Hundreds more deaths than previously expected have been recorded in Monmouthshire since the coronavirus pandemic began, new figures show.
The King's Fund think tank warned that excess deaths could climb across England and Wales this winter and called on the Government to take action before the winter.
Figures from the Office for National Statistics show Monmouthshire recorded 246 more deaths between March 2020 and June 2022 than the five-year average would suggest.
This was 10.5% more deaths than were expected over this time period – meaning the area has an excess death rate similar to the 11.1% average across England and Wales.
Across the two nations, 137,447 more deaths were registered over the 28-month period than expected compared with previous years – 64% of which were men.
The King's Fund think tank said this shows the "grim human toll of the pandemic", while wide geographical variations – caused by local infection rates, deprivation, and demographics among others – demonstrate the unequal impact of Covid-19.
The London borough of Newham had the highest rate of excess deaths (29% above normal), while Three Rivers, in the East of England, saw deaths 2.5% below normal.
Dr Veena Raleigh, senior fellow at the think tank, warned that as winter approaches, the virus is still present and its future course is "unpredictable".
She said: "NHS services were already stretched prior to the pandemic and are now facing unprecedented pressures with a backlog of almost 7 million people waiting for planned care, plus long delays in emergency services that could cause harm or be life-threatening.
"If the Government wants to forestall the risk of excess deaths climbing again, ministers must take steps now to ensure good uptake of the Covid-19 and flu vaccines, and that the NHS has the workforce and resources to cope with winter pressures.”
The ONS figures also include a small number of people who died whose usual residence is outside England and Wales.
Sarah Caul, head of mortality analysis at the ONS, said excess deaths in 2022 were being driven by higher than expected numbers of deaths since March, which could be caused by a combination of factors.
She added: "Across March, April and May we saw increases in deaths due to cardiac arrhythmias, predominantly among those aged 80 and above.
"Further work needs to be done to understand any link between the long-term effects of Covid-19 and increasing cardiac deaths."
Excess deaths nationally peaked in April 2020 and January 2021, which were also the months which had the highest number of deaths due to coronavirus.
In Monmouthshire, the month with the highest excess deaths was April 2020, when they were 57.8% above normal.
By contrast, January 2022 saw deaths 25.6% below usual levels.
The Department of Health and Social Care said its world-leading vaccination programme continues to save lives, with all those over 50 being offered jabs for both Covid and flu.
A DHSC spokesperson added: “The Health and Social Care Secretary is focused on delivering for patients and has set out her four priorities of A, B, C, D – ambulances, backlogs, care, doctors and dentists."