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Original research
Excess mortality in England and Wales during the first wave of the COVID-19 pandemic
  1. Evangelos Kontopantelis1,2,
  2. Mamas A Mamas1,3,4,
  3. John Deanfield5,
  4. Miqdad Asaria6,
  5. Tim Doran7
  1. 1 Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
  2. 2 NIHR School for Primary Care Research, University of Oxford, Oxford, UK
  3. 3 Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Keele, UK
  4. 4 Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, USA
  5. 5 Institute of Cardiovascular Sciences, University College London, London, UK
  6. 6 Department of Health Policy, London School of Economics and Political Science, London, UK
  7. 7 Department of Health Sciences, University of York, York, UK
  1. Correspondence to Evangelos Kontopantelis, Division of Informatics, Imaging and Data Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK; e.kontopantelis{at}manchester.ac.uk

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.

  • Mortality
  • Infection
  • Epidemiology
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/jech-2020-214764

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    Footnotes

    • Twitter Evangelos Kontopantelis @dataevan, Mamas A Mamas @mmamas1973, Miqdad Asaria @miqedup and Tim Doran @narodmit.

    • Contributors All authors designed the study. EK and TD drafted the manuscript, MM, JD and MA critically revised it.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open access repository.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.