Poorer areas in England with a high population of South Asians identifying as Pakistani, Indian or Bangladeshi are most at risk of COVID-19 infection, according to a new study published on Monday 14 February in The Lancet Regional Health.

The study is the first to consider how the risk of COVID-19 infection changed for different communities over the course of the pandemic - from the point widespread testing began until September 2021. 

Researchers found that deprivation played a bigger role in COVID-19 incidence in the first wave of the pandemic, until October 2020. 

Ethnicity, however, played a larger part in the second wave from December 2020 until January 2021 and again from May until June 2021. From the spring of 2021 onwards, there was a less clear distinction between deprivation and ethnicity. 

Many studies use the number of positive COVID-19 test results to calculate COVID-19 infections, but this does not take into account factors like habits and access to testing. In this study, researchers coupled this measure with an estimate of the underlying infection rate and show that the role of deprivation and ethnicity is consistent across the two. 

Inequalities in England have become more evident during the pandemic, contributing to unequal death tolls across communities. People living in the most deprived areas in England and Wales were reportedly twice as likely to die from COVID-19 in the first wave.  

Socio-economic deprivation is often closely linked to ethnicity, so considering these factors together is important to assess their impact on the risk of COVID-19 infection. 

Study lead Marta Blangiardo, Professor of Biostatistics in the Department of Epidemiology and Biostatistics at Imperial College London, said:

“This research highlights that the role of deprivation and ethnicity on COVID-19 infection changed as the pandemic progressed. It is an essential first step to understanding why some groups are more at risk of contracting COVID-19 than others.

“There is a lot more work to be done to understand the reasons why this is the case and to better disentangle the effect of ethnicity from other factors. It’s only when we know why that we can begin to address the reasons behind it.” 

Director of the Health and Medical Sciences Programme at The Alan Turing Institute, and Professor of Biostatistics at the University of Oxford, Chris Holmes added:

“The unfortunate reality is that inequalities in England have become more prominent during the pandemic. And so research like this is vital in highlighting the impact of COVID-19 on different communities.

“We must continually monitor how different groups are responding so that no one is left behind.  We hope that this research will assist policy makers to help reduce social inequalities relating to COVID-19.” 

ENDS

The paper, ‘Time varying association between deprivation, ethnicity and SARS-CoV-2 infections in England: a population-based ecological study’, is the result of a collaboration between The Alan Turing Institute, MRC Centre for Environment and Health, Dept of Epidemiology and Biostatistics, Imperial College London, CHICAS, Lancaster Medical School, Lancaster University, University College London, University of Oxford, MRC Harwell Institute, MRC Biostatistics Unit, University of Cambridge and Members of The Alan Turing Institute and Royal Statistical Society’s “Statistical Modelling and Machine Learning Laboratory”, in partnership with the Data, Analytics and Surveillance Group, a part of the UKHSA.