Excess mortality in england and wales during the first wave of the COVID-19 pandemic
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Abstract
BACKGROUND: Deaths during the COVID-19 pandemic result directly from infection and exacerbation of other diseases and indirectly from deferment of care for other conditions, and are socially and geographically patterned. We quantified excess mortality in regions of England and Wales during the pandemic, for all causes and for non-COVID-19-associated deaths. METHODS: Weekly mortality data for 1 January 2010 to 1 May 2020 for England and Wales were obtained from the Office of National Statistics. Mean-dispersion negative binomial regressions were used to model death counts based on pre-pandemic trends and exponentiated linear predictions were subtracted from: (i) all-cause deaths and (ii) all-cause deaths minus COVID-19 related deaths for the pandemic period (week starting 7 March, to week ending 8 May). FINDINGS: Between 7 March and 8 May 2020, there were 47 243 (95% CI: 46 671 to 47 815) excess deaths in England and Wales, of which 9948 (95% CI: 9376 to 10 520) were not associated with COVID-19. Overall excess mortality rates varied from 49 per 100 000 (95% CI: 49 to 50) in the South West to 102 per 100 000 (95% CI: 102 to 103) in London. Non-COVID-19 associated excess mortality rates ranged from -1 per 100 000 (95% CI: -1 to 0) in Wales (ie, mortality rates were no higher than expected) to 26 per 100 000 (95% CI: 25 to 26) in the West Midlands. INTERPRETATION: The COVID-19 pandemic has had markedly different impacts on the regions of England and Wales, both for deaths directly attributable to COVID-19 infection and for deaths resulting from the national public health response.
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There was greater disconnect between estimates in hard-hit countries such as the UK, Spain, Italy, and Belgium.
“However, there was greater disconnect between estimates in hard-hit countries such as the UK, Spain, Italy, and Belgium (Kontis et al., 2020; Kontopantelis et al., 2021; Odone et al., 2021).”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Kontopantelis et al., 2021
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“However, there was a greater disconnect between estimates in hard- hit countries such as the UK, Spain, Italy, and Belgium (Kontis et al., 2020; Kontopantelis et al., 2021; Odone et al., 2021).”
Background
- Authors
- Kontopantelis, E., Mamas, M. A., Deanfield, J., Asaria, M., & Doran, T.
- Affiliations
- University of Manchester (GB)
- Thomas Jefferson University (US)
- University College Hospital (GB)
- London School of Economics and Political Science (GB)
- University of York (GB)
- Corresponding author
- Kontopantelis, Evangelos
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2020-10-15
- Volume
- 75
- Issue
- 3
- Pages
- 213-223
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC7892396
- OpenAlex
- W3092689956
- Cited by
- 121
- References
- 12
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 13 · 2023: 19 · 2022: 26 · 2021: 48 · 2020: 9
- FWCI
- 4.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion, other-oa)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (acceptedVersion, other-oa)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- excess mortality, COVID-19 pandemic, all-cause mortality, regional variation, public health response, delayed care, England and Wales, London
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Child, Child, Preschool, England, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mortality, Wales, Causality, Young Adult, Pandemics
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