Community factors and excess mortality in first wave of the COVID-19 pandemic in England

Davies, Bethan; Parkes, Brandon; Bennett, James L.; Fecht, Daniela; Blangiardo, Marta; Ezzati, Majid; Elliott, Paul

doi:10.1038/s41467-021-23935-x

Cited by 53 publications

(41 citation statements)

References 47 publications

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“…We find that the percentage of older adults negatively correlates with per capita mobility (r = −0.29), and thus neglect of demography-specific mortality risk will lead to inaccurate estimation of risk for different age groups. By contrast, our proposed BD model finds differences in mobility behaviors outweighed by the change in IFRs due to age structure and predicts higher mortality risk in communities with higher percentages of older adults, consistent with previous research (24,40). Moreover, communities with lower average household incomes and higher percentages of essential workers are associated with higher levels of mobility, likely following from limitations in their ability to significantly reduce mobility during the pandemic (26,31,32).…”

Section: Behavior and Demography Informed Epidemic Modellingsupporting

confidence: 86%

Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Chen¹,

Xu²,

Han³

et al. 2021

Preprint

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Balancing social utility and equity in distributing limited vaccines represents a critical policy concern for protecting against the prolonged COVID-19 pandemic. What is the nature of the trade-off between maximizing collective welfare and minimizing disparities between more and less privileged communities? To evaluate vaccination strategies, we propose a novel epidemic model that explicitly accounts for both demographic and mobility differences among communities and their association with heterogeneous COVID-19 risks, then calibrate it with large-scale data. Using this model, we find that social utility and equity can be simultaneously improved when vaccine access is pri-1

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Section: Behavior and Demography Informed Epidemic Modellingsupporting

confidence: 86%

Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Chen¹,

Xu²,

Han³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…After the initial decline in symptom prevalence between 4 and 12 weeks the prevalence of persistent symptoms plateaued indicating that large numbers of people may have chronic symptoms requiring investigation and intervention including rehabilitation. We show here that economically disadvantaged people and those in deprived areas appear to have a higher burden of persistent symptoms post COVID-19, compounding the excess burden of severe illness and mortality from COVID-19 experienced by these groups 36 , 37 .…”

Section: Discussionmentioning

confidence: 77%

Persistent COVID-19 symptoms in a community study of 606,434 people in England

et al. 2022

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Long COVID remains a broadly defined syndrome, with estimates of prevalence and duration varying widely. We use data from rounds 3–5 of the REACT-2 study (n = 508,707; September 2020 – February 2021), a representative community survey of adults in England, and replication data from round 6 (n = 97,717; May 2021) to estimate the prevalence and identify predictors of persistent symptoms lasting 12 weeks or more; and unsupervised learning to cluster individuals by reported symptoms. At 12 weeks in rounds 3–5, 37.7% experienced at least one symptom, falling to 21.6% in round 6. Female sex, increasing age, obesity, smoking, vaping, hospitalisation with COVID-19, deprivation, and being a healthcare worker are associated with higher probability of persistent symptoms in rounds 3–5, and Asian ethnicity with lower probability. Clustering analysis identifies a subset of participants with predominantly respiratory symptoms. Managing the long-term sequelae of COVID-19 will remain a major challenge for affected individuals and their families and for health services.

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“…Nor did we have data on total mortality by individual or community sociodemographic status to understand inequalities in the impacts of the pandemic beyond deaths assigned to COVID-19 as the underlying cause of death. Where data have been analysed for population subgroups, excess mortality tends to be higher in marginalised individuals and communities 37 – 39 . More detailed data will allow more granular analysis of the impacts of the pandemic, which can in turn inform resource allocation and a more targeted approach to mitigating both the direct and indirect effects of the COVID-19 pandemic.…”

Section: Resultsmentioning

confidence: 99%

Lessons learned and lessons missed: impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination

et al. 2022

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Background: Industrialised countries had varied responses to the COVID-19 pandemic, which may lead to different death tolls from COVID-19 and other diseases. Methods: We applied an ensemble of 16 Bayesian probabilistic models to vital statistics data to estimate the number of weekly deaths if the pandemic had not occurred for 40 industrialised countries and US states from mid-February 2020 through mid-February 2021. We subtracted these estimates from the actual number of deaths to calculate the impacts of the pandemic on all-cause mortality. Results: Over this year, there were 1,410,300 (95% credible interval 1,267,600-1,579,200) excess deaths in these countries, equivalent to a 15% (14-17) increase, and 141 (127-158) additional deaths per 100,000 people. In Iceland, Australia and New Zealand, mortality was lower than would be expected in the absence of the pandemic, while South Korea and Norway experienced no detectable change. The USA, Czechia, Slovakia and Poland experienced >20% higher mortality. Within the USA, Hawaii experienced no detectable change in mortality and Maine a 5% increase, contrasting with New Jersey, Arizona, Mississippi, Texas, California, Louisiana and New York which experienced >25% higher mortality. Mid-February to the end of May 2020 accounted for over half of excess deaths in Scotland, Spain, England and Wales, Canada, Sweden, Belgium, the Netherlands and Cyprus, whereas mid-September 2020 to mid-February 2021 accounted for >90% of excess deaths in Bulgaria, Croatia, Czechia, Hungary, Latvia, Montenegro, Poland, Slovakia and Slovenia. In USA, excess deaths in the northeast were driven mainly by the first wave, in southern and southwestern states by the summer wave, and in the northern plains by the post-September period. Conclusions: Prior to widespread vaccine-acquired immunity, minimising the overall death toll of the pandemic requires policies and non-pharmaceutical interventions that delay and reduce infections, effective treatments for infected patients, and mechanisms to continue routine health care.

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Community factors and excess mortality in first wave of the COVID-19 pandemic in England

Cited by 53 publications

References 47 publications

Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Strategic COVID-19 vaccine distribution can simultaneously elevate social utility and equity

Persistent COVID-19 symptoms in a community study of 606,434 people in England

Lessons learned and lessons missed: impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination

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