Coronavirus in Scotland: Huge spike in deaths outside hospital as nearly 500 people a week die in own homes during outbreak

This is 67 per cent higher than the five-year average of 2,327for the same eight-week period.

Of the 1,554 ‘excess’ deaths, 237 (15%) were linked to coronavirus on the death certificate, but the vast majority - 1,317 - were non-Covid deaths.

These are likely to include dementia, heart disease, strokes, cancer, and other causes, such as accidents or suicides.

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However, the increase in people dying at private addresses - which can also include sheltered housing complexes - has coincided with a decline in hospital deaths, once Covid is excluded.

This suggests more people who would normally have died in hospital have been discharged for palliative care.

Charity Marie Curie, the largest independent provider of hospices and end-of-life care in the community, said its nurses have experienced an increase in demand since mid-March compared to last year.

Ross Brown regional manager for the Marie Curie Nursing Service in Scotland said this could be a good thing, but urged anyone struggling to seek help from a GP, district nurses or the Marie Curie support line on 0800 090 2309.

He said: “Seven out of 10 people cared for by Marie Curie nurses die in their own homes, the place most people say they would like to be, so an increase in demand for our care is a positive.

"Since coronavirus we have seen an increase in need for short visits and have adapted how we’re able to deliver care at this time to best support families as well as ease pressures on hospitals.

"We do have concerns that people may be struggling to care for a loved one or be living with a terminal illness and need support."

There have been 989 fewer non-Covid deaths than normal in hospital since March 16, but that still leaves at least 328 of the excess 'at home' deaths unexplained.

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Deaths at home peaked between March 30 and April 12, the same weeks that excess deaths from cancer, dementia, heart disease and strokes also peaked, and shortly after A&E attendance fell to a record low.

Frontline medics have already spoken up about fears that patients were delaying seeking help for hearts attacks, strokes, infections and other ailments such as appendicitis, due to fears about catching Covid in hospital or burdening the NHS.

Dr Chaand Nagpaul, chair of the British Medical Association, also warned earlier this month that referrals from GPs were not being accepted "unless for serious medical conditions".

He added: "Routine investigations to aid diagnosis are not available in many cases.

"This means many ill patients are not getting the care they so desperately need now – and crucially, risking their conditions getting worse and with some even dying as a result.”

Dr Andrew Buist, a GP in Blairgowrie and chair of BMA Scotland’s GP committee, said the figures "raise a lot of questions", including possible delays in patients either seeking or being admitted for medical care.

However, Dr Buist said there was also growing evidence that fatalities recorded as cardiovascular deaths were actually triggered by Covid - even in cases where patients had had mild symptoms.

Dr Buist said: “What we are seeing is a growing trend - especially in countries that are ahead of us, like Spain and Italy - of cardiovascular deaths among people who have survived Covid.

"They have an increased tendency to clotting - so coronoary thrombosis or stroke disease - and also post-Covid respiratory diseases.

"Some of that will be relatively unrecognised because how could you tell that the cardiac arrest was due to Covid, sometimes even a mild Covid?

"Some of them may also be mental health-related deaths in people depressed at being shut away.

"It needs to be explained.”

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Linda Bauld, professor of public health at Edinburgh University, said: "We've known for some weeks now that the health consequences of Covid-19 would extend well beyond illness and death due to the virus.

"It's becoming increasingly clear that people have been reluctant to bother the NHS, even with urgent symptoms. This is because they are either worried about putting extra pressure on services, or going into hospital where there might be a risk of infection.

"As a result, more people are dying at home. In many cases these are preventable deaths and are part of the collateral damage from Covid-19 lockdown."

Similar patterns have been seen elsewhere during the pandemic.

In the US, Detroit authorities reported a four-fold increase in the number of reports of dead bodies at home in late March and early April.

Around the same time in New York, city officials were recording more than 200 cases a day of people being found dead at home compared to the normal daily average of 35.

Some of this was blamed heart attacks and strokes, but also on people infected with the virus not seeking treatment in time - or having been instructed to shelter at home only to end up dying there.

However, the Scottish Ambulance Service said it had not received an usual level of these types of callouts during Covid.

A spokesman said: “According to our data there has been no increase in the number of calls we are receiving for patients found deceased at home. The figures, which we monitor closely, are variable, which is consistent with the previous year’s data.”