Increased alcohol consumption during the pandemic, particularly amongst heavy drinkers, is likely driving an unprecedented acceleration in alcoholic liver disease deaths, according to Public Health England.
Public Health England has today published the trends in alcohol consumption and harm since the onset of the COVID-19 pandemic. The findings show an increase in total alcohol-specific deaths, driven by an unprecedented annual increase in alcoholic liver disease deaths above levels seen pre-pandemic.
Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance UK, said: “Rising alcohol harm has been a devastating consequence of the COVID-19 pandemic. Increased drinking among some of the population, rising hospital admissions for liver disease and the highest level of deaths caused directly by alcohol since records began are cause for serious alarm. Tackling alcohol harm must be central to the COVID-19 recovery plan if we are to curb this growing health crisis.
“We are concerned about the increase in the consumption of wine and spirits over the last year. Cheap, strong drinks are linked to the highest harms. The ongoing alcohol duty review is an opportunity for the Treasury to ensure that stronger drinks, like spirits, always cost more than weaker drinks, in order to decrease consumption and protect our health.”
Despite pubs, clubs and restaurants closing for approximately 31 weeks during the national lockdowns, the total amount of alcohol released for sale (meaning that tax has been paid and it is available to be bought) during the pandemic was still similar to the pre-pandemic years which suggests people were drinking more at home.
Data from a consumer purchasing panel show that in shops and supermarkets just over 12.6 million extra litres of alcohol were sold in the financial year 2020/21 compared to 2019/20 (a 24% increase). Those that typically bought the most alcohol pre-pandemic bought a lot more once the first lockdown happened. When adult buyers were spilt into five equal sized groups based on their level of purchasing in the two years before the first lockdown, the heaviest buying group increased their buying by 5.3 million litres of alcohol compared to 2019/20 (an increase of 14%).
The findings reflect the survey data published on PHE’s Wider Impacts of COVID-19 on Health (WICH) dashboard that also shows an increase in increasing and higher risk drinking following the first national lockdown. This was maintained over much of 2020, but from 2021 onwards shows signs of returning to levels more similar to before the pandemic. Comparing March 2020 and March 2021, there was a 59% increase of people reporting that they are drinking at increasing and higher-risk levels (50 units a week for men, 35 units a week for women). Other published reports analysing surveys suggest that it is those drinking the heaviest before the pandemic that are more likely to report increasing their drinking.
The increased consumption of alcohol during the pandemic has occurred alongside increases in deaths. Alcohol-specific deaths increased by 20% in 2020 (from 5,819 in 2019 to 6,983) and alcoholic liver disease accounted for just over 80% of all deaths in 2020. There was a rapid increase in the number of alcoholic liver deaths, rising by 21% between 2019 and 2020, compared to a rise of 3% between 2018 and 2019.
Other findings include:
- In 2020 to 2021, duty-paid wine and spirits increased compared to 2019 to 2020 (+9% and +7% respectively), while cider and beer decreased (-17% and -14% respectively). The diverging trends likely relate to the fact that beer and cider are more often bought in on-trade settings, so are probably more affected by on-trade closures.
- Deaths from mental and behavioural disorders due to alcohol increased by 11% between 2019 and 2020 (compared to a 1% increase between 2018 and 2019) but hospital admissions were down
- Deaths from alcohol poisoning increased by 15% between 2019 and 2020 (compared to a decrease of 4% between 2018 and 2019)
- 33% of all alcohol-specific deaths occurred in the most deprived 20%
- The North East has the biggest increase in death rate out of all regions, reaching a peak rate of 28.4 deaths per 100,000 population in July 2020 (80% higher than the baseline rate in 2018 and 2019 combined)
- The rate of unplanned hospital admissions per 100,000 population for alcoholic liver disease increased by 3% between 2019 and 2020, though the rate of total alcohol-specific admissions decreased by 3.2% (which mirrors the direction of all hospital admissions irrespective of cause)
Rosanna O’ Connor, Director of Drugs, Alcohol, Tobacco and Justice at Public Health England said: “Our research suggests that lockdown has affected heavy drinkers the most and that they are drinking more.
“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.
“Tackling harmful drinking must be an essential part of the COVID-19 recovery plan.”