having all but vanished over the previous two winters as a result of Covid restrictions.

By the beginning of January this year, Scotland was recording its highest number of flu deaths in more than 20 years.

Influenza was the 4th most common cause of excess winter deaths last year (Image: NRS)

Frontline NHS staff described how the health service was engulfed in its "worst winter ever" last year as a result of the combination of flu, Covid and other viruses on top of bed and staff shortages, waiting list backlogs, and gridlocked A&E departments which saw record numbers of patients spending over 12 hours in emergency rooms and at times dozens of ambulances queueing up outside hospitals unable to offload patients.

Reacting to the NRS report, Dr Lailah Peel, an emergency medicine doctor and deputy chair of BMA Scotland, said the figures on winter deaths were "not really surprising".

She added: "It was the worst winter ever, with our NHS and social care services broken and struggling throughout.

"What’s really concerning is that little has been done to prevent it being even worse this coming winter."

READ MORE: Overcrowded A&E conditions like 'playing Russian roulette' with patients' lives, warn medics

It is normal for deaths to be higher in winter compared to other times of the year, with elderly people most affected.

NRS calculates winter mortality as the difference between the number of deaths registered between December and March compared to the average for the four-month periods before and after winter - that is, August to November and April to July.

Winter deaths in Scotland were the highest since 1989/90 (Image: NRS)

For people aged 85 and older, winter mortality last year was 29% higher compared to the non-winter periods, and up by 12% in the under-65 population.

Food inflation and the spiralling cost of gas and electricity were predicted to adversely affect people's health last winter, especially among pensioners and poorer households, but the NRS noted that "very few deaths are directly due to cold weather (e.g. hypothermia)".

In each full year since 2019, there have been fewer than 10 deaths in Scotland caused directly by "exposure to extreme natural cold". However, living in cold, damp housing can exacerbate other health conditions.

Over time, winter deaths have generally decreased.

In the 1950s and 1960s, the seasonal increase was around 5,200 extra deaths but this was averaging around 2,800 by the Noughties.

READ MORE: Is Scotland's NHS Covid-ready for winter? Questions over testing and vaccines

However, recent years "suggest a departure from the long-term downward trend in the number of deaths", according to NRS.

While the total number of death recorded in Scotland last winter was the highest in 33 years, excess winter mortality - at 4,137 deaths - was similar to levels seen in 2017/18 and 2020/21, at 4,813 and 4,329 respectively.

Daniel Burns, head of Vital Events Statistics at National Records of Scotland, said this shift "may be partly driven by Scotland’s ageing population".

He added: “Winter months generally see more deaths than other times of the year, however the seasonal increase in winter mortality fluctuates year on year.”

Flu rates last winter (dark green) reached extraordinary levels during December. Current flu rates (red) remain low (Image: PHS)

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said last year's winter death toll was "truly awful", adding: “The extreme increase in fatalities – the highest number in over 30 years – is appalling, and deeply worrying as the NHS is bracing to face what is feared will be the worst winter ever.”

Scottish Labour Health spokesperson Jackie Baillie said “These devastating deaths show the twin crises engulfing Scotland is costing lives.

“Last winter our health and social care system was on the brink of collapse while soaring bills forced people to make impossible choices between heating and eating.

“Both of Scotland’s governments were missing in action during the most deadly winter in 30 years – the SNP and the Tories must both act now to ensure this catastrophe doesn’t repeat itself.”

A spokesman for the Scottish Government said its 10-year dementia strategy and Heart Disease Action Plan are geared to ensuring "timely diagnosis" and improved care for both conditions. 

He added: "We continue to work with our partners, including Public Health Scotland and National Records of Scotland, to understand what is needed at a national and regional level to support local, preventative action to drive improvements in population health."