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11th April 2021 data update

Team members James Beecher and Claire Biggs summarise local data on the pandemic and put it in national and international context

Before this week’s data update for Stroud, Gloucestershire and beyond, a reminder of the next stage of the Government’s roadmap for ending restrictions, taken from gov.uk begins on Monday 12 April:

  • “non-essential retail will be able to reopen
  • personal care premises such as hairdressers and nail salons will be able to reopen
  • public buildings such as libraries and community centres will be able to reopen
  • outdoor hospitality venues will be able to reopen, with table service only
  • most outdoor attractions including zoos, theme parks, and drive-in performances (such as cinemas and concerts) will be able to reopen
  • some smaller outdoor events such as fetes, literary fairs, and fairgrounds will be able to take place
  • indoor leisure and sports facilities will be able to reopen for individual exercise, or exercise with your household or support bubble
  • all childcare and supervised activities will be allowed indoors (as well as outdoors) for all children. Parent and child groups can take place indoors (as well as outdoors) for up to 15 people (children under 5 will not be counted in this number)
  • weddings, civil partnership ceremonies, wakes and other commemorative events will be able to take place for up to 15 people (anyone working is not included in this limit), including in indoor venues that are permitted to open or where an exemption applies. Wedding receptions can also take place for up to 15 people, but must take place outdoors, not including private gardens
  • self-contained accommodation will be able to open for overnight stays in England with your household or support bubble
  • you should continue to minimise the amount that you travel where possible
  • care home residents will be able to nominate two named individuals for regular indoor visits (following a rapid lateral flow test)”

“You can read the ‘COVID-19 Response – Spring 2021’ (the roadmap out of lockdown) for more information on how COVID-19 restrictions will be eased in England. You can also read the law that underpins these changes and the ongoing restrictions.” (further re-opening is scheduled for “no earlier than 17 May.”)

Key data:

  • There is only 1 patient in a hospital in Gloucestershire with Covid-19 as of the 6th April (the most recent date data is available), down from 5 the week before (having peaked at 262 on the 6th January). There haven’t been fewer people with Covid-19 in local hospitals since 23rd September when there were 4. There have been no patients in Mechanical Ventilation beds locally since 17th March, ie, for over three weeks.
  • 5 people from Stroud district tested positive in the most recent week – to 7th April (down from 20 in the previous week). There have been several days recently where no specimens submitted tebmitted resulted in positive tests: 2nd, 4th, and 6th April (we can assume all results should have been returned by now for those dates). The ZOE/Kings College London app estimates that there are a total of 60 people with active sympomatic infections across the district (but this is down 20 from the previous week, and – as with the numbers receiving positive PCR tests is back to levels of September)
  • Across Gloucestershire, 49 people tested positive in the week to the 7th April (down from 91 in the previous week). This is the lowest number of people to test positive in a week in the county since week-ending 26th August 2020 (when 35 people tested positive). The rate per 100,000 people across Gloucestershire is 8 – making it the 12th lowest rate for equivalent local authorities in the UK, and the 3rd lowest in England (after Devon and Southwark).
  • Data from the NHS on vaccinations shows that – as of 4th April, the latest publicly available data – 69% of the Stroud district population aged 16+ has had at least one dose of a Covid-19 vaccine (68,276). This is only 727 higher than the previous week (67,549 people), whereas weekly vaccinations were running at between 3 and 5,000 in previous weeks. This is in-line with our expectation that first doses would slow because of a combination of supply-issues, and the need to switch to getting people who had their first dose 10-12 weeks ago their second doses (though data on second doses isn’t available for Stroud district, it is for Gloucestershire – see below).
  • Across Gloucestershire, more people have received a second dose by 4th April (68,891) than had received a first dose 11 weeks ago (62,140) – indicating that overall people are receiving their second doses before the 12 week deadline, just as they should. 65% have had a first dose and 13% of people have had a second dose. Across the South West, 64% have had a first dose and 10% a second, and across England over 26.5 million people have recevied a first dose of vaccine (58% of the population aged 16+, and 10% a second dose)
  • In Gloucestershire – 2 people died with Covid-19 mentioned on their death certificate in the most recent week for which data is available (to 26th March), bringing the total for the county to 1,179 people. 197 of these people were from the Stroud district (one of the two people across Gloucestershire to die was from the district). We send our condolences to all affected.
  • Across the UK 149,968 people have died with Covid-19 mentioned on their death certificate, as of 26th March, this includes 799 people added to the total in the most recent week. However, the number of people dying each week with Covid or because of it is falling, and “the number of deaths registered in England and Wales was 5.0% below the five-year average (528 fewer deaths); this is the third consecutive week that deaths have been below the five-year average.” (ONS)
  • Further detail and charts on the above and more are below:

People who have tested positive

Across Gloucestershire, 49 people tested positive in the week to the 7th April (down from 91 in the previous week). This is the lowest number of people to test positive in a week in the county since week-ending 26th August 2020 (when 35 people tested positive). The rate per 100,000 people across Gloucestershire is 8 – making it the 12th lowest rate for equivalent local authorities in the UK, and the 3rd lowest in England (after Devon and Southwark). You can view daily numbers for Gloucestershire on the government’s dashboard. Across Gloucestershire, a total of 22,281 people have now tested positive.

Source: data.gov download – data and chart by Claire Biggs

5 people from Stroud district tested positive in the most recent week – to 7th April (down from 20 in the previous week). This is the lowest number of people to test positive in a week since the week ending 16th September 2020 – and despite more people being tested now than in September. Just 0.3% of the 2,679 tests completed in the last 7-day period for which data is available tested positive (compared 0.2% of the 2,243 tests completed in the week to 16th September). There have been several days recently where no specimens submitted tebmitted resulted in positive tests: 2nd, 4th, and 6th April (we can assume all results should have been returned by now for those dates). The rate per 100,000 people in Stroud is for the past 7 days 5, the 13th lowest rate for all equivalent local authorities across the UK, behind only Forest of Dean at 4.6 across Gloucestershire.

Source: gov.uk dashboard – data download

A portion of positive tests will come from Lateral Flow Device testing associated with schools or people without symptoms – we are hopefully catching more people without symptoms who are positive and this should help break transmission chains. In order to be sure that this higher number of tests aren’t altering our understanding of what’s happening, one thing we can do is look at the proportion of PCR tests (for people with symptoms) are positive: this is falling. There is some complexity around whether people who test positive with an LFD get a confirmatory PCR test, but that shouldn’t affect the numbers too much. The most recent data for Gloucestershire has 0.3% of people who undertook a PCR test testing positive – down from 0.5% a week ago, 0.6% a week before that, and 11.9% at the peak. The rate (which covers the previous 7 days) was last this low on the 16th August – and has only been lower for a week in July 2020 (it was 0.2% from 13th-18th). This could represent a ‘floor’ – the lowest the rate will go given there will always be some false positives, or we may see even lower prevalence of the virus and fewer positive tests now that large portions of the population have been vaccinated (and given a slower reopening from lockdown that reduces the risks of transmission).

Source: gov.uk dashboard

Looking at smaller areas, the government’s map shows much of the district – and surrounding areas across the county and beyond – with fewer than 2 positive tests in the week to 6th April (this data is “suppressed” to protext the privacy of individuals when only small numbers of people test positive – but could mean no-one has tested positive in the previous 7 days in these places). See below for trends by areas of the district (“MSOAs” – “Middle Layer Super Output Areas – a statistical geography). The area with the highest rate of cases in Gloucestershire is Churchdown & Innsworth where the rate is 52.9 per 100,000 over the past 7 days – this comes from 7 cases, up by 3 from the previous week, and could represent just two households. In Stroud district, the 5 positive tests across Stroud district are presumably spread across multiple areas, as no single MSOA area has more than 2 cases.

Source: govt interactive map

Below are the charts for trends – you can see how cases are below 2 (and plausibly zero) in most of the district – up to the 4th April. You can see how the number of people testing positive has dropped everywhere.

Source: gov.uk data download – MSOA API

You can enter your postcode into the government’s dashboard to see this data as a map.

Finally on the number of people with the virus. We know that not everyone can get a test or gets one even if they can. The Kings College London/Zoe Covid-19 symptom study app reports estimates for Stroud district – based on reporting of symptoms by people using the app (of whom there are over 3,000 in Stroud district). Their latest estimate is 60 active cases for the district – down 20 from last week by their measure. Please continue to take care, keep following the guidance, and do what you can to reduce contacts and support people who need to isolate – we still want to get the infections lower than they are now.

Source: Covid 19 Symptom Study app

Across the UK, the KCL/ZOE app team estimate around 39,040 people had a symptomtic infection on the 11th April, based on symptom reporting by up to 4.6 million app users. This compares to 53,400 last week and a peak of 806,000 on the 12th January. The KCL/ZOE team estimated a similar number of people with symptomatic infections on the 12th September 2020 – 38,900.

Vaccinations

Data from the NHS on vaccinations shows that, in total and as of the 7th March (the most recent available data) there have been 407,057 Covid-19 vaccine doses delivered in Gloucestershire (21,165 doses delivered in the past week of data, compared to 51,433 doses delivered in the previous week). Of these, 338,166 are first doses and 68,891 second doses. Based on the 2019 population estimate for the area, these have covered approximately:

  • 69% of the population aged 16 or over across Stroud district. Every part of the district (“MSOA” level as above) has seen enough first doses given to cover 61% or more of the population aged 16+ (ie, those included in the current vaccination programme). Rates are highest as a percentage of estimated residents in Painswick, Bisley and Eastcombe (78%), Minchinhampton & Amberley (77%), and Frampton, Whitminster & Eastington (77%). These rates are higher because a higher proportion of the population is in eligible categories (ie, aged 50 or over, working in health or social care, or clinically vulnerable).
  • 65% of the Gloucestershire population aged 16+ has had a first dose, 13% have had a second dose.
  • This compares to 64% and 10% for the South West as a whole.
  • And across England, 58% of the population aged 16+ have had a first dose and 10% a second dose.
  • The chart below shows how the rate at which second doses are being delivered is increasing while the number receiving first doses has flattened off. There are 11 weeks between the first bars on the left and the last bars on the right. More people have received a second dose by 4th April (68,891) than had received a first dose 11 weeks ago (62,140) – indicating that overall people are receiving their second doses before the 12 week deadline, just as they should.

The chart above shows how the proportion of the population of Stroud district aged over 16 has increased over the past few weeks.

People aged 50 and over can now book to be vaccinated at one of the mass vaccination sites via this link, as can anyone who meets the criteria for other top priority groups. Making a booking at a mass vaccination site (Gloucester, Bristol, Bath, Malvern, Oxford etc) will not affect whether you receive a GP surgery invite to a local vaccination hub or site in the district. You can cancel bookings at mass vaccination sites via the link (under “manage your bookings”). Please ensure to do this with time for people to take the slot so vaccine isn’t wasted. If you are able to travel to a mass vaccination site, you free up space for people who cannot travel at the local hubs.

If you are aged over 50 or over, or believe you are Clinically Vulnerable or a carer for someone who is, you can book via the link above, but if you can’t get to one of the mass vaccination sites (Gloucester is the nearest but is often fully booked and the other sites are in Bristol, Bath, Malvern, Oxford etc) please get in touch with your surgery by email to check you have not been missed.

Check out our videos with Dr Jim Holmes and Practice Manager Karen Pitney from Rowcroft Medical Centre on “why you should get vaccinated“, “the process for receiving your vaccination” and “second doses“.

Prices Mill surgery update on 6th April says they have “now given a first dose of vaccine to 92% of our patient Cohort 1-9 including Clinically Vulnerable patients aged 16 or over (that’s 66%, or two thirds of our total registered adult population). We have also given the second dose to 12% of our total registered adult population.Despite multiple attempts and methods at contacting patients from Cohort 1-9, we are unfortunately still to hear from 266 individuals. Please contact the surgery if you are 50+ and yet to book an appointment for your first dose. Alternatively, please let us know of your intention to decline, bearing in mind you will always remain eligible if you change your mind. Thank you.”

The table below shows the vaccination hubs associated with different surgeries in the district.

We understand many people are keen to be vaccinated but please try to be patient, the vaccine rollout is an enormous logistical challenge – over 25 million people being vaccinated in 4 months is unprecedented, and GP surgeries are doing this on top of their normal workload. If you have questions about when you’ll be vaccinated please either ask in our Facebook group or email GP surgeries rather than calling them. We will be interviewing someone next week – comment with a question on this post and we’ll do our best to ask it.

There continue to be regular updates in our Facebook group about vaccination locally – including from GP surgeries (see the Facebook group topic). If you’ve had your jab recently, please do read advice on continuing to be cautious after receiving your vaccination).

Hospitals – local, national

There is only 1 patient in a hospital in Gloucestershire with Covid-19 as of the 6th April (the most recent date data is available), down from 5 the week before (having peaked at 262 on the 6th January). There haven’t been fewer people with Covid-19 in local hospitals since 23rd September when there were 4. There have been no patients in Mechanical Ventilation beds locally since 17th March, ie, for over three weeks.

Source: NHS hospital activity

Nationally, the number of Covid-19 patients being admitted to hospital has been falling fast – 221 people were admitted on the 6th April, compared to 257 seven days previously).

Source: gov.uk data dashboard

Because people with Covid-19 tend to stay in hospital for some time, the total number of people with the virus in hospitals remains 2,862 on the 6th April, similar to the 2,801 on the 4th July last year (down to less than a tenth of the peak of 39,249 on 18th January). The lowest last summer was 803 on the 2nd September, so there is still some way to go.

The number of Covid-19 patients in mechanical ventilation beds – some of the sickest patients is also now lower than in the Spring 2020 peak – having peaked at 4,077 patients (on 24th January). There are still 406 patients in these beds as of the 1st April (the lowest last summer was 60 on 28th August). We send our best for their recovery.

People who have died with Covid-19

In Gloucestershire, the most recent data – up to the 26th March – shows that 1,179 people have died with Covid-19 mentioned on their death certificate (2 people have been added to the total in the most recent week of data). 197 of these people were from the Stroud district (one more person since we last reported). We send our condolences to all affected.

The data is from registrations of death up to the 26th March, and sadly we know it will continue to rise. Barring dramatic mutations/failures of policy, however, we should never see the weekly numbers we have seen recently again.

Source: gov.uk dashboard for Gloucestershire deaths

We have previously included data comparing the death rate in Stroud district with other areas, incuding those that have seen more than twice as many people die compared to their local population.

The above data is the best we get on people who have died – from the Office for National Statistics, who report based on what clinicians determine the cause of death to be for death certificates. This data takes time to come in – so the below is only up to the 26th March. It is sobering reading – but the number of deaths continues to fall:

  • “The number of deaths registered in England and Wales in the week ending 26 March 2021 (Week 12) was 10,045; this was 266 fewer deaths than the previous week (Week 11).”
  • “In Week 12, the number of deaths registered in England and Wales was 5.0% below the five-year average (528 fewer deaths); this is the third consecutive week that deaths have been below the five-year average.”
  • “Of the deaths registered in Week 12 in England and Wales, 719 mentioned “novel coronavirus (COVID-19)”, a decrease of 244 deaths compared with Week 11.”
  • “In Week 12, deaths involving COVID-19 accounted for 7.2% of all deaths in England and Wales, compared with 9.3% in Week 11.”
  • “Of the 719 deaths involving COVID-19 in Week 12 in England and Wales, 535 had this recorded as the underlying cause of death (74.4%).”
  • “Using the most up-to-date data we have available, the number of deaths from the week ending 13 March 2020 up to 26 March 2021 was 671,655 in England and Wales. Of the deaths registered by 26 March 2021, 137,622 (20.5%) mentioned COVID-19 on the death certificate. During this period, the number of excess deaths above the five-year average was 118,748 deaths.”

The Independent SAGE weekly briefing is really worth watching this week. There’s some really good questions and answers on the Astra Zeneca vaccine, what the panel think of vaccine passports, and foreign holidays this year, as well as the usual data summary presentation for the UK from Professor Christina Pagel covering testing, positive test results, hospitals, deaths and vaccinations (and discussion of the impact of opening schools up more recently) – an extended one ahead of this becoming a fortnightly rather than weekly presentation. There are a long watch, but if you’ve not taken the time to watch one before, this would be a good place to start.

International context

Globally, over 2.77 million people have now died with their death attributed to Covid-19 at least in part (subject to different counting methods in different countries). The situation remains concerning – but there is a sign that the number of people dying may be starting to fall, with Our World in Data reporting the number of people to be reported as dying per day (on a 7-day average basis) as rising fast again – to to 11,649 on April 10th, up from 10,243 on March 31st. This is tragically still very high – considerably higher than during Spring 2020. While things are improving in the UK, there is a long way to go globally before the pandemic is over.

In terms of rates of the number of people to have died per million people, the UK remains one of the worst affected countries – based on publicly available data. However, a number of other countries have higher rates, and/or death rates that are still increasing – and with far slower vaccination programmes: Slovenia, Belgium, San Marino, Bosnia and Herzegovina, Montenegro, Hungary, Czechia There are caveats about this data as all countries will be using slightly different recording but a measure that is less subject to such caveats – though less specific about the impact of the virus as opposed to the full impact of the pandemic and the ability of contries to control it, and/or health services to deal with outbreaks, is “excess deaths”.

Source: John Burn-Murdoch

“There are several different ways of comparing excess deaths figures between countries. In absolute numbers, more people than would usually be expected have died in the in the US than in any of the other countries for which recent all-cause mortality data is available.”

The UK is 7th highest/worst by this measure (the chart above on the right) – but lower once adjusting either per million people (the chart in the middle) or, most appropriately (taking account of population age structure etc), through comparison with the 5-year average of deaths (the chart on the left). Using this measure:

“It’s abundantly clear that Latin America is the hardest-hit region in the world, with the five highest excess death rates globally. The UK is 21st out of 48 countries, and the US 24th…

Note the underlying patterns. It can be easy for people in the US and UK to think Covid is almost gone, but excess deaths are climbing again in Brazil, Bolivia and Peru to name just three countries… The grim toll of Europe’s third wave is also clear. The Czech Republic, Italy, Slovakia, Bulgaria and Poland have all climbed above the UK into the global top 20…

Latin America’s urban hotspots have endured an especially brutal year. Deaths in the Peruvian capital Lima have been almost triple the norm. In Mexico City they’ve been double usual levels, and in Manaus almost the same.

The United Kingdom is doing much better in terms of Covid-19 vaccine doses per 100 people (54) – behind only a few other countries like Israel (118 – ie, moving into enough doses to cover everyone, but some will be second doses) and United Arab Emirates (90), and Chile (63). Globally, the rate is 10 doses per 100 people. There is a real need to plan to improve global vaccination. You can Donate to treat, vaccinate and support people worldwide – which a few members of our Facebook group have reported doing to celebrate getting their own vaccination.

3 really useful charts from the Financial Times data journalist John Burn-Murdoch shared in a twitter thread today – on vaccinatin and reopening. His descriptions in quotes, and text-descriptions of the visuals from me – below:

Chart 1: “we’re on the way out of this. Several countries are very nearly there. Here is a new chart that we should all be watching over the coming months, as countries seek to follow Israel’s lead and reach the Covid endgame. For much of the last year, we’ve lived with restrictions to save lives. What we want now is for societies to reopen *without* risking illness & deaths. That’s the bottom-right quadrant here: people spending more time socialising at bars & cafés, while cases continue to fall.” [The UK is currently just in this quadrant – with mobility (the proxy for opening up) rising, while weekly new cases continue to fall. Israel is further into that quadrant. mobility is also increasing in the US, Netherland, Germany and Belgium – but cases are too. In other countries, cases have recently risen (Brazil, Chile, Poland, India) and mobility fallen as countries lock down]

Chart 2: “to the UK, where things are looking very good. The vaccine effect is still crystal clear, with more than 10,000 lives already estimated to have been saved” [The chart shows how cases, hospital admissions, and deaths have all fallen faster among the age demographic that received vaccines first (80+) – and therefore will have benefitted most from them in terms of building immune response – than in younger age groups (18-69 or 18-64 depending on the data comparison)]

Chart 3 breaks down the beneficial effect of vaccines on numbers of infections further: “as the UK’s vaccination rollout has progressed down through the age groups, so has the vaccine effect. It’s amazing how clear the pattern is.” [the chart shows that the share of people who test positive made up by people aged 90-100 – those first to be vaccinated – is 80% lower than it was on January 25th, when a first dose had been given to 50% of people aged 80+. Similar falls have followed for younger age groups: the share of cases made up by 80-90 year olds is around 70% lower, it’s 60% lower for 70-80 year olds, and around 50% lower for 60-70 year olds. As the weeks and months go on, and immunity from the vaccines builds and people receive second doses, we can expect the younger age groups to see further falls in line with the pattern]

Read the full twitter thread on “on the contest between vaccines & variants” (Burn-Murdoch also presents “data from Israel [that] suggests new variants are *not* escaping vaccine-acquired immunity”.

Lastly, two infographics on the benefits and risks associated with the AstraZeneca vaccine, and how these vary according to age, as this is in the news this week:

First, from the BBC: “Regulators are continuously combing through the details of the rare clots that have occurred to work out how many might be caused by vaccination. Assuming the worst – that they all are – we can do some ballpark calculations to get a sense of the risks.Based on the figures announced on Wednesday by the UK medicines regulator, if 10 million imaginary people were given the AZ vaccine you might expect to see 40 of these clots – with about 10 clots having fatal consequences.Ten deaths out of 10 million people vaccinated is a one-in-a-million chance.That’s roughly the same risk as being murdered in the next month or – if you get in a car and drive for 250 miles – the risk of you dying in a road accident on that journey.”

Source: BBC
Source: Winton Centre for Risk and Evidence Communication

Notes

The core advice remains: please book a test (see full details at the end of this page). You can now do this whether or not you have symptoms. The link will tell you which type of test to book if you have symptoms or not. from 9th April, twice weekly rapid tests will be available to everyone in England without symptoms. If you have symptoms, there is a permanent unit at Hempsted Meadow in Gloucester, and a walk-in unit in Stratford Park. See this link for details of testing locations in Gloucestershire. If you have symptoms (or if you are asked to by contact tracers), self-isolate until you have a negative test – or for 10 days since your symptoms appeared if you test positive or are asked to by Test and Trace. 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. Gloucestershire along with the rest of the country is in National Lockdown – guidance here. If there is a piece of guidance you have a question about, again – please ask in our Facebook group.

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.

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.

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

Local testing:

The County Council have updated their information about how you can book a test locally. You can now do this whether or not you have symptoms. The link will tell you which type of test to book if you have symptoms or not, and where you can pick up testing kits for households with school-aged children.

  • For people with symptoms, there are permanent testing units at Hempsted Meadow in Gloucester, and a walk-in unit in Stratford Park.
  • Without symptoms, there is a site in Gloucester City and one located at the Royal Agricultural University (RAU) in Cirencester. A third site will be opening in the Forest of Dean on the 10th March.
  • You can pick up a testing kit from the permanent testing units at: Hempsted Meadows, Gloucester; High St Car Park, Cheltenham; and Stratford Park, Stroud.

See this link for details of testing locations in Gloucestershire.