Who does COVID affect?

Published: 11-02-2022

Friends have described COVID as the sickest they’ve ever felt. I writhed in pain for two nights. My partner rasped for air for a fortnight and is still struggling months later.

Those outcomes were fine. I fear hospital stays, disabilities, and body bags.

I don’t know your risk of those today. I can make a guesstimate of what those risks were recently: a reasonable baseline for discussions about current and future developments.

That guesstimate comes from wrangling sources of varying quality to answer the following questions:

  • How many people in England had COVID in January 20211; and
  • What happened to those people while they were riddled with virus; and
  • What characteristics of those people seem to have affected their outcome.

How many people had COVID in January 2021?

About two million, I think.

Officially there were one million cases. These counts only include cases where someone chose and was able to take a test that came back positive2.

Two nationwide surveys suggest the official tally missed half a million cases3. Those surveys are in turn limited by their reliance on the type of person who volunteers to be actively observed. I assume that person made more effort than normals to avoid the virus.

I don't know the real number but I'm confident the proxies above undercount cases.

My fudge is to round up to two million.

What happened to those people?

On average they had 20:1 odds of hospitalisation and 65:1 odds of death.

Averages can get in the bin. Individual outcomes depended on age and health.

Outcomes by age

COVID barely touched the young: 1,200 were hospitalised and 9 died.

It was a catastrophe for older folk: 60,000 were hospitalised and 25,000 died.

It mostly affected the old. It didn’t only affect the old. Roughly 3% of working-age folk who caught COVID in January were hospitalised.

From my case estimates hospitalisation risks looked like:


Death risks looked like:


(Nb: ‘65+’ lumps 95 year olds in with 66 year olds; the difference between those cohorts was enormous. But the mortality statistics in the UK didn’t offer finer demographics slices, alas.)

Outcomes by health status

The unhealthy were at higher risk. The pre-existing health problems that mattered most are common as muck.

50% of hospital cases had high blood pressure before they caught COVID. 65% of deaths had some combination of obesity, high blood pressure, diabetes, and / or heart disease already7, and 20% had lung problems before they became ill.

It mostly affected the unhealthy. It didn’t only affect the unhealthy. 20% of those in hospital and 15% of those who died were fit and well before they caught COVID.

What does that mean for you?

Someone like you—a healthy 60-something—had ~40:1 odds8 of hospitalisation from COVID. Those odds scare me.

COVID can make you really, unacceptably ill.

Or worse. A small-but-way-too-high number of people deteriorated in hospital and ended up in ICU9. It was then a coin-flip whether they left alive.

COVID is the only avoidable threat in my lifetime that can realistically kill you, or dad, or your friends.

And there are additional long-term risks. Next up, Long COVID.

Further Reading

Many thousands of words of relevant-but-not-relevant-enough information were cut. This started with a bazillion research notes-to-self and links, then went through a round of chunking and cutting.

If I had to do this from scratch I’d start with:

  • Gov.ukCOVID dashboard Case numbers, hospitalisations, deaths.
  • Coronavirus Infection SurveyWeekly bulletins Case estimates, who’s affected and how.
  • REACT-1Findings Case estimates, who’s affected and how.
  • NHSCOVID activity Numbers, severity, and trends of COVID patients.
  • Intensive Care National Audit & Research CenterReports ICU admissions, who’s affected and how.
  • OpenSAFELYPublications Severity analyses from nationwide NHS data.