Coronavirus (COVID-19) latest insights: Deaths

The number of UK deaths involving COVID-19 continued to rise to 1,059 in the latest week (ending 13 January 2023) from 842 in the previous week (ending 6 January 2023).

Deaths involving COVID-19 accounted for 5.3% of all deaths in the UK in the latest week; this is a rise from 5.0% in the previous week.

In England, the number of deaths involving COVID-19 varied across age groups, in the week ending 13 January 2023.

There were no deaths involving COVID-19 among those aged 15 to 24 years, or under 1 year. COVID-19 deaths were low among those aged 1 to 14 years, and 25 to 44 years.

Deaths involving COVID-19 rose in all English regions except the East Midlands, where they fell.

Deaths involving COVID-19 increased in the UK

Number of deaths registered by week, UK, week ending 13 March 2020 to 13 January 2023

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The proportion of deaths involving COVID-19 that were due to COVID-19 increased in England and Wales in December 2022

Percentage of deaths involving COVID-19 that were due to COVID-19, England and Wales, deaths registered in March 2020 to December 2022

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The proportion of deaths involving COVID-19, where COVID-19 was the underlying cause, increased in England (from 64.8% to 67.9%) and in Wales (from 65.8% to 71.9%) between November and December 2022.

In England, the proportion of deaths involving COVID-19 that were also due to COVID-19 was highest in April 2020 (95.2%) and lowest in June 2022 (59.0%). In Wales, this proportion was highest in April 2020 (94.1%) and lowest in June 2021 (42.9%).

The first deaths involving COVID-19 were registered in England and Wales in March 2020. Since then, COVID-19 has been the underlying cause of most deaths involving COVID-19 (84.6% in England and 83.4% in Wales).

The doctor certifying a death can list all causes in the chain of events that led to the death, and pre-existing conditions that may have contributed to the death. Deaths with COVID-19 mentioned anywhere on the death certificate are defined as deaths involving COVID-19. Deaths where COVID-19 is also the underlying cause of death are defined as deaths due to COVID-19.

Last updated: 20 January 2023

Read more about this in our Monthly mortality analysis, England and Wales bulletin

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The mortality rate for deaths due to COVID-19 in England decreased to 22.2 deaths per 100,000 people in December 2022, from 26.1 deaths per 100,000 people in November 2022. The COVID-19 mortality rate in December 2022 is around one-third of the highest rate seen in 2022 (79.3 deaths per 100,000 people in January 2022).

In Wales, the COVID-19 mortality rate increased to 30.1 deaths per 100,000 people in December 2022, from 27.4 deaths per 100,000 people in November 2022. However, this change was not significant in Wales. The rate in November 2022 was around one-third of the highest rate seen in 2022 (81.0 deaths per 100,000 people in January 2022).

In December 2022, COVID-19 was the ninth leading cause of death in England (2.2% of all deaths), falling from eighth in November 2022 (2.6% of all deaths). In Wales, COVID-19 was the eighth leading cause of death in December 2022 (2.7% of all deaths), rising from ninth in November 2022 (2.5% of all deaths).

Last updated: 20 January 2023

Read more about this in our Monthly mortality analysis, England and Wales bulletin

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Winter mortality compares the number of deaths that occurred in the winter period (December to March) with the average of the non-winter periods (the preceding August to November and following April to July).

In England and Wales, an estimated 13,400 more deaths occurred in the 2021 to 2022 winter period than in the non-winter period. This was the second lowest number since 1950 to 1951. This fall was affected by the larger number of deaths in the non-winter months, with a peak in daily deaths recorded on 19 July 2022, coinciding with the extreme heat.

In England, COVID-19 was the leading cause of winter mortality during 2021 to 2022, with 25.9% more COVID-19 deaths occurring in the winter than in non-winter. This was significantly lower than 2020 to 2021, when there were 567.2% more COVID-19 deaths in the winter period than in the non-winter period.

In Wales, the leading cause of winter mortality during 2021 to 2022 was dementia and Alzheimer’s disease (15.2%). In Wales, more COVID-19 deaths occurred in the non-winter period than the winter period, resulting in a negative mortality index (negative 1.2%). This is a large contrast compared with 2020 to 2021, when there were 460.5% more COVID-19 deaths in the winter period than in the non-winter period.

Last updated: 19 January 2023

Read more about this in our Winter mortality in England and Wales: 2021 to 2022 (provisional) and 2020 to 2021 (final) bulletin

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The number of deaths increased in most English regions

Estimated coronavirus (COVID-19) positivity rates, overall hospital admission rates with intensive care unit (ICU) and high dependency unit (HDU) admissions, and number of deaths, by English regions, week ending 2 December 2022 to 15 January 2023

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Deaths involving COVID-19 increased in all English regions, except in the East Midlands where they decreased, in the week ending 13 January 2023.

The infection rate decreased in all English regions in the week ending 10 January 2023.

In the week ending 15 January 2023, overall hospital admissions of patients with confirmed COVID-19 decreased in all English regions.

Trends in ICU and HDU admission rates varied across English regions in the week ending 15 January 2023. London continued to have the highest ICU and HDU admission rate.

There is a delay between a person becoming infected with COVID-19 and being admitted to hospital or dying, and this is reflected in the lags in trends. Deaths figures are the number of deaths registered in the time period. The number of deaths in each region will be affected by population size and do not necessarily reflect the rate of deaths.

The data used in the chart come from our Coronavirus Infection Survey, National flu and COVID-19 surveillance reports and our Deaths registered weekly in England and Wales, provisional bulletin.

Last updated: 24 January 2023

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Deaths remain highest for those aged 85 years and over

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Deaths involving COVID-19 in England increased for those aged 45 to 54 years, those aged 65 to 74 years, and those aged 85 years and over in the week ending 13 January 2023. Deaths remained similar for those aged under 45 years and those aged 55 to 64 years, and decreased for those aged 75 to 84 years. There were zero deaths for groups aged under 1 year and aged 15 to 24 years. Deaths were low for those aged 1 to 14 years, and 25 to 44 years.

Deaths involving COVID-19 were highest for those aged 85 years and over (462 deaths). This has been consistent throughout the coronavirus pandemic and reflects the highest overall hospital admission rates in the oldest age groups.

Last updated: 24 January 2023

The data in this chart come from our Deaths registered weekly in England and Wales, provisional bulletin

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Of deaths in England and Wales where COVID-19 was the underlying cause, the most common pre-existing condition recorded on the death certificate was symptoms, signs and ill-defined conditions, which includes “old age” and “frailty” (29.4%, October to December 2022). Chronic lower respiratory diseases were the second most common at 15.7%.

Overall, the proportion of COVID-19 deaths with no pre-existing conditions decreased slightly from 12.8% (July to September 2022) to 11.8% (October to December 2022).

Pre-existing health conditions are recorded if they are believed to have made some contribution to the death. If death due to COVID-19 has more than one pre-existing condition listed as contributing towards the death, it will be included in figures for all such conditions. The categories therefore sum to more than 100%. Health conditions may not be included if they were not considered relevant.

Last updated: 20 January 2023

Read more about this in our Monthly mortality analysis, England and Wales: September 2022 bulletin

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The rate of death involving COVID-19 was higher for those with obesity than those without obesity

Hazard ratios for all-cause death, death involving COVID-19, and death not involving COVID-19, for people with obesity relative to people without obesity, stratified by sex, England: 24 January 2020 to 30 August 2022

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For those aged between 30 and 64 years, the rate of death involving COVID-19 between 24 January 2020 and 30 August 2022 was higher for both men (2.12 times) and women (2.22 times) with obesity than those without obesity. This was after adjusting for age, ethnic group, geographical factors, socio-economic characteristics, smoking status and COVID-19 vaccination status.

The adjusted rate of death not involving COVID-19 was also higher for those with obesity than those without obesity, but to a lesser extent than for death involving COVID-19 (1.14 and 1.04 times higher for men and women respectively).

Differences in the rate of death involving COVID-19 between people aged 30 to 64 years with and without obesity may be partly explained by people with obesity being more likely to have several health conditions. After adjusting for these health conditions, the rate of death involving COVID-19 remained higher for those with obesity than those without obesity, but was reduced to 1.64 and 1.62 times higher for men and women respectively. This suggests that some of the differences in the risk of death involving COVID-19 may be attributable to these comorbidities (two or more diseases or conditions in a patient) being more common in people with obesity. However, these comorbidities did not explain all of the excess risk associated with obesity.

Last updated: 14 October 2022

Read more about this in our Obesity and mortality during the coronavirus pandemic article

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Over half of the European countries analysed had a peak of excess mortality between mid-2021 and mid-2022

Relative age-standardised mortality rates by week, persons, all ages, week ending 3 January 2020 to week ending 1 July 2022

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Relative age-standardised mortality rates (rASMRs) compare an individual week’s age-standardised mortality rate (ASMR), expressed as a percentage difference, from their five-years average (2015 to 2019) ASMR of that specific week. A negative rASMR value indicates the observed weekly ASMR was below the 2015 to 2019 five-year average for that week. In contrast, a positive value indicates a weekly ASMR above the five-year average.

This analysis includes the UK as a whole, its four constituent countries and a further 28 European countries. Of the 33 countries analysed, the majority of countries (20 countries) had at least half of their weeks display a positive rASMR since the week beginning 19 June 2021 (week 25 2021). In other words, 20 countries had excess mortality in the majority of weeks since the end of the previous reporting period (18 June 2021). The rASMRs ranged from 0.1% to 120.2% above what we would expect.

The UK had the 16th highest proportion of weeks where mortality rates were above what we would expect (55.6%). However, when looking at those aged under 65 years, the UK had the second-highest proportion of weeks with a positive rASMR (79.6% of weeks).

Looking at all-cause mortality compared with the five-year average (taking into account population size and age structure) is the most effective way of comparing the mortality impact of the coronavirus pandemic internationally. Not all countries will record COVID-19 deaths in the same way, so using all-cause mortality means that robust comparisons can be made. It also considers the indirect impact of the coronavirus pandemic, such as deaths from other causes that might be related to delayed access to healthcare.

Last updated: 23 December 2022

Read more about this in our Comparisons of all-cause mortality between European countries and regions: 28 December 2019 to week ending 1 July 2022 article

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Relative age-standardised mortality rates by week for local authorities of Europe

Interactive map, persons, all ages and broad age group, week ending 3 January 2020 to week ending 1 July 2022

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This interactive map shows relative age-standardised mortality rates (rASMRs) by regions of Europe for the 33 countries from week ending 3 January 2020 to week ending 1 July 2022, where data were available.

Last updated: 23 December 2022

Read more about this in our Comparisons of all-cause mortality between European countries and regions: 28 December 2019 to week ending 1 July 2022 article

Advanced age is the greatest predictor of higher COVID-19 mortality

International evidence shows that excess all-cause mortality during the coronavirus pandemic was driven by a wide range of factors, but advanced age was consistently the greatest predictor of higher COVID-19 mortality (SAGE, 2020) (OECD, 2021). Other factors were also found to have contributed including those of:

• existing health systems and resources

• increased risk to infection from COVID-19 and differences in health vulnerability of populations, for example, pre-existing conditions and comorbidities

• settings (in particular, for those in long-term care)

• levels of deprivation and inequality or occupation

• population density

• sex or ethnicity

• climate

The response to COVID-19 across countries also contributed to the differences in COVID-19 mortality, including:

• types and timings of health protection measures

• mobilisation and resourcing of healthcare workforce

• use of technology and data

• vaccination, for example, speed, coverage and type

• treatment type

• disruption to health systems and other unmet care needs

• societal behavioural responses, for example, following guidance

Comparison across these factors is complex and difficult to disentangle, as many aspects of national-level coronavirus pandemic responses were closely influenced by prevalence of COVID-19, and by pre-existing circumstances such as existing health infrastructure and resources.

Last updated: 23 December 2022

Read more about this in our International comparisons of possible factors affecting excess mortality

Deaths due to COVID-19 were higher than those due to flu and pneumonia in winter 2021 to 2022, but much lower than in winter 2020 to 2021

Monthly deaths registered due to flu and pneumonia in December to March, England and Wales, 2001 to 2022, and deaths due to COVID-19, December to March, 2020 to 2022

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During the winter of 2020/21, deaths due to both COVID-19 and flu and pneumonia exceeded those due to flu and pneumonia alone in pre-coronavirus years. In the latest winter (December 2021 to March 2022), the number of deaths with COVID-19 as the underlying cause has fallen more in line with those due to flu and pneumonia in pre-pandemic years. However, the number of deaths due to COVID-19 is still double the amount of deaths due to flu and pneumonia in the same period.

There have been considerably fewer deaths due to flu and pneumonia over the last two winters compared with previous years, with deaths due to flu and pneumonia at historic lows. Although deaths due to flu and pneumonia seem to be rising again and deaths due to COVID-19 are decreasing, deaths due to COVID-19 remain higher than deaths due to flu and pneumonia.

Infection and antibody levels, vaccination rates, restrictions and differences between COVID-19 variants all affect the data we have on COVID-19 mortality. Some of these factors also have affected flu and pneumonia deaths over the same period.

Last updated: 23 May 2022

Read more about this in our How coronavirus (COVID-19) compares with flu as a cause of death article

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While COVID-19 is mentioned on fewer death certificates than flu and pneumonia, it is far more likely to be listed as the underlying cause of death

Number of deaths registered involving and due to COVID-19, and flu and pneumonia, England and Wales, week ending 13 March 2020 to week ending 1 April 2022 

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Around 6 in 10 (62%) of deaths involving COVID-19 in the week ending 1 April 2022 had COVID-19 identified as the underlying cause of death, with similar proportions throughout March. This is a decrease from 90% in spring 2020 and the early part of 2021, possibly because of booster vaccinations and high antibody levels across the population.

In the week ending 1 April 2022, a fifth of deaths involving flu and pneumonia (20%) were due to these conditions, similar to most weeks since March 2021. While the proportion of COVID-19 deaths due to the disease reduced in early 2022, it is still three times higher than the proportion for flu and pneumonia.

Last updated: 23 May 2022

Read more about this in our How coronavirus (COVID-19) compares with flu as a cause of death article

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The average age of death is lower for COVID-19 than flu and pneumonia

Mean age of deaths registered due to COVID-19 and flu and pneumonia, England and Wales, March 2020 to March 2022

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Deaths due to COVID-19 have occurred more evenly across age groups than deaths due to flu and pneumonia, although in both cases the majority of deaths have been among the oldest.

The average (mean) age of death for COVID-19 has been lower than that of flu and pneumonia throughout the pandemic. In summer 2021, the mean age of death fell to 73 years, but has been rising again since the majority of the population have been fully vaccinated to 83 years in March 2022.

While most deaths due to COVID-19 have occurred among those aged over 80 years, the increased risk of death compared with flu and pneumonia has been greatest for those aged 40 to 79 years. In January 2021, when COVID-19 deaths were at their peak, the number of deaths due to COVID-19 was nearly 32 times higher than the number due to flu and pneumonia for this age group. Among those aged over 80 years, deaths due to COVID-19 were 16 times higher than those due to flu and pneumonia.

Last updated: 23 May 2022

Read more about this in our How coronavirus (COVID-19) compares with flu as a cause of death article

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The Office for National Statistics’ (ONS) weekly provisional counts of the number of deaths registered in England, Wales, Northern Ireland and Scotland includes all deaths with coronavirus (COVID-19) mentioned on the death certificate. Figures presented on the latest insights tool are different from the daily surveillance figures on COVID-19 deaths published by the Department of Health and Social Care, which provide daily and cumulative deaths occurring within 28 days of a positive test.

To find out more about deaths data from different sources visit our more information page.

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