Socioeconomic inequalities in the risk of infection with SARS-CoV-2 Delta and Omicron variants in United Kingdom, 2020-22

Abstract

Objective: It is unknown whether SARS-CoV-2 exposure risks vary by socioeconomic deprivation within and across occupation sectors. We explored the risk of testing positive for Delta or Omicron variants, the predominantly dominant SARS-CoV-2 variants during our study period, within certain occupation sectors and deprivation groups in the UK. Methods and Analysis: We used the COVID-19 Infection Survey (CIS) to examine the risk of testing positive with SARS-CoV-2 across area-level deprivation and occupation sectors. We divided our cohort into Delta (02.07.2020–19.12.2021) and Omicron (20.12.2021–31.01.2022) cohorts as they were the predominantly dominant variants during our study period. Multivariable Poisson regression models were used to estimate adjusted incidence rate ratio (IRR) after adjusting for age, sex, ethnicity, comorbid conditions, urban/rural home address, household size, healthcare/client-facing job categories and calendar time. Results: There were 329,356 participants in the Delta cohort and 246,061 in the Omicron cohort. The crude incidence rate for Delta and Omicron cases were higher in the most deprived decile (Delta: 4.33 per 1000 person months; 95% CI: 4.09, 4.58; Omicron: 76.67; 71.60, 82.11) than in the least deprived decile (3.18; 3.05, 3.31; and 54.52; 51.93, 57.24, respectively); the corresponding adjusted IRRs were 1.37 (95% CI: 1.29, 1.47) and 1.34 (1.24, 1.46) during the Delta and Omicron period, respectively. The adjusted IRR for testing positive in the most deprived compared with the least deprived decile in the Delta cohort were 1.59 (1.25, 2.02) and 1.50 (1.19, 1.87) in healthcare and manufacturing or construction occupation sectors, respectively. Corresponding values in the Omicron cohort were 1.50 (1.15, 1.95) and 1.43 (1.09, 1.86) in healthcare and teaching and education sectors. The associations for the other employment sectors were not statistically significant or not tested due to small numbers. Conclusion: The risk of testing positive for SARS-CoV-2 in the Delta and Omicron cohorts was higher in the most deprived compared with the least deprived decile in healthcare, manufacturing or construction, and teaching and education sectors.