The study, published in PLOS Medicine today [23 January], has shown that children were less likely to die during the pandemic lockdown (April 2020–March 2021) than at any time before or since, with 377 fewer deaths than expected from the previous year.  

The number of deaths in the following year (2021-2022) was similar to before the pandemic, but in 2022−2023, there were 258 more deaths than expected from the pre-pandemic period. 

The aim of the research was to quantify the relative rate, and causes, of childhood deaths in England, before, during, and after national lockdowns for COVID-19 and its social changes.

The researchers identified all those children in England who died between April 2019 and March 2023 and calculated what the rate of death was for each year, for each group of children (e.g., infants or older children) and cause of death.

Using a mathematical model the research team then tested if the rate of death was going up or down across the 4 years, and if the trend seen was different for the first two years (before and during the national lockdowns) compared to the second two (after the national lockdowns).

Previous research from the same group showed a reduction in deaths during the pandemic across most age groups, regions and areas of England, and in both boys and girls. But this new work confirms that this reduction was temporary, and deaths were higher in the years after the lockdown period. One category, deaths from birth events, showed a clear increase going into, and during the lockdowns, but then a reduction back to pre-pandemic levels afterwards.

These changes may have also increased existing healthcare inequalities, with the relative rate of dying for children from non-white backgrounds, compared to white children, now higher than before or during the pandemic.

Karen Luyt, Programme Director for the National Child Mortality Database, Professor of Neonatal Medicine at the University of Bristol and Healthier Childhoods lead at NIHR ARC West, said: “These stark findings demonstrate that, for most children and most causes of death, the reduction in mortality that was seen during the pandemic was only temporary.

“The NCMD's unique data also tells us that existing inequalities have widened, with outcomes deteriorating for children from poor and non-white backgrounds compared with their peers. But it also shows that change is possible; more must be done to change these trends in the long term, and improve and save children's lives.”

The work was supported by the National Child Mortality Database (NCMD) Programme and the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West).

The research team would like to recognise all Child Death Overview Panels (CDOPs) who submitted data for the purposes of this report and all child death review professionals for submitting data and providing additional information when requested. In particular, the research team would like to thank parent and public involvement, who are at the heart of the NCMD programme.

Paper 

‘Child mortality in England after national lockdowns for COVID-19: An analysis of childhood deaths, 2019–2023’ by David Odd, Sylvia Stoianova, Tom Williams, Peter Fleming and Karen Luyt in PLOS Medicine [open access]