A new study by King's College London has revealed a persistent and varied impact of the Covid-19 pandemic on diagnosis rates for several health conditions in England. Published in the British Medical Journal (BMJ), the research found that diagnoses for conditions such as depression, asthma, and osteoporosis remained lower than expected compared to pre-pandemic trends, while chronic kidney disease diagnoses saw an increase. The study is the first to evaluate the post-pandemic recovery of diagnosis rates across a broad range of conditions.
Study Overview
The research utilized anonymized data from over 29 million individuals in England, analyzing trends for 19 major conditions between April 2016 and November 2024. The data was accessed through OpenSAFELY, a secure NHS data platform, demonstrating a method for safely using health data for disease monitoring and identifying inequities.
Diagnosis Rate Changes Across Conditions
The study identified distinct patterns in diagnosis rates:
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Decreases:
- Depression: Diagnoses were 27.7% lower than anticipated compared to pre-pandemic trends. This deficit was particularly pronounced among younger adults (aged 20-39 years) and individuals of white or mixed ethnicity. After an initial drop, rates partially recovered by late 2021 but have declined since 2022. This trend occurred while disability benefit claims for mental health conditions increased significantly during the same period.
- Asthma: Diagnoses were 16.4% lower than expected.
- Chronic Obstructive Pulmonary Disease (COPD): Diagnoses were 15.8% lower than expected.
- Osteoporosis: Diagnoses were 11.5% lower than expected.
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Increases:
- Chronic Kidney Disease (CKD): Diagnoses increased by 34.8% above expected levels. Researchers suggest this rise may be attributed to increased testing, greater awareness following updated guidelines, new treatments, or potential contributions from Covid-19 infection or delays in diagnosing related conditions like diabetes.
Disparities in Diagnosis Recovery
The study also highlighted variations in how diagnosis rates recovered across different demographic groups:
- Dementia: Diagnoses for dementia returned to pre-pandemic levels for individuals of white ethnicity and those in less deprived areas. However, these rates remained lower than expected among other ethnic groups and in more deprived communities.
Potential Contributing Factors
Researchers and co-authors identified several potential factors influencing these changes:
- NHS Pressures: Increased demands on the National Health Service (NHS) may contribute to longer times required for formal diagnoses across various conditions.
- Mental Health Support Access: For depression, a notable pattern of declining diagnoses contrasted with a substantial increase in disability benefit claims for mental health conditions. One hypothesis suggests more individuals may be accessing mental health support through services like NHS Talking Therapies without receiving a formal depression diagnosis. Referrals to NHS Talking Therapies services, for example, increased by nearly two-thirds between 2013 and 2024, with self-referrals constituting almost 70% of the total.
- Diagnostic Backlogs: Pandemic-related disruptions and backlogs in diagnostic testing are considered contributors to reduced diagnoses for conditions such as asthma, COPD, and osteoporosis. Addressing these backlogs has been identified as a priority by the NHS.