19th Sept data update

Every week SCCR admin James Beecher puts together a summary of local, national, and international data on the coronavirus/Covid-19 pandemic. Questions, feedback, or suggestions for inclusion of data you have found useful, are welcome in our Facebook group, or email: stroudcommunitycoronaresponse@gmail.com. While the sources referenced are authoritative, the analysis is my own. Though I have some research skills – I’m not a virologist, epidemiologist or public health expert.

Key points

• On Wednesday, when we have tended to publish these updates, the big news this week – was access to testing. While that’s still an issue, it has become clearer since that positive tests are rising quickly regardless of access to tests, with new restrictions likely to be announced by the government.
• This data update looks at the local picture and presents some national context, but I’m an amateur enthusiast trying to help. I imagine in the coming days and weeks people there will be much more attention to data around the country again, so I will be thinking about how to make these local updates more useful.
• I recommend the Gloucestershire County Council weekly summary for more on the local situation and the Independent SAGE weekly video (first 30 mins is a great couple of presentations on the national data and recommendations for next few weeks).
• During the week to 14th Sept, 25,738 positive tests were reported across the UK, more than double the 11,517 the previous week (and plausibly still an underestimate due to the widespread issues accessing tests).
• Despite issues around access to testing, recent testing data for both Stroud and Gloucestershire shows clear rises in the numbers of people testing positive. While numbers are still fairly low, it should be clear that infections can spread quickly – it continues to be important to follow the guidance to slow the spread of the virus (see below)
• In the most recent week for which data is available (to 11th Sept), 55 people tested positive in Gloucestershire, 11 of them from Stroud. These figures may still be revised upwards as test results from specimens submitted that week are added. The figure for Gloucestershire for the previous week (to 4th September) has been revised from 40 to 52.
• The positive test numbers for both Stroud and Gloucestershire are the highest they have been since the current testing regime has existed. While numbers of tests have been increasing through that period and a comparison with late May is not entirely fair, this is concerning. We do not have data on the number of tests or the positivity rate – but as such the cautious conclusion to draw is that the higher number of positive tests is associated with the virus being more prevalent locally.
• Globally there have been nearly 30 million cases identified, and Covid-19 has been attributed in the deaths of well over 900,000 people. More positively, over 20 million people have now been deemed to have recovered.

While the situation continues to be confusing and hard to follow, and locally the risks appear to be lower: the virus is still circulating and risks will rise if people become complacent.

The core advice remains: please book a test if you have one or more symptoms – a new continuous cough, high temperature, or loss of smell/taste. There is a permanent unit at Hempsted Meadow in Gloucester, and mobile units tour Gloucestershire (the local team have communicated this week that people who have not booked will not be tested – even though they may have been in the past, capacity does not allow for this at the moment). If you have symptoms, self-isolate until you have a negative test.

Whether or not you 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 14th September – to take account of new restrictions/advice).

Local statistics

I’m going to reduce the amount of local analysis I do as Gloucestershire County Council are now sharing a weekly data summary of their own.

Positive Tests

• In the most recent week for which data is available (to the 11th September), specimens produced 11 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.
• Across Gloucestsershire, there were 55 positive tests that week. A further 7 positive tests resulted from specimens submitted on the 12th September – but no positive tests have been received on specimens submitted since.
• There were 137 positive tests across Gloucestershire in August, and have already been 103 positive tests less than two-weeks into data for September.

You can see where cases are being confirmed by neighbourhood. This week Wotton-under-Edge is highlighted as having 5 cases confirmed in the week to 11th September. Some areas in Gloucester, Cheltenham, Bristol and Bath also show up. Interestingly, this is no longer the case for Swindon which has been on the government’s Watchlist.

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 (16th September) that 47 people may actively have the virus in Stroud district (same as on the 9th and barely higher than 46 on the 4th Sept). The Study also estimates 106 active cases in South Gloucestershire (up from 44), 54 in Cheltenham (up from 44), 38 active cases in nearby Gloucester (down from 44) and 29 in Cotswold (down from 36), 37 Tewkesbury (down from 43) and 25 in the Forest of Dean (down from 27). Other than for South Gloucestershire, these estimates have all barely changed recently, and are consistent with the positive test numbers to the extent we would expect a higher number of symptomatic people 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: ONS data on Death registrations and occurrences by local authority and place of death
• 92 of the 582 people to have died in Gloucestershire with Covid-19 mentioned on their death certificate were from Stroud district. This figure has not increased since week 24 (12th June), when two people from the district died. The chart below shows the distribution relative to deaths in the district from other causes. 9% of all people who have died from Stroud district this year have had Covid-19 mentioned on their death certificate. In week 13, 31.6% of people who died had Covid-19 mentioned.

• 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 14th September there were 908 Covid-19 patients in UK hospitals, up slightly from 843 on the 7th September a week previously, but still lower than the 928 a month earlier. 172 patients confirmed to have Covid-19 were admitted to hospitals in England, compared to 84 on the 7th Septmeber and 52 on the 31st August. Hospital admissions are now clearly rising,

As of 15th September there were 101 patients on ventilation, compared to 80 on the 8th Sept. This is the first time the number has been above 100 since the end of July. The number has effectively doubled since the low of 52 on the 30th August.

More on testing and incidence estimates

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.

On 14th September the number of cases reported was 2,621 – compared to 2,948 a week earlier. While the daily number is lower, this seems likely to be partly about an erratic daily reporting – and largely about access to testing and test result delays. The 7-day average rose over the period from 2,532 to 3,286 [at time of writing 3,991 positive tests have been reported for 16th Sept].

During the week to 14th Sept, 25,738 positive tests were reported, more than double the 11,517 the previous week (and plausibly still an underestimate due to the widespread issues accessing tests).

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 3,200 daily new cases per day (30 August to 5 September), compared 2,000/day the previous week. to while the COVID Symptom Study app currently [19th Sept] estimates: 9,642 daily new cases (four times higher than 1,974 we reported on 4th Sept)
• Prevalence – the ONS estimates 59,800 people in England having COVID-19 (4 to 10 September), more than double the the 27,100 reported two weeks ago. The COVID Symptom Study estimate 87,286 adults aged 20-69 in the UK with symptomatic COVID (more than triple the 24,418 we last reported).
• The charts below show the trends, which are clearly rising rapidly. 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?“

PHE surveillance report

Every week PHE publish a “surveillance report” on the pandemic. Some key points from the report below. The image below, from the report, shows Gloucestershire with 5-9.99 cases per 100,000 people, the second lowest rate. The nearest location with a rate over 45 per 100,000 people is Birmingham.

PHE now report regionally from 29th June (this week to 15th September), showsing:

• 3,275 positive tests in the South West – incidence rate of 58/100,000
• This is by far the lowest rate in the country: London 113/100,000, highest in the North West at 272/100,000 (19,869 positive tests during the period).

The PHE surveillance report shows a considerable increase in the positivity rate (proportion of tests that are positive – ie, aside from the number of tests being done, more people are testing positive). This is the case, dramatically, for tests in both hospitals (left hand chart – a), and of people in drive-through centres (right hand chart – b)

• “Through the GP swabbing scheme, an increase in positivity was noted in week 37 at 7.6% compared to 1.4% in the previous week.”
• “Case detections in England increased from 15,231 in week 36 to 15,693 in week 37 [7,955 in week 35]… Further increases in detections for week 37 are expected as more results for the most recent samples become available.”.
• “Positivity rates have increased across most age groups particularly in the 85+ year olds tested through Pillar 2 and those in the 15-44 years in Pillar 1. Positivity by regions remains highest in the North.
• “Case rates continued to be highest in the 20-29 year age group.”
• “The overall number of acute respiratory infection incidents reported to PHE Health Protection Teams increased notably from 246 in the previous week to 729 in week 37. The highest increases were noted in the number of incidents in care homes, educational and workplace settings in comparison to the previous week. Around half of the incidents in educational settings were confirmed as COVID-19 outbreaks. There has also been an increase in rhinovirus activity in school aged children which may account for some of the acute respiratory infection incidents reported.”

Swindon has been removed from the Watchlist. The previous week’s report included the infographic below – showing cases and positivity rates in decline.

Indeed, positive tests are lower in Gloucestershire and most of the South West than much of the country (5-10 per 100,000).

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.

The World Health Organisation provide a map of the countries where there is highest percentage increase in cases. The UK is among countries with an increase of over 10% in the seven days to 16th September. Norway, Portugal, Canada, Austria, Tunisia and others have had an increase of 50% or more in that period.

The European Centre for Disease Prevention and Control provides subnational data across Europe, including the following map (data for weeks ending 4th/11th Sept).

The ourworldindata.org website provides lots of useful comparisons on a number of metrics, including testing, cases and deaths, through interactive charts you can control which countries are listed on, and whether data is raw or per population of a country- as well as tests per confirmed case.

People who have died with deaths attributed to Covid-19

The ONS’ latest data on death registrations says:

• “In Week 35 [week ending 28 August 2020], the number of deaths registered was 9.6% above the five-year average (791 deaths higher); this is the third consecutive week that weekly deaths have been above the five-year average, however, the rise was not driven by the coronavirus (COVID-19).”
• “Of the deaths registered in Week 35 [ending 28 August], 101 mentioned “novel coronavirus (COVID-19)”, the lowest number of deaths involving COVID-19 in the last 24 weeks and a 26.8% decrease compared with Week 34 (37 deaths), accounting for 1.1% of all deaths in England and Wales.“
• “Looking at the year-to-date (using the most up-to-date data we have available), the number of deaths up to 28 August 2020 was 417,063, which is 54,309 more than the five-year average. Of the deaths registered by 28 August, 52,282 mentioned COVID-19 on the death certificate, 12.5% of all deaths in England and Wales… the number of deaths for England was 391,577, which is 52,646 (15.5%) more than the five-year average. Of these, 49,642 (12.7%) mentioned COVID-19.”

A useful Financial Times interactive chart allows comparison of 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 begun to rise – following a trend a little like Fraance where deaths are clearly rising fast. France appears to be following or perhaps exceeding the rise in Spain. The chart also shows Israel – where the “second wave” of deaths has been higher and longer than the first – and Iran – where the “first wave” never declined to low numbers, and where a “second bump” than appeared to be declining is rising before falling below the daily rates at the peak of the “first wave”. While these “waves” may reflect geographic distributions (as is clearly the case across the USA, with different States experiencing peaks at different times contributing to the particular pattern in the US), there also appears to be plenty of risk of large numbers of deaths in “second waves” from nearby countries that are not that dissimilar to the UK (Spain and France).

(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” (which avoids any issues with attribution to Covid-19 and instead explore the impact of both the pandemic and lockdown measures on the number of people dying), 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.

Another Financial Times’ interactive chart can also 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 (622.1) after Peru (922) and Belgium (862.8) – with the number of people dying in Chile (614.8), Brazil (601.6) and the United States (550.9) still increasing quickly. Other countries have far lower rates, despite the virus having been present for a similar time – such as Germany (112.2 deaths per million), Cuba (9), South Korea (6.6), and New Zealand (4.9).

Our analysis of data from the Johns Hopkins University tracker shows

As of the 14th September, he number of people who have died was 935,591.

37,906 people died in the past week with their death at least partly attributed to Covid-19 (lower than the previous week).

There are sixteen countries where over 10,000 people have died where Covid-19 was involved (same as last week). 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 this week is higher than last week in seven of the twelve countries where over 10,000 people had died by last week (US: 6,262/4,991, Brazil: 5,655/4,868, India: 8,176/7,557, France: 237/104, Peru: 951/908, Iran: 911: 870, Russia :914/574).

Recoveries

At least 20 million people have been deemed to have “recovered” after testing positive globally (20,094,781), an increase of over 1.5 million in the past week (1,553,648) – 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 2,184 people have recovered, for instance – an increase of 357 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 instances of the virus. Further, access to testing changes and this will affected confirmation. The number of people dying is arguably a more useful way to compare the impact of the virus across different countries (though methods vary there too). Nonetheless, 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 29 million cases of Covid-19 have been confirmed (29,598,820)
• That’s an an increase of over 2 million cases during the week (2,013,724, the twelth week in a row with over 1 million cases confirmed, the first with over 2 million).
• Global confirmed cases increased by 7.3% in the past week (this percentage increase has been falling slowly, but rose from 7%).
• 23 countries have over 200,000 cases, and four have over 1 million confirmed cases (India passed 5 million cases this week – with 650,231 positive tests in the week).
• Confirmed cases this week are higher than the number last week in 15 of the 23 countries (USA, India, Brazil, Russia, Peru Spain, Argentina, Chile, Iran, France, the UK, Pakistan, Phillipines, Germany, and Indonesia)
• Spain confirmed a total of 68,654 cases, a 12.8% increase
• France confirmed 60,187 cases, a 16.1% increase.

My condolences

I hope that this update helps contribute to understanding, and leads people to take care to reduce the potential impact of the virus. My best wishes and condolences to all those affected.

Notes

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

Please remember we have a list of resources to support your emotional and mental health during this time on our website (and welcome further recommendations). 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.