The fact that a much larger group of participants reported that the death was not expected (78%) than those bereaved by COVID-19 (45%), would suggest that that this aspect of a death, which likely increased in relation to both COVID and non-COVID deaths during the pandemic [e.g., due to cancer treatment delays, disruption to services, (54, 55)] may be an explanatory factor for elevated PGD levels during the pandemic. This evidence concerns the gene PGD and cancer.