Nineteen local authorities in England have recorded excess death rates of more than twice the UK average during the Covid-19 crisis. London has been hardest hit, with 16 of the 20 local authorities recording the highest excess death rates being located in the capital. Excess deaths in Harrow and Brent are three times that of the national average, at 64% and 63% respectively. At the peak of the pandemic, in the week to 17 April, there were 138 deaths registered in Harrow, five times the average for the equivalent week in previous years. Poorer boroughs, including Newham and Haringey, were also among the worst affected. Data from the Office for National Statistics (ONS) has previously shown that people living in the poorest parts of England and Wales were dying at twice the rate of those in the richest areas. The death toll across the UK in the year to date shows that the excess death rate stands at 20.5%. Excess deaths are calculated by taking the total number of people whose deaths were registered in 2020 and comparing it with the average number of deaths in the five years prior. The difference represents the excess. This method is considered the gold standard for measuring the full impact of Covid-19 crisis because it accounts not just for people who have died directly as a result of coronavirus. For example, it includes the deaths of those who may not have sought or received treatment due to lockdown measures, deaths caused by a lack of basic care or nutrition, and undiagnosed coronavirus deaths. The data also reveals that certain parts of Great Britain experienced higher death rates at different times. For example, Liverpool’s excess death rate peaked in the week ending 10 April but it would be another three weeks before Leeds experienced its peak. Birmingham had more excess deaths than any other local authority for four weeks running , recording 415 excess deaths in the week to 17 April, almost two-and-a-half times the norm. There is a strong correlation between high excess death rates and age. For example, the rural South Lakeland area’s excess death rate stands at 39%, almost twice the national average, and the area is one of the oldest in the UK when measured by median age. Some areas have remained relatively unscathed. In south-west England, Torbay, mid-Devon and east Devon experienced excess death rates within 2% of the norm, as did Hastings and Eastbourne in south-east England, and the Orkney Islands in Scotland. Na h-Eileanan Siar council area and the Shetland Islands did not experience any excess deaths, while South Hams, Conwy in Wales, North East Lincolnshire, North Devon, South Hams and the Isles of Scilly have experienced fewer deaths this year than in previous years. All but one of the 50 worst-hit local authorities are in England, the exception being Inverclyde in Scotland where the total deaths in the year to date are 36.5% higher than in an average year, far higher than the Scottish average of 16%. Previous analysis showed that people living in the most deprived areas of Scotland were more than twice as likely to die from Covid-19 as those living in the wealthiest parts. A large proportion (18.6%) of Inverclyde is made up of highly deprived areas, and some of the most deprived parts of Scotland are found in Greenock and Port Glasgow. Among the areas where excess deaths rates were above the UK average were East Dunbartonshire (26.7%), Edinburgh (24.3%) and Clackmannanshire (24%). Three local authorities in Wales: Blaenau Gwent, where the excess death rate stands at 22.6%, Rhondda Cynon Taf and Newport, had an excess death rate above the UK average. Northern Ireland does not produce data at a local authority level but excess deaths in the country are running at 10%, far below the UK average. David Leon, a professor of epidemiology at the London School of Hygiene and Tropical Medicine, said the data showed how the overall impact of Covid-19 on mortality has varied across the UK. “This epidemic has clearly had a serious impact on many local authorities that are not highly urbanised. Going forward, understanding the reasons for this substantial geographic variation will be crucial in drawing lessons for the future for how to cope with any resurgence of Covid-19 or another pandemic.” The three statistical agencies for the four nations – the ONS for England and Wales, the National Records of Scotland and the Northern Ireland Statistics and Research Agency – release their figures on different days. The figures run to week 24 for England and Wales and Scotland and week 22 in Northern Ireland.