13th Dec 2020 data update

SCCR team member James Beecher’s weekly attempt to summarise the local data – with some national and international context

Key points (see below for charts, full sourcing and more detail):

  • 140 people from the Stroud district tested positive in the most recent week (to the 11th December). Not everyone will have had their test results back so this number will likely rise. This is already a significant increase on last week (now 96 – 91 at time of reporting last week), and – a worse sign – higher than the week before. It’s not possible to strip out the effect of any increased testing, but it seems unlikely to explain a rise over such a short period of time. It is frustrating that signs of decline have stalled.
  • We know that not everyone with Covid-19 can or does get a test, for a variety of reasons. As such, the estimates provided by the Kings College London/ZOE team (behind the Covid-19 symptom tracker app) are useful for a broader picture of infections. This week they estimate 596 people in the district have active infections, a rise of 229 from last week. Their daily estimates – which are based on app users reporting positive tests and/or symptoms and which have broadly tracked and anticipated other data sources, now shows a trend rising in the district pretty much as it was before the national lockdown.
  • The number of people testing positive by week has also risen, though less dramatically, across Gloucestershire as a whole (ie, some areas will be falling, but Stroud district and other parts of the county are pushing the numbers up). In the week to the 11th December, 647 people tested positive. This is higher than the 599 for last week – and, as above, may still rise as results come trhough. It is, currently, lower than the previous week, however – that was 682. Nonetheless, there’s now no evidence of a falling trend, and hence no room for complacency. Please follow the Tier 2 guidance.
  • This is underlined by the most recent data on the number of Covid-19 patients in Gloucestershire hospitals. At 183 patients on the 8th December, this is the highest it has been in the dataset (since 1st August. A different dataset shows the previous peak was 244 on the 18th April). Last week it appeared the number of patients in hospital was stabilising, it is concerning that there is no sign of it beginning to fall – and if anything it may be rising.
  • A total of 668 people from Gloucestershire have died with Covid-19 mentioned on their death certificate, as of data to week 48 (27th November). 29 people have been added to this total in the most recent week (a higher number than in the previous week: 22, and higher than all but the worst 6 weeks of the first wave). Two people from Stroud district died with Covid-19 mentioned on their death certificate with the death registered in that week. The total number of people from Stroud district to have died is now 112. Of the other 27 people: 8 were from Gloucester, 7 were from Cotswold district, 5 were from Tewkesbury 4 were from Cheltenham, and 3 were from the Forest of Dean. Our condolences to all affected.
  • Across Gloucestershire, there have been 104.9 deaths per 100,000 people – this is close to the England average of 110.9 per 100,000. The lowest rate for England and Wales ‘Upper Tier Local Authorities (ie. County Councils or equivalent) is 34.5 in Devon. The highest rate is 222.5 in Tameside, more than double the Gloucestershire rate. Nearby South Gloucestershire and Swindon have lower rates: 72.3 and 85.1 deaths per 100,000 people.
  • You should be able to enter you postcode via this link and receive up to date information for your local area, the Stroud district, Gloucestershire, the South West and more.

National

For a summary of the situation in terms of people testing positive, being admitted to hospital, and dying nationally – and by English region and age group – please watch the 20 minute summary by Christina Pagel for the weekly Independent SAGE briefing. This week’s Independent SAGE briefing also includes a presentation on the vaccines by Professor Danny Altmann, who answers questions. Highly recommended.

Also worth a watch are Professor Tim Spector’s short (6 minute) updates based on the data collected by the Kings College London/ZOE Covid-19 symptom tracking app. Spector discussed regions which might move tiers – noting that nearby Bristol may be moved out of Tier 3 and into Tier 2. This week the same team have also published a guide to Covid-19 symptoms beyond the ‘classic’ 3 (e.g. “skin rashes in the app, which we now know are present in around 8% of positive cases“). They’ve also posted about how you can now log if you have had a Covid-19 vaccine in the app.

https://www.youtube.com/watch?v=XJBPiGwItPE

In brief:

  • Across the UK, the number of confirmed COVID-19 patients in hospitals at midnight 10th December was 16,531 (up 992 on the previous week), and approaching the ‘second wave’ peak of 16,661 on the 23rd November. For comparison, on the 27th March – the earliest data for comparable data, there were 7,043 patients, and at the peak in the ‘first wave’ on 12th April 19,849 patients in hospital. In other words, the number of patients in hospitals is 83% of the previous peak.
  • Across the UK, the number of people who tested positive in the 7 days to the 8th December was 115,887, which compares to 101,580, in the week to 1st December, and 167,740 in the week to the 10th November. However, this is still some way above the number who tested positive in the week to 8th September: 23,550.
  • See the UK summary via the gov.uk dashboard.

Charts and information for the local area

Source: gov.uk data download

The chart below represents estimated cases, but you can see how it broadly tracks the numbers that are confirmed through testing (though it is a daily rather than weekly chart and starts in September rather than May as above).

Source: Kings College London/ZOE app – you can only see this chart via the app
Source: gov.uk data download

The chart below compares positive test results for Gloucestershire by month. Even if cases have passed a peak in Gloucestershire, there have still been more people testing positive in the first 11 days of December than in the whole month of September (comparisons with March and April are included in the chart below in a different colour – as all of those cases were hospitalised, while since May testing has been for “anyone with symptoms” – and people’s contacts. We know even the current testing system does not catch everyone with the virus, but the numbers for March and April are certainly a huge underestimate as – unlike now – they did not include people with mild symptoms).

Source: gov.uk data download

In a piece titled “Worries for Wales and London as cases rise“, the KCL/ZOE team identify Gloucestershire – along with nearby Somerset and Bath and North East Somerset, and Wiltshire and Swindon – as the worst performing regions in Tier 2 (along with Essex, Thurrock and Southend on Sea) – on the basis of prevalence rate, prevalence rate in the 60+ age group (people more at risk), and % NHS bed occupancy with Covid-19. In Gloucestershire, the prevalence rate is 407 per 100,000 people – compared to 569 in London (which will no doubt get more national media coverage so is a useful comparison). In the over 60 age group, prevalence is 90 per 100,000 people (165 in London). R is 0.9 (below 1 should mean numbers are falling, but only just – in London it is estimate to be 1), and NHS bed occupancy is 8.9% compared to 11.6% in London. By constrast, “Bristol, South Gloucestershire and North Somerset” (as an area) is one of the “Best peforming regions in Tier 3” – prevalence is still higher than Gloucestershire County area: 558 compared to 407. But prevalence among the over 60s is now the same: 90, as is % NHS bed occupancy with Covid-19. If Bristol comes out of Tier 3 into Tier 2, we can hope that Gloucestershire will stay in Tier 2… but it doesn’t look possible (as it did last week) that Gloucestershire might move down a Tier. If anything, the county is nearing a trend where it may be moved up a Tier. Again, there is no room for complacency – please continue to follow the Tier 2 guidance.

Source: NHS Covid-19 Hospital Activity

Across the South West the number of beds occupied by confirmed Covid-19 patients has stablised at around 1,000 (946 on 11th December). It sadly seems there is little sign of a significant downward trend.

Source: NHS Covid-19 Hospital Activity

The chart below show weekly deaths with Covid-19 on the death certificate for Gloucestershire.

Source: gov.uk data dashboard / ONS

There is a new version of the government’s interactive map which shows weekly cases at a more localised scale than districts (an alternative map shows this as dots).

Rates have largely fallen back to low number save in a Dursley and Cam where they are falling but still 10 people testing positive in a week. Only in Frampton, Whitminster and Eastington is the number of people who tested positive higher than the previous week, and the rate per 100,000 people higher than the England average.

Seven-day rolling rate of new positive test results by MSOA (parts of Stroud district) for the week ending 8th December are as follows. Rates per 100,000 people are recorded only for the places with the highest numbers of people testing positive – if this doesn’t include your area, click through to the map to find your rate.

  • 16 – Dursley (up from 10 last week, a rolling rate of 209.2 per 100,000 – above the England average )
  • 14 – Stonehouse (up from 5, rate of 174.3 per 100,000, above the England average)
  • 13 – Cam (up from 11, a rate of 150.9 per 100,000, in line with the England average)
  • 9 – Frampton, Whitminster & Eastington (down from 12, a rate of 131.2 per 100,000 people)
  • 8 – Stroud Town (same as last week, rate of 68.5 per 100,000)
  • 8 – Ebley & Randwick (up from 5)
  • 7 – Berkeley & Sharpness (up from 3)
  • 6 – Painswick, Bisley & Eastcombe (up from 5)
  • 6 – Upton St Leonards & Hardwicke (down from 10, rate of 59.7 per 100,000)
  • 5 – Michinchimhamptom & Amberley (down from 6)
  • 4 – Wotton-under-Edge & Kingswood (down from 7)
  • 3 – Nailsworth (down from 4)
  • 0-2 – Chalford & Bussage (down from 4)
  • 0-2 – Leonard Stanley & Uley (down from 4)
  • 0-2 – Rodborough & Thrupp (down from 7)

The highest number of people testing positive per MSOA in Gloucestershire in the past week was once again Barton in Gloucester, with 33 positive test results in the week (down from 44 last week) – the chart below from the government’s interactive map shows a number of areas in Stroud district and Gloucestershire with very low numbers (below 3 appears as white on the map). However, as above, some areas of the county are still seeing rises.

More national information and charts

The chart below shows the number of people who died in England and Wales with Covid-19 mentioned on the death certificate in the weeks to the 27th November, and how these compare to deaths not involving Covid-19, and how the total number of deaths each week relates to the 5 year average. The chart shows that, as the ONS say:

  • “In Week 48, the number of deaths registered was 20.3% above the five-year average (2,099 deaths higher).”
  • “Of the deaths registered in Week 48, 3,040 mentioned “novel coronavirus (COVID-19)”, accounting for 24.4% of all deaths in England and Wales; an increase of 343 deaths compared with Week 47.”
  • “Using the most up-to-date data we have available, the number of deaths up to 27 November 2020 was 554,893, which is 64,711 more than the five-year average. Of the deaths registered by 27 November 2020, 66,907 mentioned COVID-19 on the death certificate. This is 12.1% of all deaths in England and Wales.”

ONS also say:

  • “Of the 3,040 deaths involving COVID-19, 2,637 had this recorded as the underlying cause of death (86.7%).”
  • “In England, the total number of deaths decreased from 11,675 (Week 47) to 11,645 (Week 48); all English regions had a higher number of deaths than the five-year average for the third week in a row.”
  • “The number of deaths registered in the UK in the week ending 27 November 2020 was 14,106, which was 2,329 deaths higher than the five-year average; of the deaths registered in the UK in Week 48, 3,371 deaths involved COVID-19, 331 deaths higher than in Week 47.”

The below chart – based on deaths as they are reported daily by Public Health England (people who have died within 28 days of a positive test, a less robust measure but more up to date measure than the ONS method based on death certificates which take a couple of weeks to come in) shows that the daily number of new Covid-19 deaths appears to be declining in the UK from a seven day average of around 485 people dying each day roughly half as many people as were dying each day as during the first peak (at worst, around 900 deaths per day). Though there appears to have been a peak, there is sadly not yet a clear sign of a declining trend. The chart is interactive, so you can change how it displays and add countries for comparisons.

Below is a chart showing the proportion of tests in the UK that are positive. The chart shows how:

  • At the lowest point – at the end of July – just 0.4% of people tested were testing positive, but the proportion testing positive is now 5.0% (of people tested on December 2nd, one in every 20 people tested, tested positive). The changes in the proportion of tests that are positive make clear that ‘false positives’ are not driving the changes in numbers of positive tests (as we’d expect the proportion of false positives to remain roughly the same). The stable positivity rate is sign that infections are not declining.

While data on the numbers of tests or share of tests that are positive isn’t available for Stroud or Gloucestershire specifically (at least so far), a chart below shows the same thing but for the South West. The dramatic decrease in the proportion of people testing positive in the community is a really good sign. Both figures are below 5% – the WHO threshold (above this they say there is a risk cases are being missed). As they are falling, they indicate that rising test trends in the South West region as a whole could be as a result of increased testing (this is a good sign that a higher proportion of cases are being identified, which should help stop the spread).

* The proportion of “Pillar 2” tests (conducted for people in the community) that returned positive results across the South West was 2.9% in the most recent week (to 4th December) – still falling from a peak of 7.7% three weeks previously – though still far from a low of 0.3% in mid-July.

* The proportion of “Pillar 1” tests (conducted for people in hospital) that returned positive results across the South West was 3.2% in the most recent week (to 4th December) – still failing a peak of 5.1% three weeks ago, but well above the low of 0.1% in August.

Source: PHE spreadsheet as part of weekly Covid-19 and flu surveillance

PHE also present an interesting chart on positivity rate by whether someone reported having symptoms or not. We can see that people are much more likely to test positive if they have symptoms (in week 49, around 15% of people with symptoms test positive, compared to under 2.5% of people without symptoms).

Source: PHE spreadsheet as part of weekly Covid-19 and flu surveillance

Each week, the ONS does a testing survey. This goes out like other survey work it isn’t based on symptoms or people seeking a test. This week (6th November they say:

  • “In the most recent week, the percentage of people testing positive for the coronavirus (COVID-19) in England has continued to decrease; during the most recent week (29 November to 5 December 2020), we estimate 481,500 people (95% credible interval: 450,800 to 513,600) within the community population in England had the coronavirus (COVID-19), equating to around 1 in 115 people (95% credible interval: 1 in 120 to 1 in 105).” (down a bit from the previous week: “In the most recent week, the positivity rate in England has decreased; during the most recent week (22 to 28 November 2020), we estimate 521,300 people (95% credible interval: 490,600 to 552,600) within the community population in England had the coronavirus (COVID-19), equating to around 1 in 105 people (95% credible interval: 1 in 110 to 1 in 100).”)
  • “Over the most recent week, the percentage of people testing positive has increased in London and there are early signs that rates may have increased in the East of England; the percentage of people testing positive has decreased in all other regions.”

Read more about the ONS methdology.

The ONS also produce data on the social impacts of the pandemic (thanks to Wendy Thomson for highlight this).

“This week, over the period 2 to 6 December, based on adults in Great Britain:

  • compliance with most measures to stop the spread of the coronavirus (COVID-19) remained high, with 89% reporting always or often handwashing after returning home, 97% using a face covering, and 89% avoiding physical contact when outside their home
  • around 3 in 10 (28%) adults felt that life will return to normal in six months or less, an increase from 1 in 10 (9%) on 21 to 25 October

We also look at the mental health of adults (depression and anxiety) over the period 11 to 29 November:

  • In November 2020, 19% of adults experienced some form of depression, indicated by moderate to severe depressive symptoms, while 17% of adults experienced some form of anxiety.
  • The proportion of adults experiencing some form of depression in the latest period is similar to earlier in the pandemic (19% in June 2020); however, these rates have almost doubled from around 1 in 10 (10%) before the pandemic (July 2019 to March 2020).
  • A higher proportion of younger adults, women, disabled adults and those whose households were unable to afford an unexpected but necessary expense of £850 reported some form of depression and some form of anxiety.”

Please see our resources on emotional and mental health – we hope neighbour networks and local mutual aid groups can also be a source of support, with regard to self-isolating, but also emotional and mental health and financially.

Global

I no longer have time to do much in the way of global updates. Please do visit the OurWorldInData website for more comparisons and trends. Some key data on the numbers of people dying and excess mortality are covered below.
This week I did read a sad summary of the awful situation in the United States. The blogpost is worth reading in full but here is the intro summary: “By nearly all measures it has been a horrible week, a horrible month (nine days in), and a horrible year. The United States set pandemic records in all three metrics that measure the pandemic’s severity this week, recording a total of 1.4 million new cases and 15,966 deaths. Yesterday, states and territories reported 3,088 deaths from COVID-19—a record no one wanted to see—and the average number of deaths per day this week exceeded 2,000, surpassing the highest average we saw in the spring’s deadly first surge. More than 106,000 people are currently hospitalized with COVID-19″. It is worth noting that while things are currently very bad in the US, the UK still has a worse rate of people dying per million population, see below.

The chart below compares cumulative confirmed COVID-19 deaths per million people for selected countries. As of December 12th, there have been 1,527 Covid-19 deaths per million people in Belgium – the worst affected country by this measure. Peru is next most badly affected – 1,108. In the UK 945 people per million have died with Covid-19 mentioned, comparable to other badly affected countries like the United States (890), Spain (1,018), and Italy (1,059) – where deaths continue to rise sharply. Deaths are still increasing in Sweden – almost as badly affected (744). European countries that had relatively better pandemics are also seeing deaths increase – from 110 in September to 261 per million in Germany, and from 36 per million in Greece to 340. There remain a number of countries where less than 1 person per million has died because of Covid-19: Thailand, Vietnam and Taiwan, and Finland, South Korea and others all have figures below 100 people per million.

From OurWorldInData’s page on “Excess Mortality”: “The chart here shows excess mortality during the pandemic for all ages using the P-score.9 You can see that some countries – such as [the United States,] England & Wales10 and Spain – suffered high levels of excess mortality… [though] others – such as Germany … experienced much more modest increases in mortality.”
(“It is important to note that because the P-scores in this chart combine all ages, they are impacted by differences in mortality risk by age and countries’ age distributions. For example, countries with older populations – which have a higher mortality risk, including from COVID-19 – will tend to have higher all-age P-scores by default. When comparing countries it is informative to look at the P-scores for different age groups.”)

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 (or if you are asked to by contact tracers or others conducting tests). There is a permanent unit at Hempsted Meadow in Gloucester, and mobile units tour Gloucestershire. If you have symptoms (or if you are asked to by contact tracers), self-isolate until you have a negative test. If you are struggling with self-isolating, please get in touch with us or with one of the local support groups. You may be able to receive financial support to self-isolate from Stroud District Council.

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 on the “Tier 2” restrictions that apply to Gloucestershire here online (last updated 30th November). If there is a piece of guidance you have a question about, again – please ask in our Facebook group.

Notes

These updates are designed to improve understanding of the pandemic and its impacts, with the hope this can help us to reduce those impacts locally. I appreciate they do not involve space to properly convey the full impact of the virus nor the restrictions that are making life difficult for many people.

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.