The Government is keen to better understand the wider health impacts9 of the Covid- 19 pandemic as identified by the Chief Medical Officer. These health impacts may relate to mortality, in terms of excess deaths, or morbidity, in terms of effects on health more generally. Relevant papers have been published by both SAGE and ONS on this matter, produced by DHSC, the Home Office, and the Government Actuary’s Department. The first SAGE paper on this matter, published in June 2020, presented initial estimates of excess deaths from the Covid-19 pandemic.10 The second, published in 8 The health, economic and social effects of COVID-19 and the tiered approach - GOV.UK (www.gov.uk) 9 There are four forms of health impacts9 identified by the CMO that might occur as a result of the Covid-19 pandemic: Health impacts from contracting Covid-19, Health outcomes for Covid-19 worsened because of lack of NHS critical care capacity, Health impacts from changes to health and social care made in order to respond to Covid-19, and Health impacts from factors affecting the wider population, both from living through the pandemic and the economic impacts increasing deprivation. 10 https://www.gov.uk/government/publications/initial-estimates-of-excess-deaths-from-covid-19-8-april-2020 August 2020, captured both mortality and morbidity impacts.11 The papers have also been used to inform analysis of the health effects of Covid-19 related to the introduction of tiers.12 A third, updated paper, was published in January 2021 and seeks to provide an update with more recent evidence.13 These analyses aim to discuss and quantify, as far as possible, the impacts of the Covid-19 pandemic on health, using the four forms of health impacts. However, in some cases it is not possible to quantify the health impacts that may occur, and instead, where necessary, qualitative discussion is provided. It is important to note that the analyses use scenarios to consider potential future impacts and are neither projections nor forecasts. On 17 July 2020, the ONS published a report looking at all deaths between 1 March and 30 June 2020 where Covid-19 is mentioned on the death certificate.14 The doctor certifying a death can list all causes in the chain of events that led to the death and pre-existing conditions that may have contributed to the death. Using this information, an underlying cause of death is determined. More information on this process can be found in the supporting user guide.15 In the majority of cases (46,736 deaths, 92.8%) where Covid-19 was mentioned on the death certificate, it was found to be the underlying cause of death.