Coronavirus (COVID-19)

This topic area covers statistics and information relating to COVID-19 in Hull including local strategic need and service provision. Further information relating to deaths from COVID-19 is given within Causes of Death under Population as the pattern and trends in different causes of death were affected with more people (often the frail and vulnerable) dying of COVID-19 rather than other diseases and conditions (such as dementia).

Further information can also be found on the UK Health Security Agency’s Data Dashboard for COVID-19.

Headlines

• Infections: Waves of infection have been experienced throughout the pandemic. The true prevalence of COVID-19 in the community is now difficult to identify due to a reduced testing offer.
• Long COVID: For some people, the symptoms of COVID-19 infection can last longer than the original 10-days, with symptoms of “long COVID” having a profound impact on individual’s everyday life.
• Impact: Since the beginning of the COVID-19 pandemic in the UK, there has been a significant impact on the health, mental, social and financial wellbeing of the population.
• Mortality: In Hull, 872 deaths from COVID-19 were registered during 2020 (389), 2021 (323), 2022 (116) and 2023 (44) representing 8.0% of all deaths registered during these four year although the numbers were higher for earlier in the pandemic. Overall, 13.5% of all deaths registered in 2020 were deaths from COVID-19, 11.9% for 2021, 4.3% for 2022 and 1.7% for 2023. The age-standardised mortality rates were statistically significantly higher in Hull compared to England during 2020 and 2021, but the differences were generally less marked for 2022.
• Vaccination: The success of the COVID-19 vaccination programme has reduced the need for population level non-pharmaceutical interventions however inequalities in the vaccine uptake mean that groups within the population are still high risk for adverse health outcomes as a result of COVID-19 infection.
• The routine vaccination of people based on age ended on 30 June 2023. Vaccinations the NHS offer are now more targeted to those at increased risk, usually during seasonal campaigns. The latest spring 2024 campaign focused on those people aged 75 years of age and above.

The Population Affected – Why Is It Important?

COVID-19 and our response to it affected the entire population. This page focusses primarily on the direct effects of infection with COVID-19, but the indirect effects of restrictions to prevent spread are also widespread across the population. The effects of COVID-19 have been unequal. Those already in poorer health were disproportionately affected, as were those from poorer communities. People aged under 65 in the poorest 10% of areas in England were almost four times as likely to die from COVID-19 than those in the most affluent 10% of areas (Health Foundation).

There are several risk factors for a fatal outcome associated with coronavirus including: chronic comorbidities, underlying respiratory conditions, older age population, diabetes, hypertension and obesity. The risk of death involving COVID-19 is also higher for disabled people according to statistical analysis by The Office for National Statistics. The rates of death involving COVID-19 of both disabled and non-disabled people significantly decreased between the second and third waves of the pandemic in England however in each wave, analyses identified mortality rates involving COVID-19 for more- and less-disabled people of both sexes remained higher compared with non-disabled people.

The Hull Picture

Pattern of Incidence

Community testing was stood down on 1^st April 2022, so the daily confirmed COVID-19 cases no longer accurately presents the number of cases within the community as testing only occurs in specific limited places like hospital and care homes. Up until 24th March 2023, the Office for National Statistics (ONS) provided population estimates on the current prevalence of COVID-19 within the community which estimated community prevalence is 2-3 times higher than the daily confirmed case count. Unfortunately these estimates have now ceased. Therefore, the incidence charts illustrated below are from March 2020 to July 2023 and show the historical incidence of the pandemic.

The first cases of COVID-19 were identified on 29 January 2020 in York, and were taken to the Castle Hill Hospital infectious diseases unit. Over the course of the pandemic in the UK, there has been four distinct waves of infection which have been influenced by the emergence of new variants (namely Delta and Omicron) and the easing of COVID-19 restrictions.

The pattern of infections for Hull has followed the national pattern of COVID-19 cases although Hull has experienced periods of high enduring transmission.

The non-pharmaceutical interventions (NPIs) including lockdown, social distancing and face coverings were introduced at various points of the UK Government’s response to try and reduce COVID-19 spread. A full timeline of the UK response has been produced by the Institute for Government.

COVID-19 Variants

All viruses, including SARS-CoV-2, the virus that causes COVID-19, change over time. Whilst most changes have little to no impact on the properties of the virus, those that do may alter how easily it spreads, the associated disease severity, the performance of vaccines, therapeutic medicines, diagnostic tools, or other public health and social measures.

Whilst monitoring variants, they can be classified as ‘Variants of Interest (VOIs)’ or ‘Variants of Concern (VOCs)’. Continued evaluation of new variants is a normal part of infectious disease surveillance.

Since the end of June 2022, most COVID-19 infections in the UK have been Omicron variant BA.5 or its sub-lineages. This variant was first identified in April 2022 and has driven the wave of infection seen over the summer, autumn and going into the winter of 2022/23. One of these BA.5 sub-lineages, BQ.1, has been increasing. In the week ending 25 December 2022, BQ.1 comprised 55.1%, and other BA.5 variants (and sub-lineages, excluding BQ.1) comprised 9.7% of all sequenced COVID-19 infections.

Omicron BA.5 has not been found to have a higher risk of hospitalisation and does not have vaccine evading qualities.

Full technical briefings and variants information is available from the UK Health Security Agency were available until October 2022 (all available here).

Hospitalisations

COVID-19 hospitalisations have fluctuated throughout the pandemic in a similar pattern to the case rates for both England and Hull shown below. COVID-19 hospitalisations have included individuals who are admitted due to COVID-19 illness and those who are identified to have COVID-19 upon admission for other conditions.

The following chart illustrates the number of beds occupied by patients with COVID-19 at Hull Teaching University NHS Trust between 1 August 2020 when information was first collected for hospitals until the end of August 2024.

The chart will include all patients at the hospital regardless of where they live. It is likely that the majority of people living in Hull would have been admitted to Hull Teaching University NHS Trust but they could have been admitted to other hospitals. The chart will also include residents from East Riding of Yorkshire and potentially residents of other local authorities.

The patterns shown in hospitalisations follows a similar pattern to the infection patterns around a week delayed. The Office for National Statistics infection survey reported a median delay between symptom onset and hospital admission varies between one and seven days depending on age and whether the patient lives in a nursing home. Hospitalisation is higher in older age groups and those with underlying health conditions.

During hospital admissions, individuals were in isolation or within COVID-19 specific quarantine wards. Visitors were not permitted to visit unless under exceptional circumstances such as end of life visits. This has been reported to have caused considerable distress amongst families due to an inability to visit loved ones when unwell and potentially in the last few days of life.

Mortality

The directly age standardised mortality rate from COVID-19 was considerably higher in Hull compared to England and among the highest in the region for 2020-22. The morality rate in Hull was 47% higher among men and 41% higher among women compared to England.

For all geographical areas, the mortality rate was much higher among men compared to women.

There were 828 deaths registered during 2020, 2021 and 2022 in Hull, and the mortality rate was higher in Hull compared to England for all three years.

Among men, the mortality rate in Hull was much higher than England for deaths registered in 2020 being 61% higher in Hull, but the inequalities gap reduced over time with the mortality rate being 37% higher in 2021 and 30% higher in 2022. The difference in 2022 was not statistically significant.

For women, the mortality rate was statistically significantly higher in Hull compared to England for all three years. The inequalities gap did reduce from being 46% higher in 2020 to 26% higher in 2021, but the inequalities gap was at its highest in 2022 with the mortality rate in Hull being 74% higher than England.

The mortality rate for premature deaths from COVID-19 was also high in Hull particularly for men in relation to England.

For men, the premature mortality rate was statistically significantly higher in Hull compared to England for males with the mortality rate 45% higher in Hull. For women, the premature mortality rate was also higher (15% higher) in Hull compared to England, but not statistically significantly so.

There were 103 deaths registered during 2020 and 125 deaths registered during 2021 which were due to COVID-19, and a further 23 deaths registered in 2022.

The majority of the premature deaths from COVID-19 were among men particularly among 2020 (69%) and 2021 (70%) with the majority but a slightly lower percentage among men for 2022 (65%).

Among women, the mortality rate was higher but not statistically significantly higher in Hull compared to England for all three years 2020, 2021 and 2022 (latter not shown as number of deaths less than 10 but was summarised in table showing mortality rates for each local authority in the region).

As the mortality rate from COVID-19 was higher in Hull, it is not surprising that the mortality rate for deaths involving COVID-19 was also higher. These include deaths that were due to COVID-19 but also deaths where COVID-19 was not the underlying cause of death but it was mentioned on the death certificate as a secondary cause.

The number of deaths were COVID-19 was the underlying cause or mentioned on the death certificate was much higher at 1,018 for deaths registered during the three year period 2020 to 2022.

For men, the mortality rate was statistically significantly higher in Hull compared to England for 2020, 2021 and 2022.

For women, the mortality rate was statistically significantly higher in Hull compared to England for 2020, 2021 and 2022.

The premature mortality rate for deaths where COVID-19 was the underlying cause or mentioned on the death certificate was also higher in Hull compared to England, particularly for men where the rate was statistically significantly higher. It was also among the highest in the region for men.

The premature mortality rate was statistically significantly higher in Hull compared to England for all three years 2020, 2021 and 2022.

For men, the premature mortality rate was also statistically significantly higher in Hull compared to England for 2020 and 2021 with no statistically significant difference between Hull and England for 2022.

For women, the premature mortality rate was also statistically significantly higher in Hull compared to England for 2020 and 2021 with no statistically significant difference between Hull and England for 2022.

Many people who were frail and vulnerable died of COVID-19 during 2020 and 2021 rather than from other diseases and conditions, and this affected the trends over time in relation to patterns of causes of death. For instance, the mortality rate for dementia and mortality rate from COVID-19 for people with dementia was particularly high. This is likely associated with a higher percentage of people with dementia living in care homes, and social distancing might have been more difficult among people with dementia. This change in the pattern of deaths is examined further in relation to COVID-19 and the secondary causes of death among people who died from COVID-19 within Causes of Death under Population.

Long COVID

For some adults and children, coronavirus infection can cause symptoms that last weeks or months after the infection has gone. This is sometimes called post-COVID-19 syndrome or “long COVID”. Symptoms of long COVID include: extreme tiredness/fatigue, shortness of breath, chest pain or tightness, “brain fog” including problems with memory and concentration, difficulty sleeping, heart palpitations, dizziness, pins and needles, depression and anxiety, joint pain, feeling sick, diarrhoea, stomach aches, loss of appetite, high temperature, cough, headaches, sore throat, changes to sense of smell or taste, and rashes.

The evidence base for Long COVID is growing as we learn more about the consequence of infection. COVID-19 infection has been found to impact memory and cause fatigue particularly in adults aged 25 plus. Whilst memory and fatigue can improve over time it can be a slow recovery. Similarly, individuals who experience ongoing COVID-19 symptoms (such as cough, fever, gastrointestinal issues) can have a slower memory and fatigue recovery than those who have asymptomatic infection.

Long COVID can have a big impact on an individual’s life and may require referral to a specialist rehabilitation service or a service that specialises in the specific symptoms that an individual has.

An estimated 2.1 million people living in private households in the UK (3.3% of the population) were experiencing self-reported long COVID (symptoms continuing for more than four weeks after the first confirmed or suspected coronavirus (COVID-19) infection that were not explained by something else) as of 4 December 2022. Of people with self-reported long COVID, 191,000 (9%) first had (or suspected they had) COVID-19 less than 12 weeks previously, 1.9 million people (87%) at least 12 weeks previously, 1.2 million (57%) at least one year previously and 645,000 (30%) at least two years previously. Of people with self-reported long COVID, 637,000 (30%) first had (or suspected they had) COVID-19 before Alpha became the main variant; this figure was 251,000 (12%) in the Alpha period, 382,000 (18%) in the Delta period and 778,000 (37%) in the Omicron period. Long COVID symptoms adversely affected the day-to-day activities of 1.6 million people (76% of those with self-reported long COVID), with 389,000 (18%) reporting that their ability to undertake their day-to-day activities had been “limited a lot”. Fatigue continued to be the most common self-reported symptom of long COVID (71%), followed by difficulty concentrating (49%), shortness of breath (47%) and muscle ache (46%). As a proportion of the UK population, the prevalence of self-reported long COVID was greatest in people aged 35 to 69 years, females, people living in more deprived areas, those working in social care, those aged 16 years and over who were not working and not looking for work, and those with another activity-limiting health condition or disability. The ONS Long COVID study will be continuously updated so visit the ONS website for the most up to date figures.

According to a review conducted by the UK Health Security Agency (UKHSA) in February 2022, individuals who have had one or more doses of a Covid-19 vaccine are less likely to develop long COVID than those who remain unvaccinated. Vaccination prior to infection has a lower association with long COVID, although studies have identified that vaccination after infection can ease symptoms of long COVID.

For more information on the signs of long COVID and how to access support services, visit the NHS website and the NHS Your COVID Recovery resource.

COVID-19 Vaccination Programme

The COVID-19 vaccination programme began in the UK on 8 December 2020. National totals ceased to be updated after 13 July 2023, at which point 151, 248,820 had been given. The vaccines are delivered through two primary doses and a booster dose; eligible individuals (those aged over 50 years and immunosuppressed) are also offered seasonal boosters. For more information on the vaccination offer, you can visit the NHS website here. The COVID-19 vaccination programme was rolled-out across the UK by using an invitation-based prioritisation programme based on age and health risk.

Although individuals may not develop symptoms of COVID-19 after vaccination, it is possible that they could still be infected with the virus and could transmit to others. Several studies have estimated vaccine effectiveness against hospitalisation, indicating high levels of protection particularly after three doses. The vaccines (Moderna, Astrazeneca, Novavax and Pfizer) offer high levels of protection (over 90%) against mortality for COVID-19 Alpha and Delta variants. The UK Health Security Agency continuously monitored vaccine effectiveness.

The current autumn 2024 vaccination campaign concentrates on those people aged 65 years old and above, residents in a care home for older adults, and individuals aged 6 months to 64 years in a clinical risk group as well as pregnant people who are also included in a clinical risk group. In Hull (as of 30 June 2024) 58.6% of this cohort have received a spring booster, compared to 65.5% in Yorkshire and the Humber and 62.3% in England as a whole. The latest data about COVID-19 vaccination levels in Hull can be found on the UKHSA dashboard.

Inequalities in vaccination uptake are evidenced by the ONS research which identified vaccination rates were lower in those who lived in deprived areas, those who identified as being from a non-white ethnic minority, worked outside the home for five or more days a week, or who had previously been infected with COVID-19 (using information from survey visits between 21 February and 20 March 2022).

Impact of COVID-19

The COVID-19 pandemic has been an international public health incident effecting all countries, people of all ages and backgrounds. Short term impacts of lockdown such as inability to see friends and family have somewhat dissipated as travel restrictions have lifted both nationally and internationally. However, longer term impacts such a health anxiety, community cohesion, skills, employment and the economy will have a lasting impact for a while. Further information can be found within a study commissioned by the UK Government from the British Academy, which details some of the long-term impacts of COVID-19 expected to be experienced over the next few years.

Research conducted by the Health Foundation has identified that the UK entered the pandemic with life expectancy stalling for the first time in a century and falling for some. The pandemic and response to it have further exposed the inequalities in our society. Some additional impacts that have been identified by the Health Foundation are:

• The pandemic has revealed stark differences in the health of the working age population – those younger than 65 in the poorest 10% of areas in England were almost four times more likely to die from COVID-19 than those in the wealthiest areas.
• Government restrictions, although required to limit COVID-19’s spread, have had wide-ranging consequences, creating a vast amount of unmet health needs and mental health problems, education gaps, early years development gaps, lost employment and financial insecurity.
• Some groups including young people, disabled people, from minority ethnic communities and care home residents have been more affected than others.

Further research conducted by the Health Foundation on the impact of COVID-19 pandemic on the population is available here.

Strategic Need and Service Provision

Ongoing vaccination promotion of additional doses as recommended by the Joint Committee on Vaccinations and Immunisations (JCVI) and promotion of the ‘evergreen’ offer. The vaccine promotion should aim to reduce inequalities in uptake, particularly in high risk groups including elderly individuals, people with severe mental illness and learning difficulties.

Healthcare services will need to consider how services can provide “long COVID” symptom management – service to manage the symptoms but also understanding of employers regarding the difficulty returning to work.

Mental health and wellbeing services will need to consider the mental health impacts of the COVID-19 pandemic both exacerbating existing conditions and consider treatment requirement for individuals with new conditions.

The health and social care system will need to support the hospital with system pressures including patient flow and supporting community care.

Many people in Hull may have lost employment or have financial implications following COVID-19 lockdown measures. The increasing cost of living and financial hardship will be a potential source of financial instability and stress within households.

It is likely that future waves of COVID-19 infections will continue to cause disruption, illness and deaths. At present, it is estimated we will continue to see waves of COVID-19 infection quarterly. Services must consider how regular waves will impact workforce and service demands.

Resources

Institute for Government. Timeline of UK government coronavirus lockdowns and restrictions. https://www.instituteforgovernment.org.uk/charts/uk-government-coronavirus-lockdowns

Coronavirus (COVID-19) in the UK: https://ukhsa-dashboard.data.gov.uk/

Office for National Statistics. Coronavirus (COVID-19) latest insights – infections: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19latestinsights/infections

Office for National Statistics. Coronavirus (COVID-19) Infection Survey technical article: waves and lags of COVID-19 in England, June 2021. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19infectionsurveytechnicalarticle/wavesandlagsofcovid19inenglandjune2021

Office for National Statistics. Updated estimates of coronavirus (COVID-19) related deaths by disability status, England. https://www.ons.gov.uk/releases/updatedestimatesofcoronaviruscovid19relateddeathsbydisabilitystatusengland

Office for National Statistics. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/alldatarelatingtoprevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk

UK Health Security Agency. The effectiveness of vaccination against long COVID: A rapid evidence briefing. https://ukhsa.koha-ptfs.co.uk/cgi-bin/koha/opac-detail.pl?biblionumber=64359

NHS. Long-term effects of coronavirus (Long COVID). https://www.nhs.uk/conditions/coronavirus-covid-19/long-term-effects-of-coronavirus-long-covid/

NHS. Book or manage a coronavirus (COVID-19) vaccination. https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/

UK Government. COVID-19 vaccine surveillance reports. Data on the real-world effectiveness and impact of the COVID-19 vaccines. https://www.gov.uk/government/publications/covid-19-vaccine-surveillance-report

UK Government. Coronavirus (COVID-19) data in the UK: Vaccinations in Hull. https://ukhsa-dashboard.data.gov.uk/topics/covid-19?areaType=Upper+Tier+Local+Authority&areaName=Kingston+upon+Hull%2C+City+of#vaccinations

The British Academy. The COVID Decade: understanding the long-term societal impacts of COVID-19. https://www.thebritishacademy.ac.uk/publications/covid-decade-understanding-the-long-term-societal-impacts-of-covid-19/

The Health Foundation. COVID-19 impact inquiry. https://health.org.uk/what-we-do/a-healthier-uk-population/mobilising-action-for-healthy-lives/covid-19-impact-inquiry

Updates

This page was last updated / checked on 30 September 2024.

This page is due to be updated / checked in March 2025.