Socioeconomic and temporal heterogeneity in SARS-CoV-2 exposure and disease in England from May 2020 to February 2023

By December 2023, the COVID-19 pandemic had resulted in over 20.5 million confirmed cases and 175,000 deaths in England. The pandemic's impact varied significantly across different population groups, influenced by deprivation, ethnicity, and policy measures. We analysed individual-level data on SARS-CoV-2 testing, hospitalisations, deaths, and vaccination records in England from May 2020 to February 2022. We used Poisson regression models to estimate incidence rate ratios (IRRs) for first pillar 2 PCR positive cases, associated hospitalisations, and deaths, adjusting for sex, ethnicity, deprivation, geographic region, age, and epidemiological week.

The data analysed included 12,310,485 first SARS-CoV-2 pillar 2 PCR-confirmed infections, 79,315 hospitalisations, and 107,823 deaths associated with the first SARS-CoV-2 infection. Significant differences were observed across IMD quintiles, and ethnic disparities were also notable. Vaccine effectiveness (VE) was also assessed, with models indicating a significant reduction in risk post-vaccination across all outcomes of interest.

Deprivation and ethnicity significantly influenced COVID-19 outcomes in England. For severe outcomes, pre-existing health inequalities lead to large and persistent disparities in outcomes; for infections, both protective and support measures need to be structured with ethnicity and deprivation in mind in the early parts of a pandemic.

Results presented here are the output of the analysis in the repo.