Excess Deaths Inuk Research Gate
Excess Deaths Inuk Research Gate
Excess Deaths Inuk Research Gate
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Excess Deaths in the United Kingdom: Midazolam and Euthanasia in the COVID-
19 Pandemic
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Wilson Sy1
Abstract
Macro-data during the COVID-19 pandemic in the United Kingdom (UK) are shown to have
significant data anomalies and inconsistencies with existing explanations. This paper shows
that the UK spike in deaths, wrongly attributed to COVID-19 in April 2020, was not due to
SARS-CoV-2 virus, which was largely absent, but was due to the widespread use of
Midazolam injections which were statistically very highly correlated (coefficient over 90
percent) with excess deaths in all regions of England during 2020. Importantly, excess deaths
remained elevated following mass vaccination in 2021, but were statistically uncorrelated to
COVID injections, while remaining significantly correlated to Midazolam injections. The
widespread and persistent use of Midazolam in UK suggests a possible policy of systemic
euthanasia. Unlike Australia, where assessing the statistical impact of COVID injections on
excess deaths is relatively straightforward, UK excess deaths were closely associated with the
use of Midazolam and other medical intervention. The iatrogenic pandemic in the UK was
caused by euthanasia deaths from Midazolam and also, likely caused by COVID injections,
but their relative impacts are difficult to measure from the data, due to causal proximity of
euthanasia. Global investigations of COVID-19 epidemiology, based only on the relative
impacts of COVID disease and vaccination, may be inaccurate, due to the neglect of
significant confounding factors in some countries.
Introduction
In a recent paper [1], it was shown that COVID injections are causally predictive of
Australian excess deaths, suggesting the Australian pandemic is iatrogenic [2]. Believing that
the iatrogenesis by COVID injections may be universally relevant, we studied closely the
case of United Kingdom, because its Office for National Statistics (ONS) is reputed to have
some of the most accurate and detailed statistics on the COVID-19 pandemic in UK.
Obviously, comparing the statistics of the “vaccinated” versus “unvaccinated” is the most
straightforward method to assess the risks and benefits of vaccination, but only if the data
1
10 January 2024, PhD, Director, Investment Analytics Research.
Page 1 of 30
were accurate, being free from data entry errors. Many data errors originated from the flawed
PCR test, which does not detect presence of the SARS-CoV-2 virus [3, 4]. The extensive
analysis [5] of detailed ONS statistics based on vaccination status and their relationships with
COVID cases and mortality has shown inconsistencies, which appear to have originated from
flawed definitions of vaccination status and erroneous data entry.
This aspect of ONS data corruption appears universal, as it also occurs with Australian data
[6] which have originated from the flawed data entry and reporting convention [7] from the
Centers for Disease Control and Prevention (CDC), which may have recorded status lagging
actual status by at least 14 days. Essentially, the death of a recently injected person may not
be recorded in the database of deaths of the “vaccinated” [8]. This simple omission makes
comparison of deaths by vaccination status a data misdirection inflating “unvaccinated”
deaths which are calculated by subtracting “vaccinated” deaths from all deaths of the
population [9].
Despite advances in modern information technology, the accuracy of data collection has not
advanced in the United Kingdom for over 150 years, because the same problems of erroneous
data entry found then are still found now in the COVID pandemic, not only in the UK but all
over the world. We have independently discovered [6] the same UK data problem and
solution for assessing COVID-19 vaccination as Alfred Russel Wallace [10] had 150 years
ago in investigating the consequences of Vaccination Acts starting in 1840 on smallpox:
“Having thus cleared away the mass of doubtful or erroneous statistics depending on
comparisons of the vaccinated and unvaccinated in limited areas or selected groups
of patients, we turn to the only really important evidence, those ‘masses of national
experience’...”
Emphasis added. The entry of incorrect data for vaccination status, over 150 years ago as now
[10], cannot be solved by technology, but by better data management. Just as did Alfred
Wallace, an eminent peer and friend of Charles Darwin, the method we have used (the
“Wallace Method”) to overcome the lack of accurate detailed vaccination data is to use
accurate macro-data such as all-cause mortality (‘masses of national experience’) and doses
of COVID injection, to perform detailed statistical analysis to draw broad and robust
epidemiological conclusions.
This paper follows the Wallace Method by examining the “masses of national experience” of
the pandemic which are the all-cause and excess mortality data over time and across the
regions of England.
Many published statistical findings, based on data misdirection, are internally inconsistent
and are contradicted by macro-data of the Wallace Method, as shown here for UK. These
factual contradictions show up as data anomalies, which are mortality data facts which cannot
be explained by data misdirection. Two main data anomalies in April 2020 and January 2021
are discussed in detail below in successive sections.
Another important data anomaly is the absence, since 2021, of any statistically significant
relationship between vaccination and mortality, even when mortality data are variously
lagged relative to the vaccination data. Therefore, apparently there is no correlation
statistically, positive or negative, between vaccination and mortality.
Page 2 of 30
This counter-intuitive absence of a relationship between vaccination and excess deaths and
other anomalies are resolved in this paper by showing the existence of a strong confounding
factor, which is a strong positive correlation between Midazolam use and excess mortality
data in England, across all regions throughout the COVID-19 pandemic, particularly before
mass vaccination.
The rest of the paper is devoted to a detailed discussion of the implications of the findings on
how UK health policy has led to the observed outcomes of euthanasia and iatrogenic
geronticide. The UK findings raise strong doubt about many epidemiological findings
worldwide regarding the evidence of positive or negative impact of vaccination on mortality
in the COVID-19 pandemic.
UK Macro-Data
The macro-data include official UK all-cause mortality published by ONS [11]. The data
collated from 2015 to July 2023 are shown in Figure 1.
Figure 1
The green curve with the left-axis, represents monthly raw death counts of all causes for
United Kingdom from 2015 to July 2023, the latest monthly ONS data. Most data analysts
(e.g. Australian Bureau of Statistics), would simply overlay the green curve with the baseline
(as expectation), with seasonal fluctuations, and a one standard deviation band around the
baseline, to show the significance of all-cause mortality outside the expected band (see an
example below). However, seasonal fluctuations make the relative significance of excess
deaths visually harder to discern, obscuring statistical significance.
Page 3 of 30
For greater clarity, seasonal fluctuations are removed by displaying excess deaths directly
where excess mortality is calculated as deviations from the baseline, which is defined by the
pre-pandemic period using 2015-2019 monthly averages. The average baseline UK mortality
is about 44,000 monthly and 532,000 annually. The purpose of the baseline is to serve as a
benchmark for assessing whether pandemic excess deaths since 2020 are statistically
significant.
The red curve with the right axis shows the excess mortality death counts. The average
baseline excess deaths is zero (by definition) and the standard deviation (sigma) is 2,470
monthly. It is now clearly evident that excess deaths in UK are statistically significant for
most periods in the COVID-19 pandemic since the enormous spike in 2020.
Note that the ONS includes 2017-2019 and 2021, but excludes 2020 in its calculation of the
2022 baseline and therefore ONS excess deaths for 2022 differ from ours as will be discussed
below.
Since the pandemic starting in 2020, there have been persistent elevation of excess mortality,
characterized sometimes by sharp spikes. The red curve for monthly excess deaths as
percentage of the baseline shows nevertheless a trend decline from 2020 before vaccination
to after 2021 onwards, suggesting (misleadingly as discussed below) a beneficial effect of
vaccination.
Many studies published in 2022 found negative correlations between excess deaths and mass
vaccination [12], and suggested mitigation effects by the COVID injections. However, these
casual observations of causation are shown below to be another example of Simpson’s
Paradox, where confounding factors were overlooked and the correlations were invalid [12].
Specifically as indicated [13], a common error of those studies comes from data selection
bias, where early studies, with synchronous correlation, occurring only in a selected subset of
the data, implied that vaccinations had immediate beneficial impact on reducing deaths,
which is medically highly unlikely [2], given the vaccinology of how mRNA injections take
significant time to affect the immune system.
The errors of earlier studies [12] can be understood, if those results were placed in the
broader contexts of other epidemiological variables and in hindsight, with fuller sets of
available data. Illustrated here are many anomalies and inconsistencies of UK data which
have led to inferences of erroneous conclusions and to harmful policies.
Page 4 of 30
Figure 2
The left axis shows excess deaths as percentages of the baseline. Note that the huge spike in
April 2020 reached 100 percent of the baseline. Since the monthly standard deviation of
excess deaths as a percentage the 2015-2019 baseline is 5.1 percent (“one sigma”), the huge
spike was a 20-sigma event, shown on the right axis. This event has received relatively little
attention or analysis, as the ONS simply stated as matter of fact, in an early version of its
latest release [14]:
“The months with the highest number of total excess deaths were April 2020 (43,796
excess deaths, a 98.8% increase) and January 2021 (16,546 excess deaths, a 29.2%
increase).”
Doubling normal death rate in April 2020, (“a 98.8% increase”) had received no special
comment by the ONS, and has been removed in recent releases. A sudden surge of 44,000
deaths cannot be explained by population growth or changes in life expectancy. The official
narrative was that the SARS-CoV-2 virus was very deadly to have caused the huge spike in
COVID deaths. This interpretation, which is disputable (see below), justified the declaration
of emergency and all public health measures, including masking, lockdowns, etc.
However, the UK Health Security Agency declared [15] “As of 19 March 2020, COVID-19 is
no longer considered to be an HCID in the UK. There are many diseases which can cause
serious illness which are not classified as HCIDs.” That is, COVID-19 was officially not
considered a high consequence infectious disease (HCID) – no pandemic. This declaration
was in stark contradiction to 44,000 excess deaths, mostly attributed to COVID-19, which
represented a doubling of all-cause mortality in April 2020. As confirmed by empirical data
below, the UK Health Security Agency was correct: there was no pandemic caused by a
HCID.
Page 5 of 30
If this interpretation of the huge spike being due to the COVID virus were really correct
(shown not to be correct below) then it is obvious apparently from Figure 2, that COVID
injections may have saved lives, because with mass vaccination since 2021 the rates of excess
deaths have decreased systematically, as Table 1 confirms – vaccination was associated
apparently, but misleadingly, with fewer excess deaths over time.
All numbers in this paper are expressed, at most, to three significant figures for ease of
reading. On an annual basis, Table 1 shows that both all-cause mortality and excess mortality
have consistently declined (columns 2 to 4) from 2020 to 2022. From this perspective,
COVID vaccinations in the years 2021 and 2022, with 54,000 and 45,000 excess deaths
respectively, would have been interpreted erroneously as effective in reducing excess deaths
of 76,000 in 2020.
The apparent effectiveness was even more pronounced in 2022, if the baseline were
calculated using the method used by ONS (see column 5), where one sigma deviation in 2022
was hardly statistically significant for UK excess deaths. This evidence of “vaccine
effectiveness” was illusory, as shown below, due to incorrect attribution of the 2020 death
spike.
Like the Australian Bureau of Statistics (ABS), the Office for National Statistics (ONS) also
excluded 2020 in its calculation of the 2022 baseline, but for diametrically opposite reasons.
For Australia [16], 2020 was a low mortality year, exclusion of which leads to higher baseline
and lower calculated excess mortality. On the other hand for UK, 2020 was a high mortality
year, exclusion of which leads to lower baseline and higher calculated excess mortality.
Had 2020 been included in the 2022 calculation, the UK baseline would have been raised by
about 19,000 and 2022 excess mortality would have dropped correspondingly even further,
astonishingly giving about three percent excess deaths above baseline. This represents a
“normalization” of the pandemic, so that excess deaths no longer provide any statistical
signal. This “too good to be true” statistic would be unbelievable and may attract undesirable
criticism to its methodology.
By the UK officially assigning the April 2020 death spike to mostly COVID deaths, the role
of other causes of excess deaths have been substantially reduced [14]:
“When deaths due to COVID-19 were subtracted from the analysis, April 2020
remained the month with the highest number of excess deaths (14,361 excess deaths, a
32.4% increase on the five-year average for deaths due to all causes).”
Page 6 of 30
However, this questionable assignment of 67.6 percent of the deaths to COVID in
March/April 2020 is inconsistent with the number of COVID cases in that period, as shown
in Figure 3.
Figure 3
Figure 3 shows inconsistent correlation between COVID cases (green line) and COVID
deaths (red line), except for early 2021 when mass “vaccination” was first rolled out. The
most glaring anomaly is in early 2020 when relatively few cases led to a disproportionate
number of COVID deaths, such that the infection fatality rate (or more accurately case
fatality rate) was very high at 24.3 percent, when the data are taken on their face values.
On 11 March 2020, the World Health Organization (WHO) declared the global pandemic
based on 4,291 deaths worldwide. In April 2020, the UK data showed 35,000 new COVID
deaths which represent an extraordinary increase in a very short time, particularly when there
were only 139,000 new COVID cases in April 2020, moreover, the UK cumulative total cases
did not exceed 500,000 (less than one percent of the population) until after September that
year.
While there were suggestions that UK may have had a shortage of PCR tests available early
in the pandemic which may explain the relatively small number of COVID cases, but this
explanation does not resolve the inconsistency. If there were a shortage of tests, then the
registration of the large number of COVID deaths could not have been verified by PCR tests
and therefore they were arbitrarily assigned.
Given the data of Figure 3, the UK case fatality rate (CFR) of SARS-CoV-2 would have been
an extreme 24.3 percent, compared to later CFR from the Omicron variant of 0.18 percent.
The high fatality rate was inconsistent with published research findings [17] that early in the
pandemic the “new coronavirus SARS-CoV-2 is less deadly but far more transmissible than
MERS-CoV or SARS-CoV.”
Page 7 of 30
The enormous April 2020 spike in UK excess deaths may have required fewer cases of
infection to cause the deaths if transmission were localized to limited numbers of regions;
otherwise unbelievably fast spreading across a wide geographic area was needed. The data on
excess deaths show the spikes in excess deaths occurred simultaneously across a wide area in
all major regions of the UK, as Table 2 shows.
Note that UK statistics are mostly represented by those in England (and Wales), which is
sometimes loosely referred, in the following discussions, as UK. The seven regions in Table 2
are geographically identified in Figure 4, where they are amalgamated into four major
regions.
Figure 4: UK Regions of ONS Data
Unsurprisingly, the small area of London had one of the highest excess deaths, less expected
is the near tripling (3X) of all-cause mortality compared to the baseline with 194 percent
excess deaths. All other regions also had very high excess deaths, the South West region
having the lowest 61 percent excess deaths, which is still highly statistically significant.
If COVID-19 were the commonly accepted explanation for the April 2020 data, then the wide
geographical spread of high excess deaths in all regions within a very short period would
Page 8 of 30
require the SARS-CoV-2 virus to be transmitted very rapidly and be very lethal at the same
time, which is biologically unlikely. The data anomaly contradicts the COVID-19 hypothesis
and the unfounded popular belief that most elderly who died early were evidence that the
elderly were particularly vulnerable to COVID-19, which was unlikely, not being prevalent.
In conclusion, the UK data anomaly of April 2020, where the data on COVID cases and
deaths are inconsistent, most likely indicated that the huge spike in death may not have been
due to SARS-CoV-2 virus. This possible misattribution to COVID-19 was confirmed by the
UK Health Security Agency [15], mentioned earlier, which declared that as of 19 March
2020, COVID-19 was not a “high consequence infectious disease”. Therefore, this data
anomaly leaves the huge spike in the non-COVID excess deaths yet to be explained, before
mass vaccination or any other factors were available, as discussed below.
Emphasis added. That is, during the smallpox epidemic of the second half of the 19th century,
the justification of compulsory smallpox vaccination in UK was due to the same type of data
flaw of confusing vaccinated with unvaccinated as in 2020. The likely confusion also
between COVID deaths and non-COVID excess deaths [11,14] in January 2021 is evident in
Figure 5.
Figure 5
Page 9 of 30
With 2020 COVID data, paraphrasing Alfred Wallace’s observations for smallpox data in UK
150 years ago [10], we observe for the UK pandemic in January 2021: …a greatly increased
fatality in the COVID deaths so exactly balanced by an alleged greatly diminished fatality in
non-COVID deaths is not explicable…
The words in bold were substituted in the above quote of Alfred Wallace [10]. Why was there
a spike in COVID deaths and a compensating plunge in the non-COVID deaths? The spike in
COVID deaths in January 2021 was slightly higher than that of April 2020, but was
incongruous with total excess deaths which were substantially lower in January 2021
compared to the first spike in April 2020. This meant that for the numbers to tally, non-
COVID deaths had to plunge deeply below expectation, which is inexplicable.
In January 2021, new COVID cases were still relatively too subdued to explain the spike in
COVID deaths and there was no apparent reason for the plunge in non-COVID deaths. The
data were apparently not explicable, suggesting errors in recording COVID deaths, which are
clear evidence confirming the unreliability of COVID data generally [5, 6].
To analyze the data confusion between COVID deaths and non-COVID deaths, we
summarize the data in Figure 4 with Table 3.
Evidently (columns 2 and 4), both COVID-19 deaths and total excess deaths have been
falling annually from 2020 to 2022, but non-COVID deaths have been rising generally,
except for 2021 due to the strange anomaly in January 2021, when the 26,800 plunge in non-
COVID excess deaths (see the yellow cell in the third column) was inexplicable. The spike in
claimed COVID deaths, as high as that in April 2020, would have conveniently persuaded the
public to accept vaccination, just as it was being rolled out in January 2021.
By now, it should be well-known that data on COVID cases and deaths are unreliable,
because they are based on flawed PCR tests which do not reliably detect the presence of the
SARS-CoV-2 virus and often produced false positives. This fundamental flaw facilitated the
inconsistent attribution of COVID cases and deaths.
In conclusion, in 2020 and early 2021, spikes in UK COVID deaths were likely
misclassification of non-COVID deaths, which begs the question: what caused the surges in
non-COVID deaths early in the pandemic? If the beginning of the UK pandemic was not
largely related to the SARS-CoV-2 virus, what was it related to?
Page 10 of 30
Vaccination and Excess Deaths
Before addressing the enigma of excess deaths in 2020, consider the Australian explanation in
vaccination causality [1. 2]. It was predicted that mass vaccination reaching population herd
immunity would end the UK pandemic, but this did not happen. Instead, COVID deaths and
non-COVID excess deaths remained elevated.
In Australia, the excess deaths since 2021 were shown likely to have been caused by COVID
injections, where deaths followed consistently and predictably after injections five-month
later [1, 2]. On average, normally it takes some time in a multistage process for the injections
to cause the generation of antibodies in response to antigenic cellular production of toxic
spike proteins which are potentially pathogenic, possibly causing death. The corresponding
relationship of COVID injections and five-month lagged excess deaths for UK data is shown
in Figure 6.
Figure 6
There were clear positive correlations in selected periods (e.g. first half of 2022), but the
whole dataset, without selection bias, shows a negative correlation of -12 percent, but the
relationship is not statistically significant with a p-value of 0.587. Therefore, the causal
relationship observed in Australia, of COVID injections being sources of harm, cannot be
similarly established for UK. On the other hand, these data also show no indication that
vaccination had any beneficial effects on UK excess deaths.
Further statistical investigation of the correlation spectrum, with different leads and lags of
the two time-series, produced no significant relations, suggesting no detectable causality.
Therefore, statistically, the unclear impact of COVID injections on UK excess deaths remains
a puzzle, and the whole UK pandemic has remained a statistical mystery.
Used orally, Midazolam is not normally lethal to healthy people. However, given
intravenously in large doses continuously, often with opioids, to the elderly with
comorbidities, particularly those who are terminally ill, it could be lethal. According to the
US National Library of Medicine [23]: “Midazolam injection may cause serious or life-
threatening breathing problems such as shallow, slowed, or temporarily stopped breathing
that may lead to permanent brain injury or death.” Midazolam is used in US executions.
From an observational study [24] in a French hospital, 60 mg could cause death in 24 hours
and at that rate few survive more than five days, and in that hospital only one third of the 54
palliative sedations had patient consent, suggesting both voluntary and nonvoluntary
euthanasia which will be discussed below.
The possible widespread use of Midazolam in the pandemic was suggested early by
anecdotes of UK funeral directors [18] and more recently by statistical observations [19].
Indeed, the Bennett Institute for Applied Data Science publishes a raw English Prescribing
Dataset [20], which includes, by English regions (as shown in Table 2 above), prescriptions
of Midazolam 10mg/2ml solution for injection ampoules, as shown in Figure 7.
Figure 7
As noted in several blog posts on the internet [19], doses of Midazolam injections show
visually remarkable correlation with excess deaths for UK. In Figure 8, excess deaths for
Page 12 of 30
various regions in England have been calculated individually and attempted colour matched
to Figure 7.
Figure 8
Visually, Figures 7 and 8 suggest a high correlation between Midazolam injections and excess
deaths across all regions in England. Figure 8 also shows similar regional numerical
distribution of excess deaths, particularly in April 2020, as though by deliberate allocation.
Midazolam Correlation
Aggregating over English regions, the time series relationship between Midazolam injections
and excess deaths in England is shown in Figure 9.
Figure 9
Page 13 of 30
Clearly, Midazolam injections and excess deaths in England are highly correlated, but not
synchronously, because medication generally does not have instantaneous impact and also
reporting of dosages used and registration of deaths may lag. Shifting the time series for
Midazolam injections one-month forward, very high correlation is seen in Figure 10.
Figure 10
The very high correlation (coefficient 91 percent) between excess deaths lagged one month
after Midazolam injections is largely due to the first two enormous spikes to early 2021.
From April 2021 onwards to May 2023, the same correlation dropped to 59 percent, but still
statistically significant with p-value at 0.0007. The misclassification of COVID deaths,
possibly deliberate, also led to their high correlation with Midazolam injections as seen
Figure 11.
Figure 11
Page 14 of 30
The high correlation (77 percent) between COVID deaths lagged one month after Midazolam
injections is largely due to the first two enormous spikes to early 2021. From April 2021
onwards to May 2023, there was no significant correlation (with any lags), implying that
Midazolam had no statistical relationship to COVID deaths, suggesting a change in
assignment policy.
The temporal separation between Midazolam cause and excess deaths effect was consistently
one month for the whole pandemic since 2020, indicating palliative use for assisted dying or
other euthanasia. Midazolam was the proximate, if not the primary, cause of excess deaths in
the UK. Statistically, correlations improve substantially when Midazolam injections lead
excess deaths by one month for all regions in England, as illustrated by Figure 12.
Figure 12
For the rest of this paper, unless stated otherwise, correlations between Midazolam injections
and excess deaths imply lags of one-month have been applied to excess deaths. Before the
pandemic, the correlations were mostly moderate with low statistical significance.
Page 15 of 30
Table 4: Midazolam Injections and Regional Excess Deaths
for March/April 2020
Midazolam Excess Dose per Death Excess %
Region
Doses Deaths (Rank) Baseline (rank)
London 2,680 8,030 0.33 (7) 194 (1)
East 3,990 4,680 0.85 (4) 96.6 (4)
North West 5,210 6,390 0.82 (5) 107 (2)
South West 4,560 2,880 1.58 (1) 61 (7)
South East 6,000 5,980 1 (3) 87.4 (5)
North East (& Yorkshire) 6,920 5,730 1.21 (2) 86.6 (6)
Midlands 6,210 8,390 0.74 (6) 101 (3)
Compared to regional baselines calculated from 2015-2019 monthly averages (see Table 2),
London region had tripled (300 percent) its expected all-cause mortality, while most other
regions had approximately doubled (200 percent) their respectively expected all-cause
mortality. Such rapid, temporally concentrated and uniformly distributed deaths across
England were unlikely to be caused naturally by an infectious disease.
Indeed, the Midazolam dose-to-death relationships were very similar across all regions,
further supporting the supposed role of Midazolam in a UK systemic policy of euthanasia.
Some regions such as London, East, North West and Midlands had less than one dose per
excess death, which suggests that Midazolam was not uniformly applied in all cases and that
Midazolam was not the only sedative used in the euthanasia, particularly in the London
region. For example, along with many other drugs, Levomepromazine hydrochloride which is
a sedative as well as an anti-psychotic drug, also had a surge in usage in UK [25] at about
same time.
Another possible reason for why the London region had relatively high excess deaths
compared to the registered doses of Midazolam may be due to selection bias by sick patients.
It is possible that many sick patients from other regions may have sought specialist treatment
from major London hospitals and clinics, which may have to use other sedatives due to
limited supplies of Midazolam.
The London outlier statistics may be another example of Simpson’s Paradox where a
subpopulation may have confounding factors including selection bias, violating a statistical
property which is valid only for the whole population or for other subpopulations.
Page 16 of 30
Table 5: Correlation of Midazolam Injections and Regional Excess Deaths
(p-values < 0.001 or zero unless specified in brackets)
Pre-pandemic June Pandemic since 2020 Pre- Pandemic Post-
Region 1918 -2020 Correlation 2020 vaccination vaccination
% (p-value) Correlation % Correlation % Correlation %
London 33 (0.09) 92 99 66
East 25 (0.16) 89 99 75
North West 48 (0.02) 92 98 62
South West 51 (0.01) 77 97 48
South East 39 (0.06) 87 96 74
North East (& Yorkshire) 49 (0.02) 91 98 57
Midlands 60 (0) 88 98 63
England 48 (0.02) 91 98 70
While the pre-pandemic correlations (second column) between Midazolam injections and
excess deaths are statistically significant to p-value < 0.05, for North West, South West, North
East (& Yorkshire) and Midlands, the correlation coefficient for the whole of England was
only 48 percent.
For 2020, the correlation coefficient (fourth column) for the whole of England spiked to 98
percent, leaving little doubt about Midazolam’s role in UK excess deaths in 2020. The overall
correlation coefficient (third column) for the whole pandemic was 91 percent, contributed
substantially by 2020 data. Importantly, even after 2020, in the vaccination era, the
correlation coefficient (last column) was still highly statistically significant at 70 percent.
Regardless of other factors, such as COVID-19 disease and vaccination, Midazolam was an
important confounding factor in explaining excess deaths, competing with other possible
factors.
The main Bradford Hill criteria of medical causality have been satisfied with strong
correlation, consistency over time and geography, specificity of effect and consistent
temporality of one-month lag in excess deaths following Midazolam injections. Other
Bradford Hill aspects, such as biological gradient or dose-response relationships, follow
naturally from consideration of the pharmaceutics of Midazolam.
In summary, Midazolam was strongly and causally associated with UK excess deaths,
particularly in 2020. It was clearly the proximate cause of excess mortality in UK, but it was
unlikely to be the primary cause in the chain of causality for deaths, because Midazolam was
used mostly for accelerated or assisted dying in euthanasia often to alleviate possible
suffering in end-of-life protocols. Midazolam’s role based on its pharmaceutics is
circumscribed in health policy guidelines.
Biological Gradient
Clearly the close association of UK excess deaths following Midazolam injections suggests
significant involvement of sedatives with euthanasia in the UK pandemic. A systemic policy
of euthanasia may be evident from the pharmaceutics of Midazolam applied across time and
Page 17 of 30
across the various regions during the pandemic. Figure 13 shows the dose-response
relationships for England over three separate periods.
Figure 13
The data points in aqua refer to the pre-pandemic period from July 2018 to 2020, the points in
red refer to 2020, the first pandemic period before mass vaccination, while the green data
points refer to the pandemic period post vaccination. The statistics of the dose-response
relationships in the three distinct periods are shown in Table 5.
In the April 2020 spike, 35,000 doses of Midazolam were associated with 38,700 excess
deaths. The statistical analysis shows that in England before the pandemic, the dose-response
relationship between Midazolam injections and excess deaths was weak and only marginally
significant. In 2020 of the pandemic, before vaccination, the impact of Midazolam injections
was very strong and highly significant statistically, while the impact of Midazolam later
moderated undoubtedly due to the competing influence of vaccination, but it remained highly
statistically significant.
Page 18 of 30
Figure 14
Note that the London region is a statistical outlier in the use of Midazolam, suggesting the
additional use of other similar sedatives which might be even more powerful than Midazolam
for euthanasia, as suggested by the comparisons in Table 6.
Note that all regional subpopulations have consistently positive correlations, avoiding
Simpson’s Paradox and suggesting the absence of significant confounding factors in the
statistical relationships. That is, even though the mathematical details of the regressions may
differ quantitatively (due to other minor confounding factors), the firm conclusion prevails
that Midazolam injections have significant causal impact on excess deaths in England.
Page 19 of 30
Pandemic Euthanasia
With dire predictions from SAGE computer modelling early in 2020, an atmosphere of panic
prevailed in the UK. After 30 years of cutbacks [26], NHS hospital beds in England were
halved from 299,000 in 1987/88 to 141,000 in 2019/20. Shortages of hospital beds were
already felt before the pandemic. Therefore, there was apprehension that UK hospitals could
not cope with the anticipated surge in COVID-19 cases.
It is clear that the highest priority of UK public health policy, early in the pandemic, was to
avoid hospitals being overwhelmed, like those sensationally reported in northern Italy around
that time. The NHS created new guidelines in March 2020 [27] to facilitate discharges from
hospitals, stating “Unless required to be in hospital (see Annex B), patients must not remain
in an NHS bed”.
In a move which was later judged irrational [28], many elderly were discharged from hospital
and died in care homes across England as shown from an ONS report [29] in Figure 15.
Figure 15
About 28,000 care home residents died in April 2020 across England, which represented
about one third or 33.5 percent of all deaths in England. As there were about 375,000 care
home residents (three quarters elderly, some with dementia, and the rest disabled) in an
English population of 65 million, the mortality rates for that month were 7.5 percent and
0.128 percent respectively, implying an April 2020 death rate in care homes about sixty times
(X60) that of the national average.
Many of the UK elderly with comorbidities or terminal illnesses have died with euthanasia in
care homes, and not from COVID-19 due to few cases of infections early in 2020. The
relative absence of COVID infections was corroborated by largely empty hospitals in early
2020 [30], as the overblown-feared spike in COVID hospitalization never eventuated. Even
temporary “Nightingale” hospitals constructed for the expected emergency were empty [31].
The circumstances of euthanasia have led to the first common fallacy that the elderly were
particularly vulnerable to COVID, whereas the elderly were vulnerable to the UK health care
Page 20 of 30
system which facilitated euthanasia in care homes [32]. A sudden surge in voluntary assisted
dying was unlikely, but the extent of nonvoluntary euthanasia, suggesting iatrogenic
geronticide in the UK has not been estimated.
A second fallacy has come from the fact that compared to the huge spike in 2020, fewer
elderly deaths occurred after 2021 with mass vaccination, has led to the false conclusion that
vaccination had saved many elderly lives, whereas Midazolam injections and other
medication were significantly reduced after 2020. The benefit of vaccination for the elderly
was illusory, but statistical evidence of vaccination causing deaths was also illusory, due to
misleading data, as shown above in the section containing Figure 5.
UK Policy on Euthanasia
In its definitions, the UK National Health Service (NHS) [33] states “Euthanasia is the act of
deliberately ending a person’s life to relieve suffering” and “Depending on the circumstances,
euthanasia is regarded as either manslaughter or murder. The maximum penalty is life
imprisonment.” Even assisted suicide is illegal according to the Suicide Act (1961) and is
punishable by up to 14 years’ imprisonment, while suicide itself is not a criminal act.
The above data analysis has shown clearly that most of the UK excess mortality during the
pandemic was associated with Midazolam use in the euthanasia of the elderly, on a
widespread and apparently coordinated scale. How was this possible when euthanasia was
still strictly illegal in UK?
New guidelines were rapidly developed in early 2020 by the National Institute for Health and
Care Excellence (NICE) for managing COVID-19 symptoms, including those at the end-of-
life [22]. The rapidly developed new guidelines effectively opened the door to implement a
policy of euthanasia in UK during the pandemic:
The interim process for developing the guidelines includes the following caveats: “no public
consultation on the scope”, “there will be no systematic literature research”, “following WHO
COVID-19 guidance”, “there will be no formal risk of bias assessment of the evidence”,
“there will be no public consultation of the draft guidance”, etc.
Table 5 of the NICE rapid guidelines on treatments in the last days and last hours of life for
managing breathlessness for adult patients include:
There were changes in the guidelines [34] for anticipatory prescribing (AP) of injectable
medications in advance of clinical needs in UK community palliative care.
Page 21 of 30
Evidently, in an environment of rapidly changing guidelines, regular oversight procedures for
care homes were suspended by the statutory regulating body, the Care Quality Commission
(CQC), and the Local Government and Social Care Ombudsman.
Amnesty International UK published [35] a 2020 report titled: “As if expendable: The UK
government’s failure to protect older people in care homes during the COVID-19 pandemic”
which stated:
“The UK government, national agencies, and local-level bodies have taken decisions
and adopted policies during the COVID-19 pandemic that have directly violated the
human rights of older residents of care homes in England—notably their right to
life, their right to health, and their right to non-discrimination. These decisions and
policies have also impacted the rights of care home residents to private and family
life, and may have violated their right not to be subjected to inhuman or degrading
treatment.”
Emphasis added. Amnesty International was careful to avoid using the word: euthanasia, but
instead used “violating human rights” – particularly right to life. De facto euthanasia in
hospitals and care homes was made possible by loosening guidelines, lack of regulatory
oversight and the blanket use of “Do Not Attempt Cardiopulmonary Resuscitation”
(DNACPR) notices or more simply “Do Not Attempt Resuscitation” (DNAR) notices.
The use of blanket DNAR notices in hospitals and care homes was a systemic policy of
euthanasia, when it was not investigated or stopped by government regulators. From a joint
investigation by the House of Commons and House of Lords, the UK Parliament admitted
[36] in September 2020:
“We have received deeply troubling evidence from numerous sources that during the
Covid-19 pandemic DNACPR notices have been applied in a blanket fashion to some
categories of person by some care providers, without any involvement of the
individuals or their families.”
Emphasis added. The Care Quality Commission (CQC), which is an independent regulator
funded from fees of hospitals and care homes to oversight them, was asked belatedly to
review DNACPR decisions during the COVID-19 pandemic:
“It was prompted by concerns about the blanket application of DNACPR decisions,
that is applying them to groups of people rather than on an assessment of each
Page 22 of 30
person’s individual circumstances, and about making decisions without involving the
person concerned.”
Emphasis added. In its interim report released in November 2020, the CQC agreed with UK
government investigation and observed somewhat apologetically [37]:
“It is clear that there was confusion and miscommunication about the application of
DNACPRs at the start of the pandemic, and a sense of providers being overwhelmed.
There is evidence of unacceptable and inappropriate DNACPRs being made at the
start of the pandemic.”
Clearly, the “user-pays” regulator was the last to admit its own failure in regulation and
merely repeated the findings of Amnesty International and the UK Government’s report on
human rights in the COVID-19 pandemic.
A systemic policy of euthanasia, which is illegal under UK laws, was couched merely as a
violation of human rights – the right to life. There is much more to the euthanasia policy
which appears to have discriminated according to vaccination status, with a bias against the
“unvaccinated”. The systemic policy has significant effect obscuring an understanding the
impact of vaccination in the UK COVID-19 pandemic.
It is beyond the scope of this paper to discuss further how the systemic policy of euthanasia
was carried out. The above discussion serves to explain that uniformity and consistency of
the statistical data, throughout the pandemic and across all regions, relating Midazolam use to
excess deaths.
Figure 16
Page 23 of 30
From the right Figure 16, vaccination had a negative correlation (-20 percent) impact on non-
COVID deaths, suggesting benefit, but statistically insignificant. On the other hand, from
2021 onwards to May 2023, there was a significant 48 percent correlation (p-value < 0.005)
between Midazolam and non-COVID excess deaths (lagged one month), implying that
Midazolam was likely involved in non-COVID deaths since 2021.
Relative impacts of Midazolam injections versus vaccination are compared for the period 30
June 2021 to 31 May 2023. The June start date of the comparison is due to a five-month lead
in COVID injections, while Midazolam injections have only a one-month lead relative to the
deaths. Table 7 shows only Midazolam injection had statistically significant correlation to
excess deaths (highlighted in yellow) in the vaccination period.
Neither Midazolam nor vaccination were statistically correlated with COVID deaths, which is
not surprising given the unreliability of the data. Midazolam, shaded yellow in Table 7, was
significantly correlated with both non-COVID deaths and excess deaths.
Vaccination had no significant statistical correlation with UK deaths with a five-month time
lag or with any other time lag. Unlike in Australia, this lack of consistent correlation, suggests
that COVID vaccination has no statistically provable impact on UK deaths: COVID deaths,
non-COVID deaths or excess deaths.
This lack of statistical evidence does not mean that vaccination may not be a primary cause
which was likely masked by the causal proximity of euthanasia with Midazolam. Given the
Australian research which proved “vaccination kills” [1], it is highly probable that the
sustained elevation of the levels of UK excess deaths was not due to natural causes, but due
to vaccination. However, for the epidemiology of the confounded situation in the UK, other
approaches and methods are needed to establish the relationship between vaccination and
excess deaths.
Attempting to attribute excess deaths solely to either COVID disease or COVID vaccination
may be erroneous. Applying simplistic models globally to estimate how many millions lives
Page 24 of 30
vaccination has saved or how many million deaths vaccination has caused, without really
understanding the actual facts of data limitations, has led to a confusion which prolonged bad
policy decisions costing many lives.
A simple example may illustrate the prevailing fallacy. Figure 17 shows the pooled weekly
total number of deaths for all ages in 27 data-providing EuroMOMO [38] partner countries
and subnational regions, consisting of Austria, Belgium, Cyprus, Denmark, Estonia, Finland,
France, Germany, Germany (Berlin), Germany (Hesse), Greece, Hungary, Ireland, Israel,
Italy, Luxembourg, Malta, Netherlands, Portugal, Slovenia, Spain, Sweden, Switzerland, UK
(England), UK (Northern Ireland), UK (Scotland), and UK (Wales).
Figure 17
Ignoring confounding factors in individual countries, the pooled all-cause mortality (solid
line) of 27 countries is shown above their baseline bands (dotted lines). Due to seasonal
fluctuations and a slight rise in the baseline over time, Figure 17 is not the clearest way to
compare excess deaths.
Evidently, comparing major all-cause mortality peaks, excess deaths in the European
pandemic have never exceeded the peak of early 2020. The general observation has allowed
European governments, with the help of flawed research based on flawed data, to claim that
excess deaths are all explained by COVID virus and its variants. Our paper here has shown
that the COVID virus had evidently little consistent impact on excess deaths in the UK.
Some governments, with pharmaceutical funding, have speculated with computer modelling
that without vaccination excess deaths would have been much higher, saving millions of
lives. Equally unjustified are the opposite claims that the data show that vaccination has cost
millions of lives. This paper has shown that neither may be the case for UK, because
currently available data may not be adequate for proving either case using existing methods.
This paper has shown that for global pandemic epidemiology, countries need to be classified
at least into two groups: one group has members such as the US and UK which have
intervened significantly with medical and clinical protocols early from the start of the
pandemic. Another group has members such as Australia and New Zealand which apparently
had no such medical intervention until the rollout of COVID vaccination. (Australia allowed
voluntary assisted dying only recently in most states, except for Victoria which first allowed
it in 2019, but also it happens to have the highest Australian COVID deaths in 2020.)
Page 25 of 30
Summary of Findings
The COVID-19 pandemic in UK was iatrogenic, as it did not originate from the SARS-CoV-2
virus, but originated from Midazolam use in euthanasia and then likely later from mass
vaccination. The main findings supporting this conclusion are:
There were relatively few cases of infections in early 2020, indicating the non-
prevalence of the SARS-CoV-2 virus in the UK.
The UK Health Security Agency declared on 19 March 2020, the absence of any
“high consequence infectious disease”, denying the existence of a pandemic.
The enormous spike in excess deaths attributed to COVID-19 was inconsistent with
the lack of prevalence of the SARS-CoV-2 virus, which was not verified, due to
shortages and unreliability of PCR tests.
NHS and Nightingale hospitals were mostly empty, confirming absence of a
pandemic.
The excess deaths were spread uniformly and simultaneously across all English
regions, inconsistent with natural contagion.
The spikes in excess deaths across all regions were strongly correlated with
Midazolam injections, implicating euthanasia, particularly of the elderly in care
homes.
On investigation, the UK Government, Amnesty International and the Care Quality
Commission have all acknowledged that “a systemic or structural dysfunction in
hospital services” and the widespread blanket use of “Do Not Attempt
Cardiopulmonary Resuscitation” (DNACPR) notices in care homes have contributed
to excess deaths in the UK.
That “COVID vaccination kills” has been proven statistically using Australian macro-data,
which should apply universally. However, this causality has not been confirmed for the UK,
because the same method of proof is not available from UK macro-data due to the
confounding effect of Midazolam use in UK euthanasia.
A major finding of this paper is that the very high excess deaths in 2020 in the UK were due
to Midazolam intervention rather than SARS-CoV-2 infections, demonstrating the
unreliability of COVID data as evidence of a SARS-CoV-2 pandemic, which was denied the
status of a “High Consequence Infectious Disease” by UK Health Security Agency in March
2020.
Any claim that COVID vaccination saved lives has little merit, because few lives were
threatened by the largely absent SARS-CoV-2 virus in the UK; the spike in so-called COVID
deaths in 2020 was actually euthanasia deaths by Midazolam, which remains the dominant
causal explanation of the pandemic, overwhelming other factors.
Midazolam injections were agnostic to vaccination status. Therefore, excess deaths caused by
Midazolam were randomly related to vaccination status, confusing the raw data on “deaths by
vaccination status” and thus invalidating most UK studies based on that flawed data.
The illusion that COVID vaccination was “safe and effective” was caused by Midazolam
injections in UK being very high in 2020 and diminishing after vaccination, resulting in
Page 26 of 30
falling excess deaths over time, mistakenly credited to vaccination. This fallacy is material in
justifying a continuation of vaccination policy in UK and Europe.
Most epidemiological studies of excess deaths in the COVID-19 pandemic have considered
the relative impact of only two factors: COVID disease and COVID vaccination. Due to the
presence of significant confounding factors, claims of observed correlation between deaths
and vaccination for many countries are illusory.
Only those countries such as Australia, which were apparently free from euthanasia and other
medical intervention, are suitable for the epidemiological study of the impact of vaccination
on excess deaths.
Conclusion
The extraordinary spike in UK excess deaths in April 2020 was not due to the SARS-CoV-2
virus, because there were relatively few infections and there was no “high consequence
infectious disease”, as officially declared in March 2020.
The UK COVID-19 pandemic was iatrogenic, created with widespread and persistent use of
Midazolam injections in all regions of England, particularly in care homes, under a systemic
policy of euthanasia. The nature of the euthanasia needs further investigation.
Statistically, Midazolam injections were highly correlated with UK excess deaths throughout
the pandemic, overwhelming COVID-19 disease or vaccination as other possible
explanations for excess mortality.
Midazolam was the common proximal cause of excess deaths in the pandemic, but there were
likely many other primary causes including comorbidities, infections and vaccination. The
data available are not sufficient to measure the precise impact of vaccination on excess
deaths.
Vaccination was unlikely to have saved many, if any, lives because the unreliable early data
grossly exaggerated COVID deaths, inflating the extent of the SARS-CoV-2 threat which was
subsequently assumed and projected in computer models which created illusory benefits.
Most global investigations of COVID-19 epidemiology, only based on the relative impacts of
COVID disease and vaccination, are probably inaccurate, because their assumptions are
generally false due to the significant presence of confounding factors in some countries, such
as the UK.
Acknowledgment
Lex Stewart, Jeremy Beck and David Richards are thanked for helpful comments.
Page 27 of 30
References
[1] Sy W. Early Indication of Long-Term Impact of COVID Injections. 26 September 2023.
https://www.researchgate.net/publication/374261986_Early_Indication_of_Long-
Term_Impact_of_COVID_Injections/stats
[2] Sy W. Australian COVID-19 pandemic: A Bradford Hill analysis of iatrogenic excess mortality. J
Clin Exp Immunol 2023; 8(2), 542-556. https://www.opastpublishers.com/open-access-
articles/australian-covid19-pandemic-a-bradford-hill-analysis-of-iatrogenic-excess-mortality.pdf
[3] Centers for Disease Control and Prevention. CDC 2019-Novel Coronavirus (2019-nCoV) Real-
Time RT-PCR Diagnostic Panel, FDA News Release. https://www.fda.gov/media/134922/download
[4] Corman V, Landt O, Kaiser M et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-
time RT-PCR, Euro Surveill. 2020;25(3):pii=2000045.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988269/pdf/eurosurv-25-3-5.pdf
[5] Neil M, Fenton N, et al. Official mortality data for England suggest systematic miscategorisation
of vaccine status and uncertain effectiveness of Covid-19 vaccination. ResearchGate 12 January 2022.
https://www.researchgate.net/publication/357778435_Official_mortality_data_for_England_suggest_s
ystematic_miscategorisation_of_vaccine_status_and_uncertain_effectiveness_of_Covid-
19_vaccination
[6] Sy W. Data reporting flaw in plain sight distorting COVID-19 mortality statistics, ResearchGate,
25 August 2022.
https://www.researchgate.net/publication/374587533_Data_reporting_flaw_in_plain_sight_distorting
_COVID-19_mortality_statistics [accessed Oct 15 2023].
[7] Centers for Disease Control and Prevention, COVID-19 Vaccine Breakthrough Case Investigation
and Reporting (Updated June 23, 2022), https://www.cdc.gov/coronavirus/2019-ncov/php/hd-
breakthrough.html#report (accessed 15 August, 2022).
[8] Neil M, Fenton N, McLachlan S. Discrepancies and inconsistencies in UK Government datasets
compromise accuracy of mortality rate comparisons between vaccinated and unvaccinated,
ResearchGate 20 October 2021.
https://www.researchgate.net/publication/355437113_Discrepancies_and_inconsistencies_in_UK_Go
vernment_datasets_compromise_accuracy_of_mortality_rate_comparisons_between_vaccinated_and
_unvaccinated
[9] Office for National Statistics. Estimation method – COVID-19 Un-vaccinated population. Release
date: 30 May 2023.
https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/estimationmeth
odcovid19unvaccinatedpopulation
[10] Wallace AR.Vaccination a Delusion, Official Evidence in the Reports of the Royal Commission,
Swan Sonnenschien & Co., London, 1898. https://iiif.wellcomecollection.org/pdf/b21356336
[11] Office for National Statistics. Deaths registered monthly in England and Wales, Release date; 23
August 2023.
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/mo
nthlyfiguresondeathsregisteredbyareaofusualresidence
[12] Rahmani K, Shavaleh R, Forouhi M et al. The effectiveness of COVID-19 vaccines in reducing
the incidence, hospitalization, and mortality from COVID-19: A systematic review and meta-analysis,
Front. Public Health, 26 August 2022, Sec. Infectious Diseases: Epidemiology and Prevention Volume
10 – 2022 https://doi.org/10.3389/fpubh.2022.873596
[13] Sy W. Simpson’s paradox in the correlations between excess mortality and covid-19 injections: a
case study of iatrogenic pandemic for elderly Australians. Medical & Clinical Research 2023; 8(7),
01-16. https://www.medclinrese.org/open-access/simpsons-paradox-in-the-correlations-between-
excess-mortality-and-covid19-injections-a-case-study-of-iatrogenic-pandemic.pdf
Page 28 of 30
[14] Office for National Statistics. Excess deaths in England and Wales: March 2020 to June 2022, 20
September 2022.
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/exc
essdeathsinenglandandwalesmarch2020tojune2022/2022-09-20
[15] UK Health Security Agency. Guidance: High consequence infectious diseases.
https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid
[16] Sy W. Australian Excess Deaths: Moving the Goalposts. Principia Scientific International, 29
August 2023. https://principia-scientific.com/australian-excess-deaths-moving-the-goalposts/
[17] Petersen E, Koopmans M, et al. Comparing SARS-CoV-2 with SARS-CoV and influenza
pandemics. The Lancet, 3 July 2020, 20: e238-44. https://doi.org/10.1016/S1473-3099(20)30484-9
[18] Naughton L. Interview with Funeral Director, UK: Deaths Jumped 250% When Injections Began,
Interviews Funeral Director John O'Looney. BitChute 2021 Sep 5.
https://www.bitchute.com/video/iopPf0YM6m7C/
[19] Alexander P. 2 graphs of UK's data (2017 to 2022), one on excess mortality, the other on the
powerful sedative midazolam usage; what do you see in terms of March 2020 & March 2021 in both
graphs? Alexander COVID News-Dr. Paul Elias, 12 Mar 2023. https://palexander.substack.com/p/2-
graphs-of-uks-data-2017-to-2022
[20] OpenPrescribing. Items for Midazolam 10mg/2ml solution for injection ampoules by all regional
teams.
https://openprescribing.net/analyse/#org=regional_team&numIds=1501041T0AAAAAA&denom=not
hing&selectedTab=chart
[21] World Health Organization. Model List Essential Medicines, 26 July 2023, 23rd List.
https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-HPS-EML-2023.02-
eng.pdf?sequence=1
[22] National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing
symptoms (including at the end of life) in the community, 3 April 2020.
https://web.archive.org/web/20200409054527/https:/www.nice.org.uk/guidance/ng163/resources/covi
d19-rapid-guideline-managing-symptoms-including-at-the-end-of-life-in-the-community-pdf-
66141899069893
[23] MedlinePlus, Midazolam Injection. US Government National Library of Medicine.
https://medlineplus.gov/druginfo/meds/a609014.html
[24] Gamblin V, Berry V, et al. Midazolam sedation in palliative medicine: retrospective study in a
French center for cancer control. BMC Palliat Care. 2020 Jun 19;19(1):85. doi: 10.1186/s12904-020-
00592-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305615/
[25] Frazer JS, Frazer GR. Analysis of primary care prescription trends in England during the
COVID-19 pandemic compared against a predictive model. Fam Med Community Health. 2021
Aug;9(3):e001143. https://pubmed.ncbi.nlm.nih.gov/34344766/
[26] The King’s Fund. NHS hospital bed numbers: past, present, future, 05 November 2021
https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers
[27] National Health Service. COVID-19 Hospital Discharge Service Requirements. 19 March 2020.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/911
541/COVID-19_hospital_discharge_service_requirements_2.pdf
[28] Dyer C. Covid-19: Policy to discharge vulnerable patients to care homes was irrational, say
judges. BMJ 2022;377:o1098 https://www.bmj.com/content/377/bmj.o1098
[29] Office for National Statistics. Deaths involving COVID-19 in the care sector, England and Wales:
deaths registered between week ending 20 March 2020 and week ending 2 April 2021 Release date:
11 May 2021.
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/dea
Page 29 of 30
View publication stats
thsinvolvingcovid19inthecaresectorenglandandwales/deathsregisteredbetweenweekending20march20
20andweekending2april2021
[30] West D. NHS hospitals have four times more empty beds than normal, HSJ, 14 April 2020.
https://www.hsj.co.uk/acute-care/nhs-hospitals-have-four-times-more-empty-beds-than-
normal/7027392.article
[31] Day M. Covid-19: Nightingale hospitals set to shut down after seeing few patients BMJ 7 May
2020; 369 doi: https://doi.org/10.1136/bmj.m1860
[32] Menage J. Assisted dying is open to Abuse. BMJ 2021;374:n2128.
https://www.bmj.com/content/374/bmj.n2128/rr-11
[33] National Health Service. Euthanasia and assisted suicide, 12 July 2023.
https://www.nhs.uk/conditions/euthanasia-and-assisted-suicide/
[34] Antunes B, Bowers B, et al. Anticipatory prescribing in community end-of-life care in the UK
and Ireland during the COVID-19 pandemic: online survey. BMJ Supportive & Palliative Care
2020;10:343-349. https://spcare.bmj.com/content/bmjspcare/10/3/343.full.pdf
[35] Amnesty International United Kingdom. As if expendable: The UK government’s failure to
protect older people in care homes during the COVID-19 pandemic. 4 October 2020.
https://www.amnesty.org/en/documents/EUR45/3152/2020/en/
[36] UK Parliament. The Government’s response to COVID-19: human rights implications, Joint
Committee on Human Rights, House of Commons House of Lords, 21 September 2020,
https://committees.parliament.uk/publications/2649/documents/26914/default
[37] Care Quality Commission, Review of Do Not Attempt Cardiopulmonary Resuscitation decisions
during the COVID-19 pandemic, Interim Report, November 2020,
https://www.cqc.org.uk/sites/default/files/20201204%20DNACPR%20Interim%20Report%20-
%20FINAL.pdf
[38] Euromomo, Pooled number of deaths by age group. Graph and maps, Last updated on week 44,
2023. https://www.euromomo.eu/graphs-and-maps
Page 30 of 30