COVID-19 First Wave Somerset Overview
A new strain of coronavirus, SARS-CoV-2, causing the illness COVID-19 was first discovered in China in December 2019. It rapidly spread round the world and by the end of January 2020, the UK had its first diagnosed case. In mid-February, the first diagnosed case had occurred in Somerset. Infections rose rapidly after this point, peaking in mid-April. By late July nearly 1,300 laboratory confirmed COVID-19 cases had been diagnosed in Somerset, at which point the incidence of the infection was falling significantly.
Help is available from the Somerset Coronavirus website.
Somerset, along with much of the northern hemisphere, experienced a second wave starting in the autumn of 2020. The most recent information on the number of COVID cases for Somerset by district and Middle Super Output is published on the coronavirus dashboard.
Throughout the first wave of the pandemic, and in common with many parts of the South West, Somerset had comparatively low rates of new COVID-19 infection. In part this reflects the characteristics of Somerset in terms of low population density and relative affluence. Other factors, including ongoing commitment by residents of Somerset for social distancing and hand hygiene measures, and effective infection prevention and control in health and care settings, will have contributed.
As the pandemic progresses, more is being learnt about the physical and mental health needs of those who are recovering from severe COVID-19. Patients who have been on intensive care can have significant respiratory, renal and cardiac complications in addition to psychological problems. Around 45% of these patients will need some form of medical or social input for recovery and 5% will require intensive rehabilitation.
Deaths from COVID-19
By mid-July, around 200 people in Somerset had died from COVID-19. Most of the deaths occurred in March and April, accounting for 17% and 30% of all deaths occurring in those months, respectively. In common with most of the South West, death rates from COVID-19 in Somerset have been among the lowest in England – in the bottom 10%.
Figure 2: COVID-19 death rates in England, County and UAs and London Boroughs, March-June 2020 (ONS)
Deaths rise quickly during a pandemic and lack of accurate diagnosis and testing, particularly in the early stages, meant that some COVID-19 deaths may not have been identified. The pandemic and the lockdown measures implemented by governments to slow the spread of the virus created major changes in society, affecting areas such as the economy and access to services. This is the indirect impact of the COVID-19 pandemic, and some of these changes will have increased mortality. Measuring mortality from all causes and excess mortality, is a useful way of assessing the overall impact – deaths from both COVID-19 and indirect mortality. In 2020, up until the end of May, deaths were 10% higher than the previous five years. COVID-19 was main cause of 60% of these excess deaths.
Figure 3: Deaths from all causes in Somerset (ONS)
There were increases in deaths from some conditions, including 15% more deaths from diabetes; obesity-related deaths were twice as high as average. Declines were seen in areas including deaths from transport accidents and other respiratory infections. Recent research has identified the link between increased risk of severe COVID-19 infection in people with diabetes and obesity, so it is likely that some of these deaths are attributable to the infection. Other changes in the patterns of deaths are likely to reflect changes occurring during lockdown, including reduced road traffic and fewer people at work, school and social gathering reducing transmission of respiratory infections including flu and pneumonia.
The Pandemic’s Initial Spread
Certain settings, including hospitals, care homes and workplaces such as food processing plants, can act as amplifiers for spreading the virus. By mid-July, most outbreaks had occurred in care homes. In Somerset 27% of all homes reported an outbreak, slightly below the South West average of 30% and substantially lower than the national average of 44%. Care home residents are extremely vulnerable to COVID-19 and by July 42% of all deaths from COVID-19 in Somerset had occurred in a care home.
High Risk Groups
Some groups are more likely to be seriously ill or die as a result of COVID-19. Data on some risk factors, particularly ethnicity and occupation, for those that are seriously ill or have died from COVID-19 are currently lacking in Somerset. Mirroring the national pattern, deaths from COVID-19 were higher in men, with 65% of all COVID-19 deaths occurring in men. Most deaths occur in older people, with 80% of all COVID-19 deaths in those aged over 75.
The association between deprivation and risk of poor outcomes with COVID-19 is complex. People living in deprived areas are more likely to have risk factors associated with increased risk of death from COVID-19 including multiple long-term conditions, obesity, and some working conditions. They are also more likely to experience discrimination, have low levels of health literacy and have difficulty accessing health services. In contrast to the national pattern, there was only weak evidence of an association between deprivation and COVID-19 deaths in Somerset. This pattern may be different in future months and subsequent waves of the pandemic.
Figure 5: Association between deprivation and COVID-19 deaths in Somerset (to end May 2020)
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