Was the UK already in a bad place to respond to COVID?

By Peter Warrington

The UK was already considered one of the “sickest” countries in Europe¹

The House of Lords Public Services Committee heard that “a lack of investment in services that prevent ill-health had resulted in the prevalence of chronic diseases such as obesity and diabetes. This meant that the country lacked resilience when the pandemic hit, which placed additional pressures on the NHS. People with preventable chronic diseases were more likely to be hospitalised than others.”

It also concluded that “While avoidable ill-health is widespread, it disproportionately affects poorer people. The chronic diseases which made people more susceptible to COVID-19 are concentrated in deprived areas, where death rates from the virus were highest. Many of these deaths could have been avoided if there had been a greater investment in preventative services.”

“Our evidence suggested that the COVID-19 crisis would not have been as acute if preventative services had received sufficient funding and emphasis in the past. Dr De Gruchy reported: ‘We have had to play catch-up because of the cuts over time to the public health system.’”²

“The NHS was [already] facing its longest and deepest financial squeeze in NHS history with over 100,000 workforce vacancies in the trust sector alone and staff exhausted after coping with year-round levels of ‘winter’ demand.” – NHS Providers³

How COVID affected different groups

“Diabetes was mentioned on 21% of death certificates where COVID-19 was also mentioned… This proportion was higher in all BAME groups when compared to White ethnic groups and was 43% in the Asian group and 45% in the Black group.”

“The [death] rate in the most deprived quintile was 2.3 times the rate in the least deprived quintile among males and 2.4 times among females.”

“The highest age standardised diagnosis rates of COVID-19 per 100,000 population were in people of Black ethnic groups (486 in females and 649 in males) and the lowest were in people of White ethnic groups (220 in females and 224 in males). An analysis of survival among confirmed COVID-19 cases shows that, after accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death when compared to people of White British ethnicity. People of Chinese, Indian, Pakistani, Other Asian, Black Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British.” ⁴