2.1  Study population
We included all COVID-19 deaths as reported to Public Health England (PHE) by June 30, 2020. These include deaths that had a laboratory confirmed report of COVID-19 (including at post-mortem) (EpiCell 2020), as well as suspected COVID-19 deaths, defined as deaths without a positive test but with mention of COVID-19 in the death certificate. These definitions were consistent during the study period and over the study region. The main outcome of this study was laboratory confirmed deaths. We selected COVID-19 deaths up to June the 30th to ensure we captured COVID-19 deaths attributable to the first wave of epidemic that in England and Wales was over by the end of May, when all-cause mortality was no longer elevated (Kontis et al. 2020). Individual data on age, sex, ethnicity, lower tier local authority (LTLA) of the residential address and type of residence type (i.e. nursing homes, prisons, medical facilities etc.) were available. Population at risk in England was available through Office for National Statistics (ONS). Information at the LSOA level about age and sex was available for 2018, whereas about ethnicity for 2011 (the most recent years available at time of analysis).