This paper looks at the geographical patterns of COVID-19 cases observed over the course of the pandemic in England in 2020. It reveals a strong relationship between COVID-19 cases and embedded forms of inequality in small geographical areas. These areas have been left exposed to the impact of COVID-19 by virtue of the type of low paid and unskilled works available, alongside low investment in public services and public spending cuts. Deprivation appears to be a key driver of the emerging spatial patterns.