This paper, published in BMJ’s Archives of disease in Childhood, investigates overall child mortality during the pandemic. Using the National Child Mortality Database’s unique data, it shows that child mortality in the first year of the pandemic was lower than it had been in the previous 12 months – and, in fact, was likely the lowest on record.

The study seeks to quantify the relative risk of childhood deaths across England during the first year of the Covid pandemic, compared to a similar period of 2019, and found that the number of children in England who died fell to 3,067 between April 2020 and March 2021. This is 356 fewer deaths than were recorded in the preceding 12 months (April 2019 – March 2020), and likely represents the lowest level of child mortality on record.

Findings from the analysis showed that deaths from non-Covid infections and other underlying medical conditions fell, and there is some evidence that deaths from substance abuse also reduced. The reduction in mortality appeared to occur during the winter months, where the seasonal increase, often caused by infections other than Covid-19, was not apparent. This period coincided with the prolonged lockdown in England from January to April 2021, suggesting that public health measures may be able to modify a significant number of childhood deaths every year. The reduction in child deaths was most prominent in children under ten years old.

These findings stand in stark contrast to overall mortality for England’s population, which was 14% higher than the previous year – and suggest that widespread changes in the delivery of healthcare during the pandemic may have prevented child deaths.

Professor Karen Luyt, NCMD Programme Lead and Professor of Neonatal Medicine at the University of Bristol, said: “There was clear evidence that the reduction in mortality was seen in two key areas: those children with underlying health conditions and those who died of infectious diseases other than Covid. Our data demonstrate that child deaths caused by seasonal infections are potentially substantially modifiable at population level. It is therefore important that we learn from the effects highlighted in this study to improve the outcome for the most vulnerable children in our society.”