COVID-19 Infections and Mortality

Key statistics

By the end of February 2021, 7,816 in every 100,000 Londoners had tested positive for COVID-19, with more than 17,000 Londoners having lost their lives[1].

After adjusting for differences in age, London has the highest regional COVID-19 mortality rate in the UK:

  • London’s age-adjusted COVID-19 mortality rate: 263.8 per 100,000 people.[2]
  • The North West’s age-adjusted COVID-19 mortality rate (the second highest in the UK): 231.2 per 100,000 people.
  • England average: 186.6 COVID-19 deaths per 100,000 people.

COVID-19 mortality has hit some populations harder than others:

  • In London, 90% of the deaths within 28 days of a positive COVID-19 test have been among people aged 60 or over.[3]
  • Even after controlling for a range of neighbourhood characteristics, mortality rates are 23% higher in the most deprived 20% of neighbourhoods than in the least deprived 20% of neighbourhoods. They are also higher in neighbourhoods with a high proportion of Black residents.

At the time of writing (March 2021), more than 100,000 people across the UK have tragically lost their lives. In London alone, more than 17,000 have died.[4] The human costs of this are immeasurable.

While individuals, neighbourhoods and communities all over the UK have been impacted to some extent, the overall direct health impacts of COVID-19 have not been evenly spread; as well as the disproportionate impact on older people, infection rates and death (mortality) have been higher among people living in deprived areas and people from Black and minority ethnic (BME) backgrounds.

The course of COVID-19 infections in London

London was one of the first areas of the UK to experience widespread transmission of the virus. By the start of the first national lockdown on 23 March 2020, 47 in every 100,000 Londoners had tested positive for COVID-19[5], compared with an average of 14 people per 100,000 across the rest of England. By 7 March 2021, this had risen to 7,816 in every 100,000 Londoners, compared to an average of 6,260 per 100,000 people across the rest of England.

Figure 1: Cumulative infections per 100,000 population (January 2020 - February 2021)

COVID-19 infections have not been evenly spread across London’s population. In fact, the rate of positive tests between July 2020 and March 2021[6] was more than a third (35%) higher in the most deprived 20% of London neighbourhoods compared with the least deprived 20% of neighbourhoods.

Figure 2: Cumulative COVID-19 infection rates in London by neighbourhood deprivation quintile (25th July 2020 - 3rd March 2021)

Figure 3 shows how this compares to the rest of England. It indicates that across the whole of England, infection rates are highest in more deprived neighbourhoods. It also shows that, across all deprivation quintiles, infection rates are higher in the capital than in the rest of England.

Figure 3: Cumulative COVID-19 infection rates by neighbourhood deprivation quintile (September 2020 - March 2021)

With such stark differences in infection rates by level of neighbourhood deprivation, it is no surprise that different parts of London have fared very differently. This can be seen both at specific points in time, when infections have grown rapidly as the virus transmitted quickly in a specific local area, and overall, with total infection rates varying significantly across different parts of the capital. By 3 March 2021, Barking and Dagenham had the highest cumulative infection rate (10,816 infections per 100,000 people) and Camden the lowest (5,091 infections per 100,000 people).

Figure 4: COVID-19 infection rates per 100,000 people in London neighbourhoods (MSOAs[7]) for all weeks between 25 July 2020 and 3 March 2021

COVID-19 mortality in London

By mid-February 2021, nearly 18,000 Londoners had lost their lives to COVID-19[8]. To understand how this compares to other regions across the UK, we can look at deaths as a proportion of the population and adjust to take account of the different age profiles of different areas. This is important when considering London statistics as the LPP shows that London has a relatively young population. Given that older age is a risk factor for COVID-19 mortality, we would expect London to have a lower mortality rate than other regions with older populations. Controlling for age allows us to compare areas on a consistent basis.

After doing this London has the highest regional mortality rate for COVID-19. By January 2021, the cumulative mortality rate in London was 264 deaths per 100,000 people compared to 187 per 100,000 for the rest of England. The North West had the second highest rate, with 231 in every 100,000 people having lost their lives to the virus.

Figure 5: Cumulative age-standardised COVID-19 mortality per 100,000 population (March 2020 - January 2021)

Figure 6: Cumulative age-standardised COVID-19 mortality per 100,000 population (March 2020 - January 2021)

As with infections, COVID-19 mortality varies significantly between different parts and populations of the capital. By January 2021 cumulative COVID-19 mortality rates were:

  • 2.2 times higher in the most deprived 20% of London neighbourhoods than in the least deprived 20%.
  • 2.94 times higher in the worst impacted London borough (Newham – 441 deaths per 100,000 people) than the least impacted borough (Camden – 150 deaths per 100,000 people).

Figure 7: Cumulative COVID-19 mortality rates per 100,000 population in London by neighbourhood deprivation quintile (March 2020 - January 2021)

Figure 8: Crude cumulative COVID-19 mortality rates across London per 100,000 population (March 2020 to January 2021)

To understand how factors like age, deprivation and ethnicity interact with each other with regards to COVID-19 infections and mortality, we can analyse them all together. Doing so allows us to see the individual impact of each characteristic – shown in Table 1 and Figure 9.

Table 1: Relationship between different neighbourhood characteristics and COVID-19 mortality rates in London
Characteristic This change in the characteristic Leads to this change in COVID-19 mortality per 100,000 population
Care Home Residents Increasing by 100 residents 58 increase
Ages 65 Plus Increasing by 100 persons 11 increase
Cases Rate Increasing by 100 cases 2 increase
Black Population Increasing by 100 persons 2 increase
Population Aged 0-14 Increasing by 100 persons -2 decrease
Population in Elementary Occupations Increasing by 100 persons -6 decrease

Source: Deaths due to COVID-19 by local area and deprivation, ONS; regression inputs trustforlondon.org.uk/publications/ covid19mortalitylondonlpp/

We can also see a clear impact of deprivation. Even after controlling for a range of neighbourhood characteristics, mortality rates are 23% higher in the most deprived 20% of neighbourhoods than in the least deprived 20% of neighbourhoods.

Figure 9: Percentage difference in cumulative deaths per 100,000 relative to least deprived 20% of neighbourhoods (March 2020 - January 2021)

ENDNOTES

[1] Office for National Statistics (ONS) weekly COVID-19 death registrations from week commencing 6 March 2020 to 19 February 2021. Note the ONS data which we predominantly use in this report counts COVID-19 deaths where COVID-19 is mentioned anywhere on a death certificate.

[2] Deaths due to COVID-19 by local area and deprivation, ONS.

[3] 9 March 2020 to 19 February 2021 from coronavirus.data.gov.uk, Public Health England. Note these data count deaths within 28 days of a positive COVID-19 test and do not use death certificates. These counts tend to be slightly lower than the ONS measure, but do give us age groups within the London region.

[4] ONS weekly COVID-19 death registrations from week commencing 6 March 2020 to 19 February 2021.

[5] Number of people with a positive COVID-19 test (either lab reported or from a lateral flow device) as reported by coronavirus.data.gov.uk (accessed 12 March 2021).

[6] At the time of writing, this was the earliest point from which the data was available from coronavirus.data.gov.uk at middle layer super output area level.

[7] Middle layer super output areas (MSOAs) are a statistical geography developed by the ONS with an average population of around 8,000 people.

[8] ONS weekly COVID-19 death registrations from week commencing 6 March 2020 to 19 February 2021.