How many people have had Covid-19?

Published 12 January 2021

Our new research, which we did for the Guardian, estimates that 1 in 5 people in England has had Covid-19. Since the start of the pandemic, that is about 12.4 million people – see grey bars in the chart below.

The numbers are substantially higher than the 2.4 million confirmed infections from PHE testing (see red bars in the chart above), which has grown significantly since the spring. Our estimate of total cases is calculated by looking at a local authority’s age profile and applying age-specific infection fatality ratios – adjusted for the second wave (due to improvements in treatment).

There is substantial variation across local authorities with Barking and Dagenham being as high as 54% and Cornwall being as low as 4.8%. This infection level reflects London being hit – by surprise (twice) – in both the first and second (mutant) wave of Covid-19.

Perhaps the most startling finding is that almost half (49%) of these infections are estimated to have happened since the end of the first national lockdown. This suggests that, aside from draconian lockdowns, the measures to control spread could be better understood and implemented. This would be helped with more information on where and why the spread is happening (non-compliant birthday celebrations, lessons in Victorian school classrooms, car sharing, coffee in the park, bits of all of the above, etc.).

Unfortunately, this increase in cases translates into more occupied hospital beds – now at critically high levels. The horrifying milestone of critical care bed occupancy from the 10th of April (1,057) was hit in London today and will only get worse for the next few days. Nationally there are now 3,055 in critical care – also higher than the first wave. (Excellent article from the Global Health Security Team in the Telegraph on this here.)

This is unimaginably given how much more is known about Covid-19 this time.

Relying on the vaccines alone to protect the NHS, and end lockdowns is not enough. And, if it is, what happens if the vaccine for the next pandemic doesn’t work as effectively? More needs to be done to understand how and where infections are happening so that control measures can be less draconian. This is unlikely to stop being important even after we have all had our vaccination.

Read more about our work on total infections here (you can even download the detailed data): https://www.edgehealth.co.uk/post/as-many-as-1-in-5-people-in-england-have-had-the-covid-19-disease

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[*] Any suggestion that these numbers take us close to herd immunity need to remember that it would require redoing 2020 at least three more times – possibly more if you can catch Covid-19 more than once (e.g. due to a variation).