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21 July 2021

Who has been hit hardest by the UK’s third wave of Covid-19?

More than 60 per cent of those who died of the Delta variant had received at least one vaccine dose, and more young people are being hospitalised.

By Polly Bindman

The much-anticipated “freedom day” arrived this week as three of the UK’s most senior ministers – Boris Johnson, Rishi Sunak and Sajid Javid – joined hundreds and thousands of other people in self-isolation after coming into contact with Covid-19. 

To some, England’s reopening is a major risk given that deaths and hospitalisation rates are once again rising (by 60 per cent and 39 per cent respectively in the past seven days). To others, that deaths and hospitalisations remain low relative to case numbers – thanks, chiefly, to the vaccine roll-out – means the balance of risk has shifted. But who is right? Here, the New Statesman looks at where we are now and how the current wave differs from those that preceded it.

How the UK’s vaccine roll-out has dramatically reduced Covid-19 deaths
Cases versus deaths over days 1-50 of the UK’s second and third Covid waves

Calculations based on a seven-day rolling average of daily recorded cases and deaths. Second wave is recorded from 8/9/20, third wave is recorded from 14/5/21.
Source: UK Government, ONS

The UK is clearly in a better position now with regards to deaths than it was at the same point during the second wave (see graph). Though cases have risen sharply, deaths and hospitalisations have risen more slowly than last time. 

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This might appear reassuring, but there is a major caveat: during previous waves the number of cases was curtailed by lockdowns and restrictions. This time, restrictions are being removed. Daily new cases have risen from around 3,000 at the start of June to roughly 50,000 on “freedom day”. Vaccines may have weakened the link between cases and hospitalisations and deaths, but they have not completely broken it. 

Here is who has been most affected by the third wave so far.

Recent data shows that the gap between over-75s and under-75s dying from Covid is narrowing. This could be seen as positive news as it reflects the success of the vaccine, but with only 68 per cent of the adult population having received both doses of the vaccine, those in younger age groups in particular remain less protected from the virus. Recent figures suggest that London – with one of the youngest age profiles in the UK – has the lowest vaccine uptake in England, with more than a third of Londoners not having had their first dose.

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The gap between deaths among over-75s and under-75s has narrowed
Proportion of deaths in England involving Covid-19 in people aged 0-75 and 75+

An important factor is that while vaccines are effective at reducing the risk of death, they don’t prevent it entirely. This is particularly true for those who have not had both jabs. A recent report by Public Health England showed that 163 of the 257 people (63.4 per cent) who died of the Delta variant within 28 days of a positive Covid test between 1 February and 21 June had received at least one vaccine dose.

More than half of Delta deaths had at least one dose of the vaccine
Deaths by vaccination status among confirmed Delta cases (sequencing and genotyping) in England, 1 February to 21 June 2021

Hospital admission rates are also increasing across all age groups, particularly for those between the ages of 18 and 55. During the current wave, hospitalisations have risen faster, relative to cases, than deaths. That is an important consideration, too: preventing death is not the only aim of an anti-Covid strategy. Too many people in hospital could overwhelm emergency health services and have profound consequences for other elective procedures, and forms of care, at a time when the NHS is only beginning to clear its pandemic-related backlog. 

Hospital admissions are rising across all age groups
Hospital admissions with confirmed Covid-19, per 100,000 people, 23 May to 11 July 2021, by age

The total number of young people with Covid in hospital has increased during the third wave. From December to February, the age bracket with the highest total number of hospital admissions and inpatients were 75- to 84-year-olds, but from May to July, this changed to the 18-to-54 age bracket. Although the latter group is larger, this still marks a distinct shift from previous months.

More young people are being hospitalised due to Covid-19
Percentage of patients admitted with Covid-19 and number of inpatients diagnosed with Covid-19 by age group, 1 Dec – 1 Feb; 1 May – 1 July

At present, England is suffering the highest rate of deaths and cases. Although at the end of June, Scotland’s case rate was almost double that of England’s, a sharp reversal has taken place in recent weeks. On 18 July England had 73 cases per 100,000 people whereas Scotland had 41. Northern Ireland’s rate was 46 per 100,000, while Wales only had 28 cases per 100,000 people.

England has suffered the worst Covid third wave
Daily new confirmed Covid-19 cases per 100,000, as a rolling seven-day average

Hospital admission rates and deaths have increased across all regions, although the highest concentration of hospital admissions is in the North East, whereas the North West has the highest number of deaths.

Hospital admissions have increased across all regions
Change in hospital admission rates per 100,000 people involving Covid-19 from previous week in England (weeks ending 2 and 11 July 2021)

Death rate highest in the North West
Change in number of deaths involving Covid-19 from previous week in England (weeks ending 2 and 11 July 2021)