First Covid wave raised UK adult risk of death by 40%, study finds

Britain’s first wave of coronavirus raised the risk of death by more than 40% for most adults regardless of their underlying health and other factors, research suggests.

Scientists examined medical records for nearly 10 million people aged 40 and over and found that, whatever a person’s risk of dying before the pandemic, it rose 1.43 times on average as the virus spread between March and May 2020.

The finding means that Covid amplified people’s pre-existing risks by a similar amount, leading those most vulnerable before the pandemic to bear the brunt of the deaths.

“Covid-19 seems to have multiplied the death rate by a similar amount for most adults in the UK,” said Dr Helen Strongman, an epidemiologist on the study at the London School of Hygiene and Tropical Medicine. “It really exploits any frailty or health or demographic risk factor. It picks on people who are already at risk of ill health or death more than other people in the population.”

The researchers compared relative rates of all-cause mortality before and during the first wave, taking into account the impact of 50 different medical conditions and other characteristics, such as where people lived, their body mass index and ethnicity.

While the first wave of Covid multiplied the risk of death by a similar amount for most people, there were stark exceptions. Mortality rates for those with dementia and learning disabilities rose from three times higher than background levels to five times higher. Meanwhile, the death rates for people of colour and people living in London, which were lower than those of white people and people living outside the capital respectively before the pandemic, increased during the first wave.

Strongman said the work, which is published in Plos Medicine, reinforced the importance of protecting the most vulnerable. “No one is completely detached from someone who is frail or in poorer health and therefore at higher risk,” she said.

In a separate UK study, researchers found that countries with high levels of trust generally fared better than others at bringing Covid infections and deaths down from their peak levels.

As the Covid pandemic took off, countries brought in measures to tackle rising infections and deaths, with many resorting to lockdowns. The measures quickly brought down such levels in some countries, but not in others.

“Even if they’re the same measures, they’re not always being obeyed to thge same degree in different places,” said Prof Tim Lenton, the director of the global systems institute at the University of Exeter and a co-author of the study.

The research, published in Scientific Reports, looked at more than 150 countries’ resilience to Covid – the rate at which daily cases or deaths fell from peak levels – in 2020. It also explored the stringency of government measures in the countries, based on the Oxford Covid-19 government response trackers, and levels of trust using the World Values Survey.

The results show higher resilience to Covid in countries where the stringency of government interventions increased from a low background level in the face of a new wave of Covid, and the level of trust in each other was high – in other words there was a strong “social contract”.

Lenton said that in every country where trust is about 40% or higher the peaks were reduced to very low levels of cases and deaths, including in the UK, where trust is near that threshold.

“The UK is not a roaring success … and yet once we had managed to peak-out and we got on the decline curve, we actually are a case where we seem to have just enough trust to have really successfully brought the waves down,” he told the Guardian.

“Success with this awful pandemic appears to be more hinging on trust in each other than trust in government, which is probably a damn good thing given where we’re at with trust in government,” he added.

Stephen Reicher, a member of the Sage subcommittee on behavioural science and a professor of psychology at the University of St Andrews, said the findings fit with evidence that a sense of community identity is a key determinant of adherence to measures such as mask wearing, testing and social distancing.

“People, even if they don’t feel personally at great risk, are doing it for ‘us’. And a sense of shared identity – of ‘us-ness’ – is a critical antecedent of trust,” he said.