Increased drinking during the Covid pandemic may have fuelled a sharp rise in deaths from diseases caused by alcohol, data for England suggests. Hospitality venues closed for much of last year during lockdown, but figures suggest an increase in drinking at home. According to a report by Public Health England that looked at alcohol consumption and harm during the pandemic, the number of deaths in England from diseases caused by drinking increased by 20% in 2020 compared with 2019. There was a rise of almost 11% in deaths from mental and behavioural disorders caused by alcohol, an increase of more than 15% in deaths from alcohol poisoning, and an almost 21% rise in deaths from alcoholic liver disease, the latter condition accounting for more than 80% of the alcohol-specific deaths. By contrast, deaths from alcoholic liver disease rose by about 3% between 2018 and 2019. “Before the pandemic, there were already increased alcohol-related hospital admissions and deaths. The pandemic seems to have accelerated these trends,” the report notes. The authors say the rate of alcohol-specific deaths was highest and rose most during 2020 among more deprived communities. It also varied by region, with an increase of almost 80% in the north-east in 2020 compared with the average for the preceding two years. The report says that surveys and polls show many reported drinking the same amount of alcohol during the pandemic compared with before, while similar proportions reported drinking less or more. “The proportion of respondents drinking at increasing or higher-risk levels was higher than previous years throughout much of the year of the pandemic and into 2021,” the team note. The rise in drinking, however, seems to have been largely concentrated in particular groups. “Where surveys measured a respondent’s drinking before the pandemic, they suggest that people who reported drinking more during the pandemic than before tended to be heavier drinkers,” the team write, adding that that could mean the harms from alcohol may persist or get worse among those already at risk. The report reveals that sales of alcohol by volume in settings such as supermarkets increased by 25% in England between 2019 and 2020, equal to an extra 686m litres, according to data from barcode scanning. “This increase was consistent and sustained for most of 2020,” the report notes. Data from HMRC shows that there was little difference in the volume of alcohol available for purchase in the UK in 2020 compared with 2019, although this does not reveal whether it was actually consumed. The authors of the report say that purchasing in other settings such as supermarkets offset, at least in part, the fall in drinking at hospitality venues. Rosanna O’Connor, PHE’s director of drugs, alcohol, tobacco and justice, said tackling harmful drinking must be an essential part of the Covid recovery plan. “Liver disease is currently the second leading cause of premature death in people of working age and this is only set to get worse if the Covid pandemic results in a long-term increase in drinking,” she said. Rajiv Jalan, a professor of hepatology at UCL Medical School, who was not involved in the report, said the rise in deaths from alcoholic liver disease was startling but not unexpected given that the burden of the disease in the UK is very high, and that the report suggests there has been a rise in drinking among those most likely to be affected. “They have now had this second hit from excessive binge [drinking] and this is on the background of existing liver disease which leads to the development of a condition called acute-on-chronic liver failure that is known to be associated with a high risk of death,” he said. More must be done to tackle alcohol-related liver disease, he said, suggesting England should follow Scotland’s example: “The simplest intervention would be to introduce a minimum price for alcohol.”