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20th December 2020 data update

Dear followers of the Stroud Coronavirus Community Response updates. This will probably be my last data summary for the year. I am sorry that I’m not able to pass on better news in it – but nonetheless send my seasonal greetings to all readers, and wish you the best over the next couple of weeks. It’s been a really difficult year, and yesterday’s press conference bringing ubrupt changes to plans is obviously challenging in lots of ways for lots of people. Below is the usual summary of the latest local data, with some national and international context, but – because of it’s importance – I’ve started with a summary of links to the new guidance and some additional resources around Christmas.

Christmas and Tier Updates

Key data points

  • There were 218 patients who have tested positive in Gloucestershire hospitals as of the most recent data (15th December), this is the highest it has been in the dataset (since 1st August), and a dramatic rise from last week’s 183.
  • Across Gloucestershire, over 10,000 individual people have now tested positive through the course of the pandemic: 10,191 as of the 19th December. This is a rate of 1,600 per 100,000 people – 16 people in every 1,000, or one in every 63 people.
  • In the most recent week (to 18th December) 869 people from Gloucestershire have already tested positive – higher than the previous week (864) even before all test results have been processed. This number is much higher than the week before that – 593, and higher than the number for the week to the 6th November which preceded the previous Autumn peak in the week to the 13th November – when 1,006 people tested positve in one week.
  • Here in Stroud district, 141 people from the Stroud district tested positive in the most recent week (to the 18th December). Not everyone will have had their test results back so this number will likely rise (last week I reported 140 positive test results, this is now 151 and a few test results may yet come in). The increase from the week before (96) is dramatic, though there is a hint that numbers are plateauing at this level in the district and hopefully we will see falls again soon.
  • A total of 691 people from Gloucestershire have died with Covid-19 mentioned on their death certificate, as of data to week 49 (4th December). 23 people have been added to this total in the most recent week (a lower number than in the previous week: 29). Three 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 115. Of the other 20 people: 6 were from Gloucester, 4 were from Cotswold district, 4 were from Tewkesbury 4 were from Cheltenham, and 2 were from the Forest of Dean. Our condolences to all affected.
  • Across Gloucestershire, there have been 108.5 deaths per 100,000 people – this is a little lower than the England average of 115.6 per 100,000. The lowest rate for England and Wales ‘Upper Tier Local Authorities (ie. County Councils or equivalent) is 37 in Devon. The highest rate is 227.8 in Tameside, more than double the Gloucestershire rate. However, nearby Somerset (46.8), Bath and North East Somerset (54.3), City of Bristol (71), South Gloucestershire (80.7) and Swindon (85.5) all have lower deather per 100,000 people than Gloucestershire, sometimes less than half as high.
  • Across the UK, the Office for National Statistics say: “Using the most up-to-date data we have available, the number of deaths up to 4 December 2020 was 567,199, which is 66,322 more than the five-year average. Of the deaths registered by 4 December 2020, 69,771 mentioned COVID-19 on the death certificate. This is 12.3% of all deaths in England and Wales.”
  • 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

Watch the Coronavirus press conference from yesterday, 19th December, where the new Tier 4 was introduced and Christmas restrictions updated.

Though it came out before the press conference introducing Tier 4 and changing the government’s approach to Christmas, this week’s Independent SAGE video is absolutely worth watching. The 20 minute data summary by Kit Yates makes clear the situation the country is in, there are useful questions and answers, and at the end the members of the Independent SAGE answer a question about their own Christmas plans – it’s useful to hear how they are approaching the different situations they are in.

In brief:

  • Across the UK, the number of confirmed COVID-19 patients in hospitals at midnight 17th December was 18,771 (up 2,162 on the previous week). For comparison, 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 95% of the previous peak.
  • As of the 15th December, there were 265 people with at least on positive Covid-19 test result per 100,000 people in the previous 7 day period. This has rising dramatically since 8th December – one week earlier – when it was 174. The rate is now higher than it reached at the peak on 13th November (258/100,000)
  • Compared to last week, the number of people testing positive is up (51%), deaths within 28 days of a positive test are up (10% – data based on mentions on death certificates is covered below), the number of patients being admitted to hospital with Covid is up (18%). The rate of testing cannot explain these rises – as it is only up 4%. See the UK summary via the gov.uk dashboard for more.

Charts and information for the local area

Source: gov.uk data download

I am pleased to pass on that the government data dashboard now provides public information about the number of tests, and the positivity rate, by district or county (click for Stroud district testing data). Every time I post about the number of positive tests rising, someone pops up to suggest this is only because of a higher number of tests being conducted (oddly the same doesn’t happen when positive test numbers fall). Until now I’ve had to rely on UK and South West level positivity rates to say “no, the proportion of tests that are positive is also rising”, but the chart below now makes this clear for the district. You can see that the pattern is broadly similar to the test data. From the 3rd – 19th July, the proportion of people testing positive was 0.1% at the most, and no-one tested positive for three days in the month (6th-8th). During July between 900 and 1,200 tests were being completed across each 7 day day period.

That intro aside, the recent data is concerning: the proportion of people testing positive was rising sharply to the 15th December (the latest day for which data is available) – from 3.7% on the 8th December, to 5.6% a week later.

The government data dashboard now helpfully breaks down positive test results by age – first, simply, by people aged over or under 60 (a crude but still useful metric of how damaging infections may likely be – as those of us aged over 60 are at much greater risk). The two lines on the chart below show how the proportion of people testing postive aged 60 or over tracks proportions for those aged under 60 – except in the early part of the pandemic, likely because only those being hospitalised were tested and this would largely have been older people who were more badly affected. The recent dramatic rise in positive test results for people aged 60 or over is hugely concerning. It shows the clear risk of community transmission at high rates among the population broadly. It is not possible to expect the virus to avoid those of us most at risk if it is being transmitted by others.

Source: gov.uk data dashboard

The updated government dashboard also includes a “heatmap” of positive tests by age bracket with 5 year age bands – for Stroud district or other areas at district, county, or national level. The chart below for Stroud district shows how rates have risen for all age groups recently (around November), falling back for those aged 35-75, but remaining high or experiencing another rise for people aged over 75, and for aged 25-34. Again, this should underline that protecting those of us most at risk from the virus requires suppressing it among all age groups.

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. 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). This week they estimate 269 people in the district have active infections, down from 596 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, suggests a recent rise may be back under control and falling again. Fingers crossed this is an early indicator of a decline just as previous data has been an early indicator of increases.

Source: Kings College London/ZOE app – you can only see this chart via the app

Across the UK as a whole, the Kings College London/ZOE Covid Symptom Study team estimate “There are currently 26,897 daily new symptomatic cases of COVID in the UK on average over the two weeks up to 13 December (excluding care homes)”.

“With just a week until Christmas Day it’s a bleak picture across the UK, particularly for Wales and London. Our data shows that cases and hospitalisations are rising again, which worryingly could mean the start of a third wave earlier than we expected. Sadly, Christmas 2020 won’t be normal . People should stay in small groups, avoid travelling to and from higher risk areas and socialise outdoors. People also need to know about the 20+ symptoms of early infection they can experience including fatigue and headache and not take risks if they start feeling unwell. There are no exceptions, everyone needs to take care, but we are urging people to consider postponing Christmas socialising until Easter.”

Tim Spector OBE, lead scientist on the ZOE COVID Symptom Study app and Professor of Genetic Epidemiology at King’s College London
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

There were 218 patients who have tested positive in Gloucestershire hospitals as of the most recent data (15th 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), and a dramatic rise from last week’s 183. The government data dashboard now provides this data by NHS Trust (there are two Trusts in Gloucestershire: Gloucestershire Hospitals – which runs Cheltenham and Gloucester “Acute” hospitals, and Gloucestershire Health and Care – which runs the district hospitals including Stroud and the Vale in Dursley).

Source: NHS Covid-19 Hospital Activity

Across the South West the number of beds occupied by confirmed Covid-19 patients is rising again – 1,005 as of the 15th December. This is just below the recent Autumn peak of 1,038 on the 24th November. At 218, Gloucestershire patients account for over 1 in 5 of Covid-19 patients in the South West (22%) – as opposed to 1 in 7 on the 24th November (14%).

Source: NHS Covid-19 Hospital Activity

The chart below show weekly deaths with Covid-19 on the death certificate for Gloucestershire. 100 people died with Covid-19 mentioned on their death certificate in the five weeks across November and the first week of December, compared to 591 in the 32 weeks from the end of March to the end of October.

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).

Seven-day rolling rate of new positive test results by MSOA (parts of Stroud district) for the week ending 15th December are as follows. If this doesn’t include your area, click through to the map to find your details.

  • 40 – Frampton, Whitminster & Eastington (up from 9, a rate of 583.0 per 100,000 people). This high number of positive test results is sadly likely associated with a care home outbreak.
  • 18 – Cam (up from 13, a rate of 208.9 per 100,000, above the England average)
  • 16 – Dursley (same as last week, a rolling rate of 209.2 per 100,000 – above the England average)
  • 14 – Upton St Leonards & Hardwicke (up from 6, rate of 139.4 per 100,000 – below the England average)
  • 13 – Berkeley & Sharpness (up from 7 – rate of 201.4 – in line with the England average)
  • 13 – Michinchimhamptom & Amberley (up from 5 – rate of 194.5 per 100,000)
  • 11 – Stonehouse (down from 14, rate of 137.0 per 100,000, below the England average)
  • 9 – Ebley & Randwick (up from 8 – rate of 75.8 per 100,000)
  • 9 – Leonard Stanley & Uley (down from 0-2 – rate of 130.2 per 100,000)
  • 9 – Wotton-under-Edge & Kingswood (up from 4 – rate of 101.4 per 100,000)
  • 8 – Stroud Town (same as last week, rate of 68.5 per 100,000)
  • 3 – Painswick, Bisley & Eastcombe (down from 6, rate of 45.4 per 100,000)
  • 3 – Nailsworth (same as last week)
  • 3 – Chalford & Bussage (up from 0-2)
  • 3 – Rodborough & Thrupp (up from 0-2)

The highest number of people testing positive per MSOA in Gloucestershire in the past week was once again Barton in Gloucester, with 34 positive test results in the week (33 last week) – the chart below from the government’s interactive map no longer shows areas in Stroud district and Gloucestershire with below 3 positive tests – in short, there are people who have tested positive around the district and county.

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 4th December, 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 49, the number of deaths registered was 15.0% above the five-year average (1,608 deaths higher).”
  • “Of the deaths registered in Week 49, 2,835 mentioned “novel coronavirus (COVID-19)”, accounting for 23.0% of all deaths in England and Wales, a decrease of 205 deaths compared with Week 48; this is the first decrease since Week 36 (week ending 4 September 2020).”
  • “Using the most up-to-date data we have available, the number of deaths up to 4 December 2020 was 567,199, which is 66,322 more than the five-year average. Of the deaths registered by 4 December 2020, 69,771 mentioned COVID-19 on the death certificate. This is 12.3% of all deaths in England and Wales.”

ONS also say:

  • “Of the 2,835 deaths involving COVID-19, 2,469 had this recorded as the underlying cause of death (87.1%).”
  • “In England, the total number of deaths decreased from 11,645 (Week 48) to 11,450 (Week 49); all English regions had a higher number of deaths than the five-year average for the fourth week in a row.”
  • “The number of deaths registered in the UK in the week ending 4 December 2020 was 13,956, which was 1,820 deaths higher than the five-year average; of the deaths registered in the UK in Week 49, 3,160 deaths involved COVID-19, 211 deaths fewer than in Week 48.”

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 rising again in the UK and is around 450 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). 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 6.4% (of people tested on December 16th, more than 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 rising positivity rate is sign that infections are rising.

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:

  • “The percentage of people testing positive for the coronavirus (COVID-19) in England has increased; during the most recent week (6 to 12 December 2020), we estimate 567,300 people (95% credible interval: 533,600 to 602,300) within the community population in England had the COVID-19, equating to around 1 in 95 people (95% credible interval: 1 in 100 to 1 in 90)” (a significant increase since last 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).”)
  • “Over the most recent week, the percentage of people testing positive has increased sharply in London, with other increases in the East of England, the East Midlands, and the South East; the percentage of people testing positive in the North West and Yorkshire and The Humber has continued to decrease in the most recent week.”

Read more about the ONS methdology.

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.


The chart below compares cumulative confirmed COVID-19 deaths per million people for selected countries. As of December 12th, there have been 1,592 Covid-19 deaths per million people in Belgium – the worst affected country by this measure. Italy is next most badly affected – 1,123, then Peru at 1,118. In the UK 981 people per million have died with Covid-19 mentioned, comparable to other badly affected countries like the United States (947), Spain (1,046) – where deaths continue to rise sharply. Deaths are still increasing in Sweden – almost as badly affected (791). European countries that had relatively better pandemics are also seeing deaths increase – though the number of people who have died per million population is still much lower in Germany (308), and Greece (390), and 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 (88), South Korea (13) 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 19th December). 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.