Relative severity of alpha compared with wild-type virus. All models include covariate adjustment for age, sex, ethnicity, smoking status, obesity status, categorical number of comorbidities, index of multiple deprivation, household size, residential rural or urban location classification, epidemiological week, and care home status, except for the Death | ICU admission model, which excludes adjustment for care home status. Cox proportional hazards regression was used; all models are stratified on region by UTLA, estimating a separate baseline hazard function for each UTLA, with model parameters estimated by maximum likelihood over the full study population. Abbreviations: aHR, adjusted hazard ratio; CI, confidence interval; Death | Hospital admission, death given hospital admission; Death | ICU admission, death given ICU admission; ICU, intensive care unit; UTLA, upper tier local authority area.