Covid-19: How has the pandemic differed across the four UK nations?

Although the overall course of the pandemic has been similar across the UK, there have been instances when the countries’ trajectory has diverged. In the first wave Northern Ireland had far fewer deaths and hospital admissions. Lockdown restrictions were similar across the UK at this time. One possible explanation for the divergence is that lockdown began at a slightly earlier stage in the pandemic in Northern Ireland, reducing the size of the peak there. In the second wave Scotland had relatively fewer cases, hospital admissions, and deaths than England and Wales. Scotland also had the most consistent set of restrictions in place between September and December 2020, which may have helped to delay the spread of the alpha variant (which was dominant in England by the beginning of December but not in Scotland until January 2021).34 Northern Ireland had a slightly later peak in cases in this wave, which may have contributed to lower mortality, as a result of the vaccination programme reducing severe disease. Northern Ireland’s younger population may also have been a factor in its lower cumulative mortality. From the middle of 2021 to February 2022 Northern Ireland had consistently higher rates of hospital admission for covid-19 than elsewhere in the UK, although case rates and mortality have been broadly similar. This suggests that hospital care for patients with covid-19 may have been organised differently in Northern Ireland, resulting in a higher admission rate. Another possibility is that hospital acquired covid-19, which has been a significant concern,5 may be a particular problem in hospitals in Northern Ireland. In February and March 2022 Scotland had the highest case rates and a rapid increase in hospital admissions, despite retaining restrictions longest in response to omicron.