Research and analysis

COVID-19 confirmed deaths in England (to 30 June 2021): report

Updated 28 April 2023

Due to a misclassification of 2 subgroups within the Asian and Asian British and Black and Black British ethnic categories, the mortality rates reported for these ethnic groups were incorrect in this report, published on 14 July 2021. These have been corrected since 12 August 2021. The impact of the correction specifically affects the mortality rates presented for those of Asian and Asian British and/or Black and Black British ethnic categories, no other ethnic groups were affected by this error. The total number of deaths and other mortality rate calculations reported are unaffected.

COVID-19 deaths

Public Health England (PHE) has published statistics on deaths in people with laboratory-confirmed COVID-19 since 29 April 2020. In this report we present the latest data on COVID-19 mortality. Further information on the data series can be found here.

Data sources

Cases of laboratory diagnosed COVID-19 resident in England were identified from the Second Generation Surveillance System (SGSS).

Fact and date of death were derived from combined sources: NHS England hospital deaths, Office for National Statistics (ONS) death registrations, PHE Health Protection Team direct reporting and Demographic Batch Service tracing of laboratory-confirmed cases.

Definitions

In this report deaths are defined as a death in a person with a laboratory-confirmed positive COVID-19 test and either:

  • died within 60 days of the first specimen date

or

  • died more than 60 days after the first specimen date with COVID-19 mentioned on the death certificate

This data does not include deaths in people where COVID-19 is suspected but not confirmed by testing (SARS-CoV-2 PCR either negative or not tested).

This data does not report cause of death, and as such represents all deaths in people with laboratory-confirmed COVID-19, not just those caused by COVID-19.

In this report, data is reported from 29 June 2020 to 30 June 2021.

Mortality rates are calculated using 2019 ONS population estimates data.

Age-standardised rates adjust for differences in the age structure of populations. The standard used throughout this report is the European Standard Population 2013.

Methods

Mortality rates presented for different time periods have been annualised in order to enable comparisons. This method involves adjusting the population data used to calculate rates for the time period covered, these are expressed as mortality rates per 100,000 population per year. These rates cannot be compared with rates that do not have this adjustment.

Mortality rates by region, local authority, sex, ethnic group and Index of Multiple Deprivation (IMD) have been age-standardised to account for the different age distributions within different populations.

All figures displaying mortality rates have been calculated using a 7-day rolling average, to allow for smoothing of fluctuating data.

To note, from 6 July, ethnicity data has been updated based on a new method for assigning ethnicity developed by PHE. The previous method used the most recent ethnicity recorded through linkage to Hospital Episode Statistics and was supplemented by self-reported ethnicity recorded on test request forms. The new method uses self-reported ethnicity from test request forms and supplements this with the most frequent ethnicity recorded through linkage to Hospital Episode Statistics, unless the most frequent was ‘Other’ when the second most frequent was chosen. The new method has resulted in a reduction in the number of cases allocated to the ‘Other’ ethnic group and a slight increase in the % allocated to all other ethnic groups.

COVID-19 mortality rates

Within the period 29 June 2020 to 30 June 2021, 3,974,558 cases of COVID-19 were detected in England. In the same period, there have been 92,011 deaths in persons with laboratory-confirmed COVID-19. This represents a crude mortality rate of 163.0 per 100,000 population. From 29 June 2020 onwards, the highest recorded number of daily deaths was 1,504 deaths on 19 January 2021.

Month Cases Deaths Crude mortality rate (95% CI)
July 2020 19,334 1,199 2.1 (2.0-2.2)
August 2020 29,815 517 0.9 (0.8-1.0)
September 2020 127,691 826 1.5 (1.4-1.6)
October 2020 482,859 4,551 8.1 (7.8-8.3)
November 2020 526,566 11,651 20.6 (20.3-21.0)
December 2020 862,087 15,865 28.1 (27.7-28.5)
January 2021 1,079,256 33,324 59.0 (58.4-59.7)
February 2021 292,397 16,487 29.2 (28.8-29.7)
March 2021 135,912 5,197 9.2 (9.0-9.5)
April 2021 59,541 1,307 2.3 (2.2-2.4)
May 2021 61,815 498 0.9 (0.8-1.0)
June 2021 296,044 425 0.8 (0.7-0.8)

Table 1. Number of laboratory-confirmed cases, deaths and crude mortality rate (per 100,000 population) in laboratory-confirmed cases of COVID-19, by month*†

*Data is presented from 1 July 2020 to 30 June 2021. Due to continuous data quality improvements, reported number of cases and deaths may be subject to fluctuations. These numbers represent a snapshot of the number of cases and deaths at the time of report production.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 1. Number of deaths in laboratory-confirmed cases of COVID-19 by date of death, from week 27 onwards*†

*Data is presented from 29 June 2020 to 30 June 2021.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Age and sex distribution

Since 29 June 2020, the mortality rate was highest among those aged over 80 (annualised rate of 1,898.6 per 100,000 population per year).

Age group Deaths (week 27 onwards*) Mortality rate** (95% CI) (week 27 onwards*) Deaths (June 2021) Mortality rate ** (95% CI) (June 2021)
<5 <10 0.2 (0.1-0.4) <10 0.4 (0.0-2.1)
5-9 <10 0.1 (0.0-0.3) <10 0.0 (0.0-0.0)
10-19 32 0.5 (0.3-0.7) <10 0.2 (0.0-1.1)
20-29 149 2.1 (1.7-2.4) <10 1.2 (0.5-2.4)
30-39 531 7.0 (6.4-7.6) 13 2.1 (1.1-3.6)
40-49 1,519 21.2 (20.2-22.3) 26 4.4 (2.9-6.5)
50-59 4,612 60.7 (59.0-62.5) 36 5.8 (4.0-8.0)
60-69 10,041 169.5 (166.2-172.8) 69 14.2 (11.1-18.0)
70-79 21,084 445.5 (439.5-451.5) 87 22.4 (18.0-27.7)
80+ 54,009 1,898.6 (1882.6-1914.6) 185 79.3 (68.3-91.6)

Table 2. Number of deaths and annualised mortality rate** (per 100,000 population per year) in laboratory-confirmed cases of COVID-19, by age group†

Note: Numbers of deaths fewer than 10 have been excluded to minimise the risk of deductive disclosure.

*Data is presented from 29 June 2020 to 30 June 2021

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

From week 27 onwards, 49,110 (annualised rate of 224.0 per 100,000 population per year) deaths have occurred in males and 42,878 (159.5 per 100,000 per year) in females. The mortality rate in both sexes in June was considerably lower than the average for the total period 29 June 2020 to 30 June 2021.

Sex Deaths (week 27 onwards*) Age-adjusted mortality rate** (95% CI) (week 27 onwards*) Deaths (June 2021) Age-adjusted mortality rate** (95% CI) (June 2021)
Female 42,878 159.5 (158.0-161.1) 182 0.7 (0.6-0.8)
Male 49,110 224.0 (222.0-226.0) 243 1.1 (0.9-1.2)

Table 3. Number of deaths and age-adjusted annualised mortality rate ** (per 100,000 population) in laboratory-confirmed cases of COVID-19, by sex*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 2.a. Seven-day rolling average annualised mortality rates** (per 100,000 population per year) in laboratory-confirmed cases of COVID-19 by age group, from week 27 onwards*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 2.b. Seven-day rolling average annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by age group, June 2021*†

*Data is presented from 1 June to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Ethnicity

Overall, the age-adjusted annualised mortality rate from 29 June 2020 onwards was highest among those of Asian or Asian British ethnic groups (annualised rate of 350.2 per 100,000 population per year) followed by those of Black and Black British ethnic groups (annualised rate of 277.4 per 100,000 population per year).

Table 4. Number of deaths and age-adjusted annualised mortality rate** (per 100,000 population) in laboratory-confirmed cases of COVID-19, by ethnicity†

Ethnic category *** Deaths (week 27 onwards* ) Age-adjusted mortality rate** (95% CI) (week 27 onwards*) Deaths (June 2021) Age-adjusted mortality rate** (95% CI) (June 2021)
White / White British 80,372 158.9 (157.8-160.0) 308 0.6 (0.6-0.7)
Black / Black British 2,416 277.4 (265.8-289.4) 26 2.8 (1.7-4.2)
Asian / Asian British 6,563 350.2 (341.3 - 359.2) 71 3.5 (2.7-4.4)
Mixed 429 158.4 (142.6-175.2) <10 1.8 (0.5-4.1)
Other± 457 215.0 (194.1-237.3) <10 0.7 (0.1-2.3)
Unknown 1,751 12

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

***Ethnic categories are based on ONS classifications.

±The rates in the Other ethnic group are likely to be an overestimate due to the difference in the method of allocating ethnicity codes to the deaths data and the population data used to calculate the rates.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Note: From 6 July, ethnicity data has been updated based on a new method for assigning ethnicity developed by PHE which has resulted in a decrease in deaths in ‘other ethnicity’ category. This month’s ethnicity data is not comparable to previous months.

Figure 3.a. Seven-day rolling average age-adjusted annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by ethnicity, from week 27 onwards*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

***Ethnic categories are based on ONS classifications.

±The rates in the Other ethnic group are likely to be an overestimate due to the difference in the method of allocating ethnicity codes to the cases data and the population data used to calculate the rates.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Note: From 6 July, ethnicity data has been updated based on a new method for assigning ethnicity developed by PHE which has resulted in a decrease in deaths in ‘other ethnicity’ category. This month’s ethnicity data is not comparable to previous months.

Figure 3.b. Seven-day rolling average age-adjusted mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by ethnicity, June 2021*†

*Data is presented from 1 June to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

±The rates in the Other ethnic group are likely to be an overestimate due to the difference in the method of allocating ethnicity codes to the cases data and the population data used to calculate the rates.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Note: From 6 July, ethnicity data has been updated based on a new method for assigning ethnicity developed by PHE which has resulted in a decrease in deaths in ‘other ethnicity’ category. This month’s ethnicity data is not comparable to previous months.

Deprivation

Relative deprivation was assessed using quintiles of the IMD linked to residential lower super output area, with IMD 1 representing the most deprived. Overall, the age-adjusted annualised mortality rate is highest among those living in the most deprived areas, with a gradual decrease in mortality rate seen with decreasing deprivation.

**IMD Quintile (1 most deprived) ** Deaths (week 27 onwards*) Age-adjusted mortality rate** (95% CI) (week 27 onwards*) Deaths (June 2021) Age-adjusted mortality rate** (95% CI) (June 2021)
1 21,420 264.6 (261.1-268.2) 150 1.8 (1.5-2.1)
2 19,530 201.3 (198.5-204.2) 93 0.9 (0.8-1.2)
3 18,142 156.3 (154.0-158.5) 62 0.5 (0.4-0.7)
4 17,056 135.9 (133.8-137.9) 60 0.5 (0.4-0.6)
5 15,416 117.5 (115.6-119.3) 58 0.5 (0.3-0.6)
Unknown 424 - 2 -

Table 5. Number of deaths and age-adjusted annualised mortality rate** (per 100,000 population) in laboratory-confirmed cases of COVID-19, by IMD quintile*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 4.a. Seven-day rolling average age-adjusted annualised mortality rate** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by IMD quintile, from week 27 onwards*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 4.b. Seven-day rolling average age-adjusted annualised mortality rate** (per 100,000) population in laboratory-confirmed cases of COVID-19 by IMD quintile, June 2021*†

*Data is presented from 1 June to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Regional breakdown

Since 29 June 2020, the annualised mortality rate was highest in the North West (203.5 per 100,000 population per year), followed by London (192.5 per 100,000 population per year) and the West Midlands (187.5 per 100,000 population per year). The lowest mortality rate was seen in the South West (87.8 per 100,000 population per year). In June, the highest annualised mortality rate was seen in London (1.0 per 100,000 population per year).

PHE Centre Deaths (week 27 onwards*) Age-adjusted mortality rate** (95% CI) (week 27 onwards*) Deaths (June 2021) Age-adjusted mortality rate** (95% CI) (June 2021)
East Midlands 8,778 180.5 (176.7-184.3) 30 0.6 (0.4-0.9)
East of England 11,671 171.6 (168.5-174.7) 32 0.5 (0.3-0.7)
London 11,498 192.5 (189.0-196.1) 62 1.0 (0.8-1.3)
North East 4,661 169.3 (164.5-174.2) 14 0.5 (0.3-0.9)
North West 14,547 203.5 (200.2-206.8) 145 2.0 (1.7-2.4)
South East 14,567 153.7 (151.2-156.2) 35 0.4 (0.3-0.5)
South West 5,843 87.8 (85.5-90.1) 13 0.2 (0.1-0.3)
West Midlands 10,942 187.5 (184.0-191.1) 46 0.8 (0.6-1.1)
Yorkshire and Humber 9,057 167.7 (164.3-171.2) 46 0.9 (0.6-1.1)
Unknown 424 - 2 -

Table 6. Number of deaths and age-adjusted annualised mortality rate** (per 100,000 population) in laboratory-confirmed cases of COVID-19, by PHE centre*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 5.a. Seven-day rolling average age-adjusted annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by PHE centre, from week 27 onwards*†

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 5.b. Seven-day rolling average age-adjusted annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by PHE centre, June 2021*†

*Data is presented from 1 June 2021 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 6.a. Age-adjusted annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19 by upper-tier local authority, week 27 onwards*†***

*Data is presented from 29 June 2020 to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

***Please note that some changes were made in June to the way deaths are allocated to Local Authorities. As a result, some deaths previously reported in England have been reallocated to different resident local authorities.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figure 6.b. Age-adjusted annualised mortality rates** (per 100,000 population) in laboratory-confirmed cases of COVID-19, by upper-tier local authority, June 2021*†***

*Data is presented from 1 June to 30 June 2021.

**Rates are annualised and expressed as the number of deaths per 100,000 population per year.

***Please note that some changes were made in June to the way deaths are allocated to Local Authorities. As a result, some deaths previously reported in England have been reallocated to different resident local authorities.

†Deaths within 60 days of a positive COVID-19 test or where COVID-19 is mentioned on the death certificate.

Figures 6a and 6b:

  • contain Ordnance Survey data © Crown copyright and database right 2020

  • contain National Statistics data © Crown copyright and database right 2020

Case fatality risk

Case fatality risk (CFR) describes the risk of death following a laboratory-confirmed positive COVID-19 test. For this report, CFR has been calculated within 60 days of an individual’s first positive specimen (from PCR, LAMP, and LFD tests) CFR is reported on data from week 27 (29 June 2020) up to and including 6 May 2021. Cases diagnosed in the last 60 days were excluded from this analysis, due to incomplete follow-up period. Deaths are excluded from the CFR calculation if they cannot be linked to laboratory-confirmed COVID-19 case data.

CFR is sensitive to:

  • changes in testing coverage and detection rate of COVID-19 infections (Dudel and others, 2020; Wu and others, 2020; Harman and others, 2021)

  • changes in the demographics of the infected population

  • changes in the effectiveness of treatment and the health system’s ability to care for severe COVID-19 cases

Cases Deaths† Case fatality risk (%)
Week 27 onwards* 3,624,950 85,685 2.4

Table 7. Number of laboratory-confirmed cases, deaths and case fatality risk in laboratory-confirmed cases of COVID-19, from week 27 onwards*†

*Data is presented from 29 June 2020 to 6 May 2021. Figures differ from Table 1 based on CFR calculation inclusion criteria.

†Deaths within 60 days of a positive COVID-19 test and linked to the confirmed COVID-19 case data.

Figure 7. Number of laboratory-confirmed cases, deaths and case fatality risk in laboratory-confirmed cases of COVID-19, from week 27 onwards*†

Note: The time period presented covers a period where testing coverage and testing modes have changed significantly, therefore apparent changes in estimated case fatality should be interpreted with caution. Numbers of cases and deaths are stacked by week. Cases are presented by week of specimen date. Deaths are presented by week of death.

*Data presented from 29 June 2020 to 6 May 2021, the last full week of full data available.

†Deaths within 60 days of a positive COVID-19 test and linked to the confirmed COVID-19 case data.

Report prepared by PHE COVID-19 Epidemiology Cell