4th Sept data update

Every week we share a lay-person summary of local, national, and international data on the coronavirus/Covid-19 pandemic. We really welcome questions, feedback, or suggestions for inclusion of data you have found useful, in our Facebook group, or email us at: stroudcommunitycoronaresponse@gmail.com. While the sources referenced are authoritative, and there is little of our own analysis, please note that the analysis is our own, and not conducted by a public health expert.

This week the update is a bit late, but we will return to a regular Wednesday updates next week.

Key points

• Across Gloucestershire, there were 40 positive tests in the most recent full week of data (to the 28th August) and there does seem to be a slowly rising trend.
• In the most recent week for which data is available, specimens produced 6 positive tests associated with people in Stroud district – this is a higher weekly rate than in June and most of July, but there does not appear to be a rising trend in recent weeks locally.
• In the most recent week of data (to the 21st August), two more people have sadly been added to the total number of people to have died in Gloucestershire with Covid-19 mentioned on their death certificates, now 581. One was from Cheltenham and one from Gloucester.
• The number of cases confirmed during the week in the UK (9,532) is the highest since the week-ending 9th June (11,184). Some – but not all – of the recent increase is due to increase in testing – see below for details.
• Over 25 million cases of Covid-19 have been confirmed globally, and over 850,000 people have died with their deaths attributed at least in part to Covid-019.

Local statistics

Positive Tests

• In the most recent week for which data is available (to the 28th August), specimens produced 6 positive tests associated with people in Stroud district. This number may be revised upwards slightly as some specimens submitted in that week may not have their results yet. Regardless, the number is broadly in line with positive tests since the week ending 24th July – these are slightly higher than the numbers in June and the rest of July, but it does not look to be a rising trend.
• Across Gloucestsershire, there were 40 positive tests that week, and there does seem to be a slowly rising trend. We can hope that instead this largely represents a higher proportion of people with/who have recently had the virus being picked up in testing, and that this can help to contain any further spread (unfortunately there does not seem to be local available data on test numbers or positivity rates so it is hard to tell if the rise represents more testing or more infections).
• Nationally, while there are higher numbers of positive tests these are not linked to higher hospitalisations or deaths, and while equivalent local data is not available it still appears that people most at risk from the virus are being protected from contracting it.
• Whether in Stroud or Gloucestershire (or even the UK) as a whole, that positive tests are still being conducted does show the virus is still circulating, so it is worth taking the basic precautions. This way, we can continue to reduce the numbers of people being hospitalised and dying, and hopefully enable further opening up of restrictions.

You can see where cases are being confirmed by neighbourhood (MSOA – an ONS geographic unit that covers areas of Stroud district like Stroud Town, Stonehouse, Nailsworth etc). Once again, the numbers in Stroud district are too low to show up on this map – though low numbers of positive tests in areas of Swindon, Bristol and Cheltenham are highlighted.

We encourage anyone with symptoms (a new continuous cough, high temperature, or loss of smell/taste) to please book a test. There is a permanent unit at Hempsted Meadow in Gloucester, and mobile units tour Gloucestershire.

If you don’t have symptoms, please still follow the guidelines to wear masks when appropriate (they will help prevent spread of the virus if you have it but don’t have symptoms yet, or are asymptomatic – meaning you have the virus but without ever getting any symptoms), keep distance from people, and wash your hands regularly. Access the latest government guidance and FAQ on “what you can and can’t do” online (last updated 26th August).

Estimated number of people with the virus

Alongside positive tests, we can also look to estimates that can cover people who – for whatever reason – do not get tested. The Covid Symptom Study currently estimates (4th September) that 46 people may actively have the virus in Stroud district (higher than the 13 last week – but both estimates are still low, and the window around them will be high due to the small smaples on which the estimates are made). The Study also estimates 46 active cases in nearby Gloucester and South Gloucestershire, 38 in Cotswold district, 54 in Cheltenham, 64 in Tewkesbury and 31 in the Forest of Dean. These estimates are all higher than last week but remain relatively low in the context of recent weeks and months, and are consistent with the confirmed cases number to the extent we would expect a higher number of active cases than are identified in testing (if people cannot access tests, do not realise they might have Covid, or do not choose to have a test even in they suspect they have Covid). Further, they are made from small samples and it would be extremely difficult to be statistically accurate at this level.

You can read about how these estimates are made on the Covid Symptom Study website.

People who have died because of Covid-19 in Stroud and Gloucestershire

• The Office for National Statistics collates data on instances where Covid-19 was mentioned on someone’s death certificate. These are broken down by local authority, place of death, and week. If you wish, you can explore the data yourself: ONS data on Death registrations and occurrences by local authority and place of death
• As of week 34 (ending 21st August), this data shows 581 people have died in Gloucestershire with Covid-19 mentioned on their death certificate since the pandemic began, in all settings (hospitals, care homes, private homes and other sites). Two people have been added to this total since we last reported the figures – one from Cheltenham and one from Gloucester.
• Of the 581 people to have died with Covid-19 mentioned on their death certificate from Gloucestershire, 92 people were from Stroud district. This figure has not increased since week 24 (12th June) when two people from the district died
• In a previous update we analysed the data for Stroud district on where people from the district who died with Covid-19 mentioned on the death certificate in March, April, May and June were from. You can explore the interactive map of England and Wales – which of course covers the whole of Gloucestershire.
• Previously, we have analysed the numbers of people who have died by place of death (care home, hospital, etc) in Stroud and Gloucestershire.

National level data

As of 29th August there were 775 Covid-19 patients in UK hospitals, down from 871 on the 22nd August a week previously. 52 patients confirmed to have Covid-19 were admitted in England, compared to 25 on the 22nd August (the lowest daily number in the public dataset). The numbers are low and fluctuating around 50, rather than rising in a clear trend.

As of 29th August there were 56 patients on ventilation, compared to 66 on the 22nd August. We hope that the falling number represents recoveries, and that the number of people requiring ventilation continues to fall.

Testing

The UK government coronanvirus dashboard summarises a number of datasources, and NHS Test and Trace data for England is also available. Check out the Independent SAGE weekly video summary too. These sources show:

• Across the UK, 1,176 positive tests resulted from specimens submitted on the 29th August – and the 7-day average was 1,313.7. This compares to 829 positive tests a week earlier on the 22nd August – when the 7-day average was 1,143.7). The daily number of positive tests has generally been increasing since 4th July when it hit a lot of 402.
• “6,732 new people tested positive for Coronavirus (COVID-19) in England in between 20 August and 26 August. This is an increase of 6% in positive cases compared to the previous week and the highest weekly number since the end of May. The number of people tested has decreased by 1% in the same time period.”
• “31,388 people were identified as coming into close contact with someone who has tested positive between 20 August and 26 August. Of these, 69.4% were reached and asked to self-isolate, compared to 77.1% in the previous week”

The image below shows that positive tests per 100,000 people are concentrated in particular locations. The rate is relatively low in Gloucestershire (5-9.9), and lower still in most of the South West (0.01-4.99). The highest nearby rate is in Swindon (15.0-29.9), which is still lower than in the North West hotspots.

As noted by Prof Christina Pagel, the number of new positive tests cannot be explained only by new tests (see below). The number of tests has increased by around 50% (from 231k to 316k) since the week-ending 1st July, but the number of people testing positive has increased by nearer 100% (from 3,122 to 6,122 for the week ending 26th August). About half the increase is due to more testing, and about half is due to more infections, in short.

Prof Christina Pagel also summarises the contact tracing data in the latest Independent SAGE weekly video, noting that of 7,673 people referred to Test and Trace in the week ending 26th August, just 65% of new cases provided at least one contact. She also argues there has been no significant improvement in the system since May.

The PHE surveillance summary shows that positive tests in recent weeks – the chart on the right in the image below (aka “b”) are more associated with people in the 20-29 age bracket than tests overall since week 5. However, it’s important to note that this largely affects availability of testing – most testing at the peak of the virus spread in the UK was only available after hospitalisation, which appears to be much more likely for older people.

Incidence estimates are higher than the the government’s number of “lab confirmed cases” because they are designed to estimate cases that have not been confirmed through testing. Prevalence is the total number of estimated cases at any given time, whereas incidence is the estimated number of daily new cases.

• Incidence – the ONS estimate 2,400 daily new cases per day (19-25th August 2020), while the COVID Symptom Study app currently estimates: 1,974 daily new cases
• Prevalence – the ONS estimates 27,100 people in England having COVID-19 (19th-25th August 2020), while the COVID Symptom Study estimate 24,418 adults aged 20-69 in the UK with symptomatic COVID (very similar for the last two weeks).
• The charts below show the trends, which – while still low – appear to be rising again, at least from the COVID Symptom Study. It is also important to understand that the methodologies have limitations because they are based on a sample of the population and modelling. Read more about the ONS methdology, or the COVID Symptom Study page, “What do all the different COVID figures mean and how do they compare?“

People who have died

• PHE report 41,592 “deaths in laboratory-confirmed positive individuals where the death occurred within 28 days” (to the end of week 35, 28th August). This is the number used by Johns Hopkins University on their international tracker. By this measure 57 people died in the most recent week, fewer than the 69 who died in the week previously.
• Of the 41,592 people, PHE say 36,881 died in England (a rate of 65.5 per 100,000 people, compared to 50.6 in Wales, 45.7 in Scotland, and 29.8 in Northern Ireland).
• The ONS report that “Of the deaths registered in Week 34, 138 mentioned “novel coronavirus (COVID-19)”, the lowest number of deaths involving COVID-19 in the last 22 weeks and a 0.7% decrease compared with Week 33 (1 death), accounting for 1.4% of all deaths in England and Wales.”
• ONS data shows the total number of people to die with COVID-19 mentioned on their death certificates is now 49,537 (covering 12.9% of all deaths this year). The PHE data is restricted to people who tested positive, while death certificates can include clinical judgement where a test didn’t take place – which was regularly the case early on in the UK when testing was restricted.
• The ONS explain: “COVID-19 has had a large impact on the number of deaths registered over the last few months and is the main reason for deaths increasing above what is expected (the five-year average). The disease has had a larger impact on those most vulnerable (for example, those who already suffer from a medical condition) and those at older ages. Some of these deaths would have likely occurred over the duration of the year but have occurred earlier because of COVID-19. These deaths occurring earlier than expected could contribute to a period of deaths below the five-year average, as seen in Weeks 25 to 32.”

While the differing PHE and ONS methods produce different results, it remains the case that tens of thousands of people have died with their deaths attributed to Covid-19. As fuller analysis of data is possible, there may be further adjustments to the total figures, but these shouldn’t be taken as an indication that Covid-19 is not a serious and regularly fatal disease, or that there is any deliberate attempt to either underestimate or overestimate the number of deaths related to the virus.

PHE surveillance report

Every week PHE publish a “surveillance report” on the pandemic.

This week they say: “Some surveillance indicators suggest that there have been small increases in COVID-19 activity at a national level during week 35 while other indicators remain stable. Case detections in England increased from 6,744 in week 34 to 7,122 in week 35. Case rates were highest in North West and Yorkshire and Humber. At a local authority level, incidence was highest in Bolton, followed by Oldham. Case rates were highest in the 15-44 year age group.”

As last week, Swindon remains on the “watchlist following the weekly Local Action Committee meeting” along with 33 other local authorities – many of them in the North West. Unlike in previous weeks the “trend” columns are both green for Swindon so hopefully the “enhanced support” in the area is helping to contain spread and the authority will be removed from the watch list soon.

PHE also say: “Emergency department attendances with a COVID-19-like diagnosis and overall hospitalisation and ICU/HDU admission rates for confirmed COVID-19 admissions remained stable. The highest hospitalisation rates were in Tameside and Manchester.”

For the South West as a whole, PHE report 13,969 confirmed cases (up 285 from last week), and an incidence rate of 249/100,000 people. This is the lowest rate for an English region, the highest rate is 690/100,000 in the North West.

International data

It is important to say that different countries are testing and collecting data on deaths in different ways, making fair comparisons difficult. However, there are reputable sources doing their best to make data available, which we summarise below

People who have died with deaths attributed to Covid-19

Last week we highlighted the Financial Times’ interactive chart that can show the “Cumulative deaths (per million), by number of days since 3 total deaths (per million) first recorded”. This shows the UK with the 3rd highest number (621.7) after Peru (904.5) and Belgium (862) – with the number of people dying in Chile (602.7), Brazil (590.4) and the United States (543.1) still increasing quickly. Other countries have far lower rates, despite the virus having been present for a similar time – such as Germany (112 deaths per million), Cuba (8.8), South Korea (6.4), and New Zealand (4.5).

Another option on the FT site is to compare the “Seven-day rolling average of new deaths, by number of days since 3 average daily deaths first recorded”. This makes it possible to see whether the worst impacts of the virus have peaked in a country, and identify any “second waves”. In the chart below, we have picked out the UK – where the 7-day average number of daily deaths has been falling consistently for a long time, but has stabilised at a low level. The chart also shows the pattern in Spain – where a sharper decline in daily deaths is accompanied by a more recent uptick that may represent the foothills of a “second wave” – though this is rising far more slowly (with an even slower return to increase in France). The chart also shows that daily deaths continue to be very high in other countries such as Peru, and the United States – though they are at least falling in these countries (note that the left-hand scale representing numbers of deaths is “logarithmic” – to make it easier to compare very large numbers with much smaller ones on the same chart).

For interanational comparisons we also recommend the Office for National Statistics “Comparisons of all-cause mortality between European countries and regions: January to June 2020“, and the Financial Times’ visual narrative of the spread of Covid-19”, with charts showing comparisons between 20 countries on the best available testing measure – “excess deaths”, as well as global regional comparisons to the 13th July. Sadly this no longer seems to be being updated. We will include a chart again when there is an update.

Our analysis of data from the Johns Hopkins University tracker shows

As of the 2nd September, he number of people who have died is now well over 850,000 – 857,413

37,167 people died in the past week (the lowest weekly figure since 29th July when 30,043 people died).

There are fourteen countries where over 10,000 people have died where Covid-19 was involved. Rather than report the figures for each of these as we have been doing in previous weeks, we will from now on produce a summary:

• The number of deaths attributed to Covid19 is below 100 in 2 of these 14 countries: the UK (69) and Italy (40).
• The number of deaths attributed to Covid19 is above 1,000 in 6 of these countries (The US, Brazil, Mexico, India, Peru, and Colombia)
• The number of deaths this week is higher than last week in two countries (India – 6,884/6,561 and Mexico – 3,791/3,676).

Recoveries

At least 17 million people have been deemed to have “recovered” after testing positive globally (17,084,969), an increase of nearly 1.5 million in the past week (1,478,875). – as reported by Johns Hopkins University. While there is considerable evidence of long-term impacts, many people who have not tested positive but have receovered are not included in this figure, and methods for recording “recoveries” vary by country.

The UK only reports 1,709 people have recovered, for instance – an increase of 158 on last week. However, this does not reflect the true number of people who have had the virus but recovered from it.

Confirmed Cases

Confirmation of cases is one way to measure the spread of the virus. It is worth bearing in mind that not everyone who has the virus, particularly if they do not develop senses, will get a test – so confirmed numbers are an underestimate of total cases. However, changes in confirmed case numbers can give us an indication of whether the virus is still spreading or is coming under control in a country. Our analysis of Johns Hopkins University data shows:

• Over 25 million cases of Covid-19 have been confirmed (25,769,252)
• That’s an an increase of over 1.8 million cases during the week (1,838,603), the tenth week in a row with over 1 million cases confirmed.
• Global confirmed cases increased by 7.7% in the past week (this percentage increase is falling slowly, a sign that global confirmation of cases may be peaking).
• 22 countries have over 200,000 cases (the same number as last week), and four have over 1 million confirmed cases (The US, Brazil, India and Russia – the latter now has 1,001,965 confirmed cases).
• Rather than details for each of these as in previous weeks, we offer a summary:
• The US, Brazil and India each confirmed over 250,000 new cases in the most recent week.
• Confirmed cases this week are higher than the number last week in 7 of these countries (India, Spain, Argentina, France, Turkey, Italy, Germany)
• Spain confirmed a total of 58,420 cases, a 14.2% increase
• France confirmed 38,066 cases, an 13.3% increase
• The number of cases confirmed during the week in the UK (9,532) is the highest since the week-ending 9th June (11,184). As above, bear in mind that some – but not all – of the recent increase is due to increase in testing.

Our condolences

The purpose of these updates is to improve understanding of the pandemic and its affects, particular in Stroud district. We appreciate that looking at data in this way does not allow space to record the humanity and individuality of the thousands of people affected, including friends and family of loved ones – to whom we send our condolences.

Notes

We welcome your suggestions for inclusion of data in these summaries. Please submit posts to our Facebook group.

Please remember we have a (growing) list of resources to support your emotional and mental health during this time on our website. The following numbers may be useful:

• Samaritans: 116 123
• Domestic Violence Hotline: 0808 2000 247
• Mind: 0300 123 3393
• Age UK: 0800 169 6565
• Childline: 0800 1111.