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to increase rapidly as soon as the fog and cold began, and started to decrease as soon
as the fog lifted and the temperature rose, the number of people falling seriously ill
each day, while starting to increase as rapidly and as soon as the deaths, continued to
increase throughout the period of fog and cold, was at its highest on the first day of
return to normal weather, and thereafter decreased more slowly than the deaths. This
means that during the week after the fog there were very considerably more persons
lying seriously ill, especially with respiratory complaints, than on any of the four days
of the fog itself; but the numbers of deaths were greatest on the four days of the fog
and the day following.
Table A, page 158, shows an analysis of the deaths registered in the County of
London each week from 15th November to 27th December, by age groups and
by certain causes. There is in general a certain delay between the occurrence and
the registration of a death and a large part of the deaths occurring on Friday, 5th and
Saturday, 6th, will have been registered in the week ending Saturday, 13th December.
The sudden great increase in mortality reflected in the registration during this week
although most pronounced among babies and the elderly, was not confined to persons
of any particular ages. Among children aged 4 weeks to 1 year and among persons
aged over 55, three times as many deaths were registered in the week ending 13th
December as could be expected from the figures for the three previous weeks, and
among persons of all other ages rather over twice as many. The causes associated with
the excess deaths were confined almost entirely to disorders of the circulatory or
respiratory systems. Compared with the average per week in the previous three weeks,
deaths from bronchitis in the week ending 13th December were ten times as many,
from influenza seven times as many, from pneumonia nearly five times as many, from
pulmonary tuberculosis four-and-a-half times as many, and from other respiratory
diseases nearly six times as many; from cancer of the lung they rose rather less, to
nearly twice as many; from disorders of the heart and circulatory system they were
nearly three times as many. Deaths from any other defined cause show no significant
increase with the exception of gastro-enteritis, deaths from which increased considerably
among children under one year old; reference to the certified causes of death in these
cases reveals that for half of them there was a parenteral infection shown as an associated
cause. At no age were any excess deaths registered from causes which are not normally
characteristic of that age during winter. Deaths from influenza, although they rose
markedly in the week after the fog, rapidly fell back to a normal winter level and at
their highest were well below the numbers to be expected in a developing epidemic.
Table B, page 162, shows day-by-day from 16th December to 31st December, the
numbers of nursing treatments begun by the district nursing associations for respiratory
causes according to the age of the patient. The age distribution here, as might be
expected, is very similar to the age distribution of deaths.
Striking increases in mortality have previously occurred in London in conjunction
with periods of intense fog and cold. The last two occasions on which mortality changes
thus observed were on a scale as great as in 1952, were in December, 1873, and February,
1880. Extracts from the Registrar-General's returns giving details of the weather at the
times of the fogs and the numbers of registered deaths each week by age and certain
causes for the seven weeks covering the fog periods for each of these years are given
below. These figures refer to an area which is substantially the area now included in
the Administrative County. At both times almost exactly the same pattern of changes
made itself apparent in the week following the fog and cold as was observed in 1952 ;
namely, rises in mortality at all ages but more especially among the very young and the
old, these rises being almost entirely confined to deaths from respiratory and heart
diseases. (No very direct comparison is possible between the numbers dying of various
causes in 1873 or 1880 and 1952, owing to the very considerable changes in the methods
of classification of causes of death which have taken place over the intervening period.)
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